Xeloda and folate?

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lpas
Posts: 1010
Joined: Wed Nov 19, 2014 11:11 pm

Xeloda and folate?

Postby lpas » Fri Feb 06, 2015 5:22 pm

So I've read several places that folic acid is an important nutrient to take for the prevention/treatment of colon cancer, but I also see that folic acid is contraindicated in those who take Xeloda, as it may increase toxicity. Does anyone know whether L-5-MTHF (folate) is safe to take during chemo as a substitute? Or should this form be avoided as well? I know that I'm heterozygous for the MTHFR mutation, so am probably somewhat folic acid deficient. The L-5-MTHF is what my ob/gyn recommended during pregnancy.

Thanks so much.
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 cimetidine & other targeted supplements
Mom to a 6 & 8yo

Redtexa5
Posts: 181
Joined: Thu Aug 02, 2012 11:41 pm
Location: Austin, Texas

Re: Xeloda and folate?

Postby Redtexa5 » Fri Feb 06, 2015 6:23 pm

You need to run this by your Oncologist along with any other supplements, vitamins, and etc that you want to take during chemo. You are paying for this expertise use it not the opinion of a bunch of random people on the internet. Further more, if your Oncologist's office has a problem answering your questions I would seriously look at finding a new one you are the consumer here they work for you.
Start of symptoms 9/08
Dx Stage IIIc/IV CC 2/09
T4bNxM0
Colostomy 2/09
Radiation/5FU 3/09-5/09
FOLFOX 6 6/09-8/09
9/09 Tumor removed Colostomy reversed
10/09-1/10 FOLFOX 6
3/10-2/15 NED
2/14 Colonoscopy NED
2/15 Colonoscopy NED
6/15 PET/CT NED
2/17 7 years NED

User avatar
O Stoma Mia
Posts: 1603
Joined: Sat Jun 22, 2013 6:29 am

Re: Xeloda and folate?

Postby O Stoma Mia » Fri Feb 06, 2015 7:18 pm

One thing that you might consider when discussing the folate issue with your doctor is this: You live in the US, and the US has a higher Xeloda side effect rate than does Europe, possibly because of US government policy on food supplementation:

The US has an aggressive policy of fortifying food with folic acid, and requires that all flour, rice, pasta, cornmeal and other grain products are enriched with 140 μg folic acid per 100 g. Similar programs have been initiated in Canada and a number of countries in South America and the Middle East, but are unusual in Europe. One could speculate, therefore, that folic acid supplementation could be a major factor contributing to the perceived excess capecitabine toxicity noted in the US.
Reference: http://www.medscape.com/viewarticle/583704_print

CrystalSue
Posts: 101
Joined: Sun Jul 20, 2014 11:30 am
Facebook Username: csiegel
Location: Tampa Bay Area, Florida

Re: Xeloda and folate?

Postby CrystalSue » Sat Feb 07, 2015 6:21 pm

DH oncologist believes that folic acid can intensify the potential side effects of Xeloda. He is all for us removing it from DH diet in any way we can.
DH 56 yo
DX RC 2a (T3N0M0)
5FU/IMRT
LAR; Ileo takedown/port removal
8 cycles Xeloda
Followup scan & scope - clear
December 2015 Colonoscopy - clear

When you die, it does not mean that you lose to cancer. You beat cancer by how you live, why you live, and in the manner in which you live..”
― Stuart Scott

lpas
Posts: 1010
Joined: Wed Nov 19, 2014 11:11 pm

Re: Xeloda and folate?

Postby lpas » Sat Feb 07, 2015 7:11 pm

Redtexa5 wrote:You need to run this by your Oncologist along with any other supplements, vitamins, and etc that you want to take during chemo. You are paying for this expertise use it not the opinion of a bunch of random people on the internet. Further more, if your Oncologist's office has a problem answering your questions I would seriously look at finding a new one you are the consumer here they work for you.


Thanks, RedTexa5. I do intend to speak with my oncologist on this subject but forgot to bring it up at my last appointment and won't be seeing him again for a few weeks. In the meantime, just wanted to check in here and see if others have may have discussed this issue with their doctors.
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 cimetidine & other targeted supplements
Mom to a 6 & 8yo


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