just started chemo

[waw4]

FOLFOX 4 regimen:
OXALIPLATIN 85 mg/m2 IV over 120 minutes Day 1
LEUCOVORIN 200 mg/m2 IV over 120 minutes Day 1 (concurrently with Oxaliplatin)
FLUOROURACIL 400 mg/m2 IV bolus, after leucovorin Days 1, 2
FLUOROURACIL 600 mg/m2 CIV over 22 hours (pump) Days 1, 2
3 trips to the onc each treatment week (Day 1 infusion & 24 hr. pump, Day 2 infusion & 24 hr. pump, & Day 3 pump removal)
Each treatment = 2 weeks = 1 cycle, standard treatment is 12 cycles total

FOLFOX 6 regimen:
OXALIPLATIN 100 mg/m2 IV over 120 minutes Day 1
LEUCOVORIN 400 mg/m2 IV over 120 minutes Day 1 (concurrently with Oxaliplatin)
FLUOROURACIL 400 mg/m2 IV bolus, after leucovorin Day 1
FLUOROURACIL 2400 mg/m2 CIV over 46 hours (pump) Days 1 & 2
2 trips to the onc each treatment week (Day 1 infusion & 48 hr. pump, (Skip a Day), & Day 3 pump removal)
Each treatment = 2 weeks = 1 cycle, standard treatment is 12 cycles total

The whole mg/m2 relates the drug amount to the size of the body surface area.
FOLFOX 6 has a higher dose of oxaliplatin & 5FU and as a result has a higher level of side effects

AFAIK, there is no FOLFOX 5 regimen

[waw4]

Michael,
As a generalization, from your initial response to treatment it sounds like your side effects are likely to be on the mild side. At least you know you are not initially allergic to the oxaliplatin or the 5 FU; nor are you initially prone to nausea. So it sounds like you are off to a fortunate start as far as side effects go.

Another generalization is as you progress through the cycles you are likely to notice the side effects more. Not to say they will be dramatically different, but fatigue now may be more fatigued later in the cycles, barely noticeable cold sensitivity now may be very cold sensitive later with development of jaw pain on first bite and eye pain on tearing (weeping). Some people develop an allergic reaction to the oxaliplatin.

One side effect you will want to know more about is oxaliplatin induced chronic neuropathy as this can be quality of life limiting and may occur without prior symptoms or even not begin until after chemo starts. On the other hand, I've read it's the 5FU which may be most likely responsible for the reported 'chemo brain' side effect.

The prep drugs you get prior to chemo will also produce side effects for time periods related to their metabolic half life. The anti-nausea drugs can produce constipation or diarrhea. The steroid can initially be a stimulant keeping you up and once metabolized you can crash physically and psychologically. If you are not prone to nausea, you may be able to reduce your steroid dose to minimize its side effects.

The dry mouth you are likely to experience because of chemo can contribute to numerous new dental cavities - as many as 4, 5, or 6 new cavities! This is one side effect I heard nothing about prior to my treatment and I would recommend bringing it up to your onc if you care about your teeth.

Hope you get through all this in a most uneventful manner. Just remember nausea & cold sensitivity aren't the only side effects to address. Stay or get informed about chronic neuropathy, chemo brain, and dental cavities!

Oh, also I'd recommend asking your onc what he thinks about 8 or 9 treatment cycles instead of the standard 12. Some feel 8 or 9 is as effective as 12 with less potential side effect damage.

[las]

wow, i sure am not much help on this compared to what I just read. The people on this board are full of wonderful advice and information. I can just tell my finances experience. He just had his 4th Chemo treatment (folfox) and from what i have just read it sounds like he is getting the folfox 6. He didn't experience the cold sensitivity side effect till the 2nd round but it was very mild, this time it is more. I wouldn't say it is horrible yet, but he can tell a difference. He can somewhat drink cold drinks alittle, but he can not hold them. He feels the pain in his fingertips. He had his chemo last Wednesday and he is still feeling it today. ( 6 days later). His nausea this time was ok expect for Friday; which he did sleep all day and didn't eat much because he couldn't keep anything down. I think part of that cause was because we let time lapse between taking the nausea pills, which we shouldn't have done. He is very fatigue, he is still able to carry on a full day, but is really tired come 8pm if not 7pm. He has dry cracks on each side of his mouth, which is new on this treatment and I am not sure what that is from, if it is the chemo treatment or something else. I will be asking that next time we see the Onc. unless any of you out there know. Just wanted to let you know our experience, but yes everyones is different.

Lisa

[justin case]

I think it is the folfox 6 regimen, exept I have the pump for 44 hrs, with a 5fu push on day1 and day 2. I don't know about any steroids unless one of these drugs is in that catagory. I will use the generic names as follows. dolasetron,oprelvekin,filgrastim,calcium gluconate,and magnesium sulfate.
I'm going in for pump takedown tommorow. So far I can drink some cold things right away, root beer is best, gatorade gives me first bite. Day 1 with the oxy, I even had vanilla ice cream, Maybe is the vannilla, in both these items. Luckily cavities are no problem, as I got dentures when I was tired if absessed teeth. Some hand and foot irritation, they feel dry for a couple of days, after infusion. This is now my third infusion. The onc wants a pet scan no sooner than 2 weeks. Then either more chemo, or on to chemo/rad. I hope the insurance doesn't balk at two pet scans within 2 months, plus the rad onc wants a ct scan for rad placement. Oh and maybe another scope! Oh well, I guess their aggression is a good thing.
Thanks for your posts, as I learn more every day from everybody here,
Warm regards,
Michael

[RixInPhx]

You're describing Folfox4, which is the 22-hrs day 1 + 22-hrs day 2.

Folfox6 is the 46 hrs from Day 1 only (no return to the clinic on Day 2).
* * *
Dolasetron is used to prevent nausea and vomiting caused by cancer chemotherapy, anesthesia, or surgery. Dolasetron is in a class of medications called serotonin 5-HT3 receptor antagonists. It works by blocking the vomiting reflex in the brain.

Oprelvekin is used to help prevent thrombocytopenia (having a lower than normal number of platelets in the blood).

Nope, no steroids in your list.
* * *

The main steroid that I'm familiar with is Dexamethasone (brand name Decadron).
What Decadron Is Used To treat nausea and vomiting associated with some chemotherapy drugs; and to stimulate appetite in cancer patients with severe appetite problems.

If nausea and/or appetite become a problem, then the onc might add this.
Unless it's contraindicated by other medical condition of you.

[justin case]

Thank you everyone who posted, and thank you to justsing for the terminology post about everything.
Warm regards,
Michael