5 fu and oxaliplatin

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natelaugh
Posts: 26
Joined: Wed Apr 03, 2019 11:40 pm

5 fu and oxaliplatin

Postby natelaugh » Fri Apr 05, 2019 3:00 am

Has anyone able to do 6 months of 5 FU and oxaliplatin non stop? Also, when on chemo, what is the chance of getting infection because the body is weak?

Thanks,
Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

User avatar
O Stoma Mia
Posts: 1600
Joined: Sat Jun 22, 2013 6:29 am

Re: 5 fu and oxaliplatin

Postby O Stoma Mia » Fri Apr 05, 2019 9:47 am

Adjuvant therapy for elderly patients with stage III colon cancer

    Evidence summary and recommendations
    Evidence summary
    In elderly patients (≥ 70 years) following surgery for stage III colon cancer, subset analyses of three randomised controlled trials found no survival benefit from the addition of oxaliplatin to a fluoropyrimidine containing adjuvant chemotherapy (involving either 5-fluorouracil or capecitabine), compared to adjuvant chemotherapy with a fluoropyrimidine alone. [7], [9], [2], [4]

    Consensus-based recommendation
    Elderly patients (≥ 70 years) with stage III colon cancer who are fit for adjuvant chemotherapy should receive 6 months of a single-agent fluoropyrimidine (either 5FU or capecitabine).

    Practice point
    The addition of oxaliplatin to adjuvant fluoropyrimidine-based therapy in elderly patients (≥ 70 years) with stage III colon cancer did not improve survival outcomes.
https://wiki.cancer.org.au/australia/Clinical_question:Adjuvant_therapy_in_elderly_CRC_patients

sch
Posts: 2
Joined: Thu Mar 14, 2019 7:21 am

Re: 5 fu and oxaliplatin

Postby sch » Fri Apr 05, 2019 2:06 pm

Hi Nate,

I managed to complete all 12 rounds of my FOLFOX (5FU, Oxy and folinic acid) treatment
I had a round of FOLFOX every two weeks for 6 months.
However, after the 11th round, I managed to contract an upper respitory infection (thanks to a cold).
This pushed my temperature above a pre-defined level and I had to go to hospital and spend a couple of days there while they used a drip to give me antibiotics.
Honestly, I felt fine, it was just the procedure I had to follow.

A couple of weeks after I got out of hospital, I completed my treatment!

I personally found the side effects of the oxaliplatin worse than the infection, but everyone is different.

Let me know if you have any other questions.

Sean

natelaugh
Posts: 26
Joined: Wed Apr 03, 2019 11:40 pm

Re: 5 fu and oxaliplatin

Postby natelaugh » Fri Apr 05, 2019 5:40 pm

sch wrote:Hi Nate,

I managed to complete all 12 rounds of my FOLFOX (5FU, Oxy and folinic acid) treatment
I had a round of FOLFOX every two weeks for 6 months.
However, after the 11th round, I managed to contract an upper respitory infection (thanks to a cold).
This pushed my temperature above a pre-defined level and I had to go to hospital and spend a couple of days there while they used a drip to give me antibiotics.
Honestly, I felt fine, it was just the procedure I had to follow.

A couple of weeks after I got out of hospital, I completed my treatment!

I personally found the side effects of the oxaliplatin worse than the infection, but everyone is different.

Let me know if you have any other questions.

Sean


Hi Sean,

What was your FOLFOX dosages? How many hours per day and how many day per week? Did the FOLFOX help remove your cancer?

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

natelaugh
Posts: 26
Joined: Wed Apr 03, 2019 11:40 pm

Re: 5 fu and oxaliplatin

Postby natelaugh » Fri Apr 05, 2019 5:46 pm

O Stoma Mia wrote:Adjuvant therapy for elderly patients with stage III colon cancer

    Evidence summary and recommendations
    Evidence summary
    In elderly patients (≥ 70 years) following surgery for stage III colon cancer, subset analyses of three randomised controlled trials found no survival benefit from the addition of oxaliplatin to a fluoropyrimidine containing adjuvant chemotherapy (involving either 5-fluorouracil or capecitabine), compared to adjuvant chemotherapy with a fluoropyrimidine alone. [7], [9], [2], [4]

    Consensus-based recommendation
    Elderly patients (≥ 70 years) with stage III colon cancer who are fit for adjuvant chemotherapy should receive 6 months of a single-agent fluoropyrimidine (either 5FU or capecitabine).

    Practice point
    The addition of oxaliplatin to adjuvant fluoropyrimidine-based therapy in elderly patients (≥ 70 years) with stage III colon cancer did not improve survival outcomes.
https://wiki.cancer.org.au/australia/Clinical_question:Adjuvant_therapy_in_elderly_CRC_patients


Hi O Stoma Mia,

Thank you for all the infor. I have soo much anxiety because the unknown and could I do more to help, keep me wake up at night.

Thanks,
Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

martd
Posts: 80
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: 5 fu and oxaliplatin

Postby martd » Fri Apr 05, 2019 6:15 pm

I completed 12 rounds of folfox but reduced the oxi by 50% round 11and eliminated round 12 due to neuropathy. It's very important your dad communicates all side effects to the Onc. Supplements are very helpful but also discuss them with the Dr before taking anything. Stay hydrated, drink lots of fluids before and during chemo.
I was very fortunate and had a complete response to chemo, I've been off treatment now only 10 months but so far so good.
Best of luck to your dad

Dan
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9

natelaugh
Posts: 26
Joined: Wed Apr 03, 2019 11:40 pm

Re: 5 fu and oxaliplatin

Postby natelaugh » Fri Apr 05, 2019 7:08 pm

martd wrote:I completed 12 rounds of folfox but reduced the oxi by 50% round 11and eliminated round 12 due to neuropathy. It's very important your dad communicates all side effects to the Onc. Supplements are very helpful but also discuss them with the Dr before taking anything. Stay hydrated, drink lots of fluids before and during chemo.
I was very fortunate and had a complete response to chemo, I've been off treatment now only 10 months but so far so good.
Best of luck to your dad

Dan


Hi Dan,

What supplements did you used?

Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

martd
Posts: 80
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: 5 fu and oxaliplatin

Postby martd » Fri Apr 05, 2019 7:45 pm

I didn't use any supplements during chemo other than ginger to help with nausea, ginger ale worked good. I didn't know much about supplements at that time but I've seen many posts here where supplements were helpful. Search for threads on supplements there are members here that are very knowledgeable on the subject. Now I use vitamin D, vitamin C, turmeric with black pepper, Some supplements can actually interfere with chemo and cause it to not work as well so again talk with the Dr before taking anything.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9

rp1954
Posts: 1478
Joined: Mon Jun 13, 2011 1:13 am

Re: 5 fu and oxaliplatin

Postby rp1954 » Mon Apr 08, 2019 12:16 am

I would look for informed and experienced alternative MD and ND sources for compatible supplements. Several sources including books and websites should be consulted.

People, and doctors, need to think more precisely about supplements and chemo. We carefully chose (and tested) supplements, used heavily to augment my wife's 5FU based chemo in terms of performance and comforts. But we never used iri-, oxi-, Avastin either - to avoid their usual side effects and compatibility issues while gaining performance from the other, nicer choices.

Which chemo combination and protocol is a crucial factor to any statement. My wife probably has one of the nicest, most compatible chemo available for CRC, metronomic, oral tegafur-uracil, where tegafur is a 5FU derivative. It seems to be broadly compatible with many of the best supplements and off label drugs. I would expect more glitches with irinotecan and oxaliplatin - I know of one such drug molecule that has problems with iri-, but works well with daily 5FU/UFT alone.

Likewise, attention to which individual form of a supplement is crucial to success, molecule by molecule. I've spent substantial effort to differentiate the evils of folic acid vs the use of folinic acid (leucovorin) and separately considered, natural folates and the human form of folate. Chemistry doesn't have to be expensive or nasty, it just needs to be right for the particular biology.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now mostly IV C & no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018

User avatar
O Stoma Mia
Posts: 1600
Joined: Sat Jun 22, 2013 6:29 am

Re: 5 fu and oxaliplatin

Postby O Stoma Mia » Mon Apr 08, 2019 9:57 am

rp1954 wrote:... But we never used iri-, oxi-, Avastin either - to avoid their usual side effects and compatibility issues while gaining performance from the other, nicer choices... Chemistry doesn't have to be expensive or nasty, it just needs to be right for the particular biology.

rp1954 -
Thank you very much for your comment on iri- and oxi- . This gives hope that someday the recommended first-line therapies for Stage II and Stage III patients will be something other than the usual FOLFOX or XELOX(CAPEOX) standard of care.

For around 15 years now, the default first-line standard of care for Stage II and Stage III patients has involved oxi-, with all of its associated short- and long-term side effects, like peripheral neuropathy. If you found that you were able to go an eight year stretch without using such a noxious product, then I think there is hope for an eventual change of framework where some kind of softer, nicer regimen could replace oxi-.

Gravelyguy
Posts: 138
Joined: Thu Jul 05, 2018 6:03 pm

Re: 5 fu and oxaliplatin

Postby Gravelyguy » Tue Apr 09, 2019 1:58 pm

I did 12 rounds but it was broken up 4 rounds before surgery then 8 after. I stayed at full strength until the final round and reduced it to 80%. I also went to every 3 weeks the last 3 rounds as my blood work went wonky and I did not like neulasta.

I have very slight neuropathy on the bottom of my feet but it doesn't really stop me from doing anything. I continue to run and am on my feet all day as a teacher. More importantly I am 1 1/2 years cancer free!

Dave
6/17 dx mCRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 clear scans, CEA .9 still NED!

Eleda
Posts: 262
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: 5 fu and oxaliplatin

Postby Eleda » Tue Apr 09, 2019 3:17 pm

I did 3 months 6 cycles apparently it's the new protocol, Its front loaded, so the latter mainly causes nothing but long term side effects, obviously it depends on the type of mutation cancer you have,
I'm n Ireland and we look to Slone Kettering and the UK For latest in treatment,,,

ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

Cured
Posts: 516
Joined: Thu Nov 27, 2008 10:53 pm
Location: MO

Re: 5 fu and oxaliplatin

Postby Cured » Wed Apr 10, 2019 4:32 pm

Nate, I am blessed not to need blood products, nor nupegen, and am able to avoid infections when on chemo.
I encourage you and others to do the full FOLFOX regimen. Statistically the Oxaliplatin adds to your life expectancy. The platinum has some misery- neuropathy- but I accept temporary inconvenience in order to stay alive. Here in the Club I have read too many people quitting the treatment due to it being uncomfortable. My FOLFOX was 8 cycles post surgery; which gave me 10 years cancer free. It would have been 12 cycles - but since I had 6 weeks of continuously pumped 5FU while doing daily radiation before surgery, my ONC said 8 cycles adjunct (after surgery mop-up chemo) was enough.

Since my cancer metastisized 10 years later, I had to do more chemo: this time 12 rounds of FOLFIRI. This time the 5FU was accompanied by Irinotecan instead of Oxaliplatin; still with Leucovorin. It was easier to tolerate- no “electrical shock” of fingers nor frying of nerve-endings. Instead I endured diarrhea- which is still better than leaving my family behind.

May God give you the strength to endure the chemo.
5-08:Stage 3 Rectal: 6/14 Nodes
Ace Surgeon Removed 90%Rectum & lots of Colon-Full Incision
Ileo Rev'd @6 Mos.
Radiation+5fu Pre-Surgery
FOLFOX 8 Cycles Done 1-09
Clear Scope 8-17; Clear CEA 2-18
Glory to God! Healed by prayers of many: for 10 years
7-18: tumor pressing against brain. Removed.
Metastatic to lung. CEA 6.9 Began Folfiri
CEA dropped to 4.5 after 1 dose of chemo!
After 8 rounds CEA=3.0,in range
After 3 week break CEA = 1.8
Finished 12 rounds of Folfiri.

natelaugh
Posts: 26
Joined: Wed Apr 03, 2019 11:40 pm

Re: 5 fu and oxaliplatin

Postby natelaugh » Wed Apr 10, 2019 6:29 pm

Cured wrote:Nate, I am blessed not to need blood products, nor nupegen, and am able to avoid infections when on chemo.
I encourage you and others to do the full FOLFOX regimen. Statistically the Oxaliplatin adds to your life expectancy. The platinum has some misery- neuropathy- but I accept temporary inconvenience in order to stay alive. Here in the Club I have read too many people quitting the treatment due to it being uncomfortable. My FOLFOX was 8 cycles post surgery; which gave me 10 years cancer free. It would have been 12 cycles - but since I had 6 weeks of continuously pumped 5FU while doing daily radiation before surgery, my ONC said 8 cycles adjunct (after surgery mop-up chemo) was enough.

Since my cancer metastisized 10 years later, I had to do more chemo: this time 12 rounds of FOLFIRI. This time the 5FU was accompanied by Irinotecan instead of Oxaliplatin; still with Leucovorin. It was easier to tolerate- no “electrical shock” of fingers nor frying of nerve-endings. Instead I endured diarrhea- which is still better than leaving my family behind.

May God give you the strength to endure the chemo.


Thank you for sharing your info. I wish you and your family all the best. My dad's oncologist said that given my dad age, over 70yrs old he would have a hard time with oxaliplatin. Also, oxaliplatin add 2-3% to overall cancer free. My dad will be on 5FU + leucoverin for 6 months. I am starting to think being cancer free or cure is a "Luck" factor. If chemo find the cancer cell and kill it then cancer free, else cancer return. The luck is in chemo finding the cancer cell.

I feel as a caregiver, I can use law of attraction to tip the scale of "Luck". I find praying and wishing help my anxiety, taking action to ask questions and do it when decision is made.

Cure, how often in the past 10yrs did you do a ct scan or check up on cancer free?
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

AppleTree
Posts: 267
Joined: Fri Mar 18, 2016 8:16 am

Re: 5 fu and oxaliplatin

Postby AppleTree » Wed Apr 10, 2019 9:43 pm

I did 12 rounds of Folfox. My platelets did not always co-operate, so toward the end it was usually every 3 weeks instead of every other. I started at the 100% strength and after maybe 5(?) treatments, dropped it down to 80%.

I knit all through chemo (although very slowly) and most every day walked the dogs, but stomping my feet like a soldier. My Onc thinks these 2 things may have warded off neuropathy.

I had severe runs, no denying it. So, I had a standing order for hydration for the 1st 3 days after disconnect. On weekends it would be in the IV room. It took 3 hours. But oh my, what a difference it made afterward. I would always be dragging my feet, not feeling well and not wanting to go, but once it was over I could blink my eyes again and was more comfortable.

I have a special fleece blanket that covers me, but is small enough to wash easily. I brought that to every appointment, my scarf and hat. I always felt freezing.

I hope that helps. Everyone seems to have a different story and experience.
Diag Feb 5, 2016 Age 45
3 cm tumor 5 cm from verge
Radiation + Xeloda pills - 3000mg 5x week
3/14 - 4/16 - 25 sessions
Shrank just over 50% L nodes 0/13
Remove rectum with temp Ileo 6/17
Reversal 7/20 due to infection
Acute hepatitis August. Chemo cancelled
June to September 2016 - 58 days in hospital

2017
6/16, MRI shadow in lung
Pet - 6.6mm Met in Upper R lobe
7/30 VAT surgery Mass General/Boston
8/24 port
8/30 - 4/28 Folfox. 12 rounds
2018
June CT shows new lung Mets.
July/Oct PETs...CLEAR!


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