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experience with oral vs IV chemo

dawnestlouis
Posts: 4
Joined: Apr 2010

My boyfriend and I need to make a decision about his chemo for colorectal cancer. The oncologist stated that both the oral and IV meds are just a affective, but what about how it affects your day to day life? We want to know which my be better and how it worked for others.

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

You guys from the St. Louis area? I am. Anyway, IV method put me NED with stage IV cancer (mets in liver and lungs)..then I was switched to pills for 3 months...now I am off all of it ..and still NED. The pills were much easier to handle...as far as side effects...but it all really depends on WHAT treatment you will be doing. i am sure others will chime in with their experiences. I was on Folfiri with Avastin and Nuelasta shots for blood counts. Then went to Xeloda pills and Avastin. Best of luck to you and your boyfriend.

Jennie

Kerry S's picture
Kerry S
Posts: 607
Joined: Dec 2009

I was offered the choice and did not take the pill form. The pills would have cost me more under Medicare. I had chemo, 5FU via the pump, with radiation for 6 weeks. All to kill one node. The first 4 weeks were not bad. The last 2 were just nasty. Did kill the damn node. Chemo/rad is just that way, but it sure beats croaking.

DXs 4/08 mets to node and liver. I am supposed to be dead next month according to my first Onc. I am NED now for 15 months. What stage is your boyfriend???

Also from St. Louis area. Jennie, I did not know you also are from STL area.

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

Yeah Kerry... I didn't know you were either!!! I actually live on the Illinois side.... East of Belleville.

Jennie

abrub's picture
abrub
Posts: 1528
Joined: Mar 2010

My "scheduled expiration date" was 12 months ago, and I've been NED for 2 years. 3 year anniversary is this week.

I had the IV chemo (Folfox for stage 4 appendix ca) but a friend of mine had rare problems with the IV, and has just been switched to the pill form (Xeloda) to see how he does.

Good point about cost: the oral form comes under your insurance prescription coverage, the IV is under medical coverage (tho the 5FU for the 42-hours on the pump fell under my Rx, as it was administered by a nursing service.) You may want to check with your insurance.

It's not easy either way, but we have to do what we have to do.

geotina's picture
geotina
Posts: 2042
Joined: Oct 2009

Hi and welcome to the board. What stage is our boyfriend's cancer and where is it?

My hubby has never had the oral, just IV, and has done very well, but he was Stage IV when diagnosed

Tina.

Jaylo969
Posts: 826
Joined: Jan 2010

Hi Dawn and welcome.

At first I was on the IV( Folfox )and had it infused through a port in my chest.Each infusion took about 3 hrs. I took home a pump connected to the port which had 46 hours of a drug called 5-FU. I learned to disconnect the pump myself so I didn't have to go back in 2 days to be disconnected.The pump is slightly a pain in the rear but you get used to it.

After 5 rounds of Folfox I was having some bad side effects so my doctor put me on the oral meds.(Xeloda) and had my port removed. I have taken 2 cycles of Xeloda so far.

This is my opinion only: Each one has their own pluses and minuses. I actually felt better and had less side effects on the IV/Folfox but I *think* that is not normally the case with most other people.My problem was I was having a side effect on the IV/Folfox that can be permanent...thus, a change to Xeloda.

And then my Mother-In-Law who was stage 3 took the Oxaliplatin by IV ( no port ) but didn't do the pump-(5-FU). She took Xeloda with the oxi.

We are all different. As far as day to day life, I would have to say the Xeloda gives you more freedom.

BTW - Insurance covered my chemo infusion 100%. Xeloda is a prescription so went on drug claims which has a co-pay of $60.00 per Rx ( in my case---BC/BS)If you need 2 different strengths that counts as 2 Rx's which made me have to pay $120.00...Money wise it was cheaper to have the very expensive infusions.

Just curious...what stage is your husband's cancer?

Best wishes for you and your husband's treatment.

-Pat

Hovea
Posts: 15
Joined: Mar 2010

Pat. I would be interested in hearing how your M.I.L.coped/ is coping with the combo of Oxiplating and Xeloda. I had a similar combo but am changing treatment due to complications from possibly the Oxiplatin. Hovea

Jaylo969
Posts: 826
Joined: Jan 2010

In answer to your question...My MIL coped like a champ. Went through all 12 treatments without any serious problems. She was 75 yrs old and is now 1 year NED from her last treatment & scan. I wish I could have been as tolerant of the Oxaliplatin.

Best wishes to you.

-Pat

herdizziness's picture
herdizziness
Posts: 3388
Joined: Apr 2010

I have only been doing chemo for 3 months now, I started on Oxi and xeloda, and he added the Avastin 2 treatments ago. For 3 or 4 days, the hand, feet thing when cold is pretty annoying, can't tap on the computer keys, etc. I get what feels like a hundred charlie horses in my legs for a couple of days, and am exhausted the first two days. Other then that and feeling tired, I feel good. I do the IV every three weeks, the xeloda 14 on 7 off. I LOVE my third week, when off of everything.

herdizziness's picture
herdizziness
Posts: 3388
Joined: Apr 2010

What were the problems with the OXI? And how long before it started causing you problems?

NWGirl
Posts: 124
Joined: Jan 2008

I was scheduled for 12 rounds of FOLFOX - plus 30 radiation treatments; while wearing the 5FU pump 24/7 for 6 weeks. I made it through 10 rounds using the pump - and the 6 weeks wearing the pump 24/7. The pump didn't really bother me, except near the end of the 6 week stint - and at that point, I was just sick of having it on all the time. It wasn't too difficult to shower with - I'd just cover my port area with plastic wrap and tape it down and then set the pump on the counter, just outside the shower. But 6 weeks is just a long time - so I was pretty happy to get it off at the end of that treatment phase.

After 10 rounds of FOLFOX, my port developed complications - so my last 2 rounds were Xeloda only; 14 days of pills (8 pills a day I think); then a week off and repeat. The pills were huge and I really hated having to take them every day - I think it was 4 in the morning; 4 at night.

Side effects, for me, were pretty much the same whether I took it orally or through an IV. The hand/foot syndrome was a little worse on Xeloda (though not terrible) and this could have been partly just due to overall build up in my system from receiving chemo for the past 9+ months.

I'd say if you don't mind taking a LOT of pills - big pills; and your insurance covers it; and you WILL TAKE THEM (that's one problem with oral chemo - some people aren't diligent about keeping to their prescribed schedule of meds); then Xeloda is fine. Except for the 6 week time frame, I think I would have opted to receive the chemo via IV again - as it got it over with in 3 days total; then I had 11 days off before the next treatment.

impactzone's picture
impactzone
Posts: 429
Joined: Aug 2006

at stanford stage 4 here and I took the Xeloda pills and fond them very convient..
Chip

dschreffler's picture
dschreffler
Posts: 58
Joined: Apr 2010

To early to tell if worked, but I had pre surgery chemo with Xeloda (the pill). I did it as part of a clinical trial. No cost to me for the pills. The outcomes are expected to be comparable.

I found the pills a lot easier to deal with then having to wear an infusion pump to deliver the liquid. 3 pills in morning after breakfast, and 3 at night with dinner. 1 weekly IV infusion of Oxy. Pills taken M-F when I had radiation. I had limited side effects, but am only 45 and in good health prior to the cancer.

dawnestlouis
Posts: 4
Joined: Apr 2010

Hi to everyone from St Louis, but I am not from there, that is my name. We live in the Upper Peninsula of Michigan. MY boyfriend, now husband, thanks everyone for the information. He has stage 3 colorectal cancer and surgery to remove the tumor is May 4th. It has helped us a lot with all the information and support from everyone on this site. I am so glad we found it.

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Hi Dawn,

I'll be thinking of and praying for your husband (!) for his upcoming surgery.
I've had both oral Xeloda and the 5FU pump. Xeloda is definitely more convenient, but everyone is different. I did find that I'd get my side effects from the 5FU pump a couple of days after going off the pump and they'd last a couple of days. My effects from the Xeloda weren't as much, but they'd last longer because I took Xeloda 2 weeks on, 1 week off & it didn't ever seem as much time as needed to get rid of the effects. Studies have shown Xeloda is just as effective as the 5FU pump, perhaps even a percentage or two more effective. My insurance covered the pump 100% and I just had a $20 copay for the Xeloda. Convenience wise, the pump stinks (I've got it on me right now). I've done both a couple of times each & I started this time only on the pump because initially my insurance denied the main chemo I'm now on (Gemzar) and the only way they'd pay for the other stuff in my IV (anti nausea, fluids, etc.) is if my onc put the request in for 5FU because it requires that leucovorin also be given in the IV). If I had just taken the Xeloda pills with the Gemzar, I would have had to pay cash for all the fluids, antinausea stuff, etc. As it turned out, my insurance has come through and is paying after all (huge relief, as I paid cash for 3 Gemzar treatments). I'll be seeing my onc in another couple of weeks & I will discuss with him whether I can maybe try changing from 5FU to Xeloda with my next treatment. We'll see...
As I said, everyone is different- some people have more/less side effects with one over the other. It's a trade off since the Xeloda effects seemed to last a bit longer than what I had with the 5FU, but I just HATE having this pump strapped to me Wed-Fri every other week, so I'm going to push my onc to let me change, now that it isn't an insurance issue anymore (I'd rather pay the $20 copay- I can handle that for a bit of more freedom!)

Hope all goes well for your boyfriend/now hubby (congrats!)

Lisa

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