Xeloda causes hand-foot syndrome (HFS) in 45-56% of patients. Studies show that most patients have their first episode of HFS within the first two cycles. I know that was the case with me. By the second cycle my hands and feet were turning red and burning. However, in the study, 89% of the HFS episodes were grade 1 or 2. Only 11% were grade 3. I was one of the grade 3's. I lost 3 toenails, had bleeding toes, and very painful hands.
So... you could take Xeloda for one or two cycles and see if you were in the 11% group that has light side-effects. Then switch to the pump if necessary at that point. Or you could hedge your bet and just start with the pump at the beginning.
I'm a little more concerned about the oxaliplatin. It causes oxaliplatin-induced peripheral neuropathy (OIPN), which could be very detrimental in your line of work.
Here is the finding from the most recent (J Clin Neurol. 2018 Jan; 14(1): 81–89.) longitudinal study of OIPN:
This longitudinal study found that chronic OIPN was present in 94% and 64% of colon cancer patients at the end of oxaliplatin treatment and 1 year after treatment, respectively. The main clinical characteristics of cumulative OIPN were distal numbness and tingling in the fingers and hands/toes and feet, and these symptoms tended to worsen as the cumulative dose of oxaliplatin increased during the 12 FOLFOX treatment cycles. Grade-3 neuropathy was identified in 0, 3, and 14% of patients after 4, 8, and 12 cycles of treatment, respectively. These results are consistent with previous studies finding chemotherapy-induced neuropathy in 80–92% of the patients who were treated with the FOLFOX regimen, in which 8–15% of the neuropathies were grade 3.
I think it's very important to monitor your hands after the oxaliplatin infusions and report any issues to your onc. The dose can be lowered or the number of cycles reduced if you're among those who experience higher grade neuropathy. Because of your line of work, you might see if you can get regular assessments of your sensory nerves to see how things are progressing. Some patients (half of all patients in the study) make it though all 12 treatment cycles and only experience grade 1 neuropathy so you might be one of the lucky ones.
So my advice is
Option 1: Try Xeloda for one or two cycles and see if you start getting HFS. If so, discontinue and switch to 5FU pump.
Option 2: Start with 5FU pump so there's no risk of HFS, but there will be some inconvenience and different side-effects.
In either case, talk to your onc about your profession and ask them to monitor any neuropathy from the oxaliplatin.
Hope this helps!
Juliej