FOLFIRI and the IRI

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

FOLFIRI and the IRI

Postby Nik Colon » Fri Jun 26, 2015 2:04 am

I am thinking of not doing the IRI and just doing the FOLF. Besides the neasua and constipation (got the atropine to prevent diarrhea and got constipated instead) and the possibility of hair loss (don't know yet) I felt like someone punched me in the ribs! On top of that, no pain meds "just take some tylenol" F**k U! It don't do shit plus I don't like it! Butt everything combined I was miserable! I would rather do the OX again but that won't happen because of those se's too! Well, it was my choice to try the iri and I say no more! Sorry, I just cant. I guess I'm a wimp :(
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: FOLFIRI and the IRI

Postby Nik Colon » Fri Jun 26, 2015 2:09 am

I'm going to be starting the BEER CURE! :shock: :twisted: :mrgreen:
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: FOLFIRI and the IRI

Postby midlifemom » Fri Jun 26, 2015 9:29 am

Talk to doc about the side effects. Maybe a dose reduction?
I may not be the norm, BUTT found my side effects lessened after the first two treatments. Good luck.
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: FOLFIRI and the IRI

Postby midlifemom » Fri Jun 26, 2015 9:30 am

And ps - you're no wimp!!!
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

JAZZToo
Posts: 509
Joined: Sun Oct 01, 2006 10:46 am
Location: New York City

Re: FOLFIRI and the IRI

Postby JAZZToo » Fri Jun 26, 2015 10:14 am

Over what time period do you get the Irineticon? I get mine at MSKCC and it takes 30 minutes. However, when I was in Florida for the winter, treatment was at the U of Miami Sylvester Cancer Center. They give the Irineticon over a 1 to 2 hour time period to minimize side effects, but I insisted on following the MSKCC protocol exactly since I was tolerating it well. Do you get Dexamethasone as a premed and pills for the next 2 days? The Atropine stops the stomach cramps. Perhaps either lowering the dose of the chemo or infusing it over a longer time period, and adjusting the premed and Atropine dosage might help you feel better.
Leslie
2014 Stage 4 Pancreatic Cancer - FOLFIRINOX
2003 Stage 3 Colon Cancer - 6mos. 5FU & Leucovorin, right hemicolectomy
1995 Stage 1 Endometrial Cancer
Lynch Syndrome

lpas
Posts: 1009
Joined: Wed Nov 19, 2014 11:11 pm

Re: FOLFIRI and the IRI

Postby lpas » Fri Jun 26, 2015 10:32 am

Nik,

What kind of anti-nausea meds are they giving you? I've heard from multiple sources that Emend is one of the few options that really helps with full fury, but not all doctors offer it.

Sorry it isn't going better for you :( .
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing celecoxib, cimetidine & other targeted supplements
Mom to a 5 & 8yo

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ktwmn
Posts: 350
Joined: Tue Aug 02, 2011 9:41 am

Re: FOLFIRI and the IRI

Postby ktwmn » Fri Jun 26, 2015 10:34 am

Hi,

I had #6 of the full fury on Wednesday. The first two days I am nauseous, especially the first day, despite atropine, aloxi and emend. The last 15 minutes of the Fury infusion my feet and ankles start to cramp up, and I get spots in front of my eyes. And I have peripheral neuropathy. My onc reduced the 5 FU a bit but doesn't want to reduce the Fury.

I totally understand. I am usually pretty stoic about symptoms and not a wimp, but it's really getting to me. It's like being slammed with the flu every other week. It's strange because I have never been sick with cancer, just from chemo.
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

Ceebo
Posts: 132
Joined: Sat Feb 14, 2015 9:15 am
Location: Southwest Michigan

Re: FOLFIRI and the IRI

Postby Ceebo » Fri Jun 26, 2015 10:55 am

I know everyone reacts to and tolerates chemo differently, but I do want to share a little about my husband's experiences on FOLFIRI & Avastin.
He has had 15 cycles. His main bowel problem has been constipation, not diarrhea. For the last couple of months he has not been getting the atropine and that has helped quite a bit. He also now has a pretty good bowel routine after chemo using Senecot and Miralax. He keeps a detailed bowel record so he can track and treat any bowel problems that come up. He hasn't had any nausea, but he has had mouth sores. He has tolerated this regimen better than the FOLFOX. His scans and CEA are stable right now. Hope this info helps!
DH 64 Stage 4 on 4/14 ; cecal tumor; 5+ nodes ; mets to liver; colon resection
5/14 FOLFOX
9/14 - Liver surgery aborted; peri mets
10/14 CT mult.1-2 mm lung mets; FOLFIRI & Avastin
1/15 CT -liver & lung mets shrinking
3/15 PET - ? New met. site colon; CEA rising
7/15 Chemo has failed; looking for clinical trial
9/29/15 started TAS-102 trial
KRAS mutant; MSS

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: FOLFIRI and the IRI

Postby Nik Colon » Fri Jun 26, 2015 12:15 pm

Thx guys. I have Zofran and Compazine. The fury is 1.5 hrs.
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

CM35
Posts: 265
Joined: Tue Dec 03, 2013 1:16 pm

Re: FOLFIRI and the IRI

Postby CM35 » Fri Jun 26, 2015 12:41 pm

I think every individual experiences side effects and handles them differently. My only advice to you would be to ask yourself this question: if you drop the irinotecan and your cancer recurs, will you still be ok with your decision or would you be kicking yourself? For me personally, I always try to make the decision where regardless of the outcome, I can say "no regrets." The answer to that question is different for everyone, however. You have already gone through so much, and are in a really good position to be "cured." How many more cycles of folfiri do you have left, if you choose to stay the course?

As for your doctor refusing you pain meds, if you are having pain, you deserve for it to be taken seriously. I would push to have that addressed. I had pain after my liver resection, and I was given gabapentin to help with the pain and get me off the heavy duty pain meds. I can tell you right now that Tylenol in no way would have touched my pain.
stg IV 4/2013 @34 - liver, ovary/peritoneum
Lots of chemo, surgery and good luck - still doing well 03/2016...

lpas
Posts: 1009
Joined: Wed Nov 19, 2014 11:11 pm

Re: FOLFIRI and the IRI

Postby lpas » Fri Jun 26, 2015 12:49 pm

ritz75 wrote:Thx guys. I have Zofran and Compazine. The fury is 1.5 hrs.


Wow. I take stronger meds than that for XELOX, which isn't even supposed to cause much nausea. You should definitely talk to your doctors about a medication adjustment.
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing celecoxib, cimetidine & other targeted supplements
Mom to a 5 & 8yo

User avatar
ktwmn
Posts: 350
Joined: Tue Aug 02, 2011 9:41 am

Re: FOLFIRI and the IRI

Postby ktwmn » Fri Jun 26, 2015 1:41 pm

Check with your onc about infused anti-nausea meds (emend, aloxi). I think you're referring to the pills you have (zofran, compazine, correct)?
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

User avatar
Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: FOLFIRI and the IRI

Postby Nik Colon » Fri Jun 26, 2015 2:06 pm

ktwmn wrote:Check with your onc about infused anti-nausea meds (emend, aloxi). I think you're referring to the pills you have (zofran, compazine, correct)?

Yes the pills, I get the steroid in the hospital while doing chemo
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

User avatar
ktwmn
Posts: 350
Joined: Tue Aug 02, 2011 9:41 am

Re: FOLFIRI and the IRI

Postby ktwmn » Fri Jun 26, 2015 4:09 pm

Ask if they can give you emend and aloxi along with the steroid in the infusion for nausea.
Dx 7/11, Stage IIIc CC
12 txs Folfox 8/2011-2/2012
MSS, KRAS-mut G12D
NED until 3/2015, mets to liver and peritoneum
April-December 2015: 15 txs folfiri+avastin
Liver mets resolved; pelvic met remains
January-May 2016: folfox+avastin; allergic rxn to oxi
June-August 2016: 5FU+avastin
October 2016: looking into immuno trial
January 2017: maintenance chemo xeloda + avastin

User avatar
Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: FOLFIRI and the IRI

Postby Nik Colon » Fri Jun 26, 2015 4:10 pm

ktwmn wrote:Ask if they can give you emend and aloxi along with the steroid in the infusion for nausea.

Thx. I will if we decide to go with the iri again. I will discuss it on Wednesday b4 hand.
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc


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