capecitabine or folfox

ambnbr1

I just found out that I have a choice of chemo to choose from and hoping anyone can offer some suggestions / insights.
Stage 2 colon cancer and I get to choose between;
Capecitabine or Folfox....?????

John23

Huh?
Huh?

Why are -you- being given the choice without explanation
or teaching?

Have you considered a second opinion yet? You really should!

Cancer is a life event, and only a series of opinions should be
had to guide you. One man's opinion can be very different
than another's.

This is a big deal; get another opinion! No decent physician
would be offended. Many learn of new methods and treatments
from "second opinions". Do it!

My best wishes,

John

abrub

Capecitabine is an oral form of 5FU
Would you be getting the IV Oxaliplatin as well? Then they would be pretty equivalent: Xelox (Capecitabine + Oxaliplatin) vs Folfox (IV 5FU + Oxaliplatin). Some people prefer the oral, others the IV form of 5FU. Oxaliplatin is a nasty drug, but proven effective against colorectal cancer. However, many patients can't tolerate it, and end up dropping that portion of the chemo. You need to discuss with your dr what he sees as the advantages/disadvantages to each option. My dr wanted me on systemic Folfox, because then they knew exactly how much of the drug was going into my bloodstream; the oral is absorbed differently. Different drs have different preferences.

thxmiker

abrub said:

Capecitabine is an oral form of 5FU
Would you be getting the IV Oxaliplatin as well? Then they would be pretty equivalent: Xelox (Capecitabine + Oxaliplatin) vs Folfox (IV 5FU + Oxaliplatin). Some people prefer the oral, others the IV form of 5FU. Oxaliplatin is a nasty drug, but proven effective against colorectal cancer. However, many patients can't tolerate it, and end up dropping that portion of the chemo. You need to discuss with your dr what he sees as the advantages/disadvantages to each option. My dr wanted me on systemic Folfox, because then they knew exactly how much of the drug was going into my bloodstream; the oral is absorbed differently. Different drs have different preferences.

My Onc thought FolFox was a
My Onc thought FolFox was a stronger Chemo and has better results. FolFox is also the more toxic to the body. My thoughts were if I ws going to endure this pain, I was going to take the one with the best results. Unless I became so sick that I could not tolerate the FolFox.

I was really strong prior to FolFox and it still ended me in the hospital. A year later and I am finally getting over the effects of Chemo. In my mind (right or wrong) I felt the stronger chemo would give me the best results.

Best Always, mike

djm_2010

I was also diagnosed to he
I was also diagnosed to he stage 2 rectal ca and was given b my doctor xeloda x 3 weeks + oxaliplatin very 21 days. I initially wanted to have folfox because it was the standard f choice for CRC. I also researched and found out that studies show folfox is bioequivalent to xelox (xeloda+oxilaplatin). Also with the added benefit of not being confined for 3 days in the hospital for folfox versus being treated in an outpatient basis for xelox i went for the oral form of 5fu ( in our country you must stay in the hospital with folfox because we dont have a pump that we could take home). Also the xelox form gave me more freedom in dealing with my cancer. I was ableto work part time and just rest at home after my oxaliplatin infusion for at least 3 days then back to work again. It was the oxaliplatin which is a much nasty drug and i was nt able to get my last and 8th dose of xelox. For the diarrhea with xeloda, it was only during the 1st few days but after that, its more of constipation due to oxaliplatin. Its been almost a year since my chemo, im doing well, all my scans and cea is normal. Its like a bad dream, everything will pass, just take one day at a time and there is a life, a good one after cancer. Best wishes and God bless you!

Cathleen Mary

djm_2010 said:

I was also diagnosed to he
I was also diagnosed to he stage 2 rectal ca and was given b my doctor xeloda x 3 weeks + oxaliplatin very 21 days. I initially wanted to have folfox because it was the standard f choice for CRC. I also researched and found out that studies show folfox is bioequivalent to xelox (xeloda+oxilaplatin). Also with the added benefit of not being confined for 3 days in the hospital for folfox versus being treated in an outpatient basis for xelox i went for the oral form of 5fu ( in our country you must stay in the hospital with folfox because we dont have a pump that we could take home). Also the xelox form gave me more freedom in dealing with my cancer. I was ableto work part time and just rest at home after my oxaliplatin infusion for at least 3 days then back to work again. It was the oxaliplatin which is a much nasty drug and i was nt able to get my last and 8th dose of xelox. For the diarrhea with xeloda, it was only during the 1st few days but after that, its more of constipation due to oxaliplatin. Its been almost a year since my chemo, im doing well, all my scans and cea is normal. Its like a bad dream, everything will pass, just take one day at a time and there is a life, a good one after cancer. Best wishes and God bless you!

Sorry that you have to deal

Sorry that you have to deal with cancer but glad that you found your way here. I, too, was diagnosed stage II (Aug. 2009). I chose no chemo. Everyone is different and options offered may be different. Was that option offered to you?
My CEA Pre op was 7.5 and I.5 within a few weeks. For the past year, it has been slowly rising. Now, 3.6. However, multiple scans remain NED, no evidence of disease. I will be scanned again in June.
Just want you to know that there are all kinds of choices out there....nothing is one size fits all.

Please let us know how you do. Welcome to a caring community.

Cathleen Mary

Kathryn_in_MN

Just my opinion
If I had stage II rectal cancer I might possibly consider doing XELOX. This is using the oral form - Xeloda instead of 5-FU, so it is XELOX instead of FOLFOX. You don't have to mess around with the 2-day pump that way. The OX part is Oxaliplatin which is a platinum based drugs that can leave you with long-term side effects. (All chemo can do that, but this is particulary bad.)

With stage II colon, I think I'd only go with XELODA. Pills - no need to spend time in the infusion center, and no need for a port-a-cath. Stage II is a grey area when it comes to the choice to do adjuvent chemo. Ask 10 oncologists and you'll get 5 on each side usually.

Ask for the numbers for how much additional cancer-free time if you do XELOX (or FOLFOX) vs Xeloda. For stage II the numbers are very low. You take high risks for low return. Stage II rectal cancer has a higher risk of recurrance, so that is why I'd think stronger about the Oxaliplatin if I had rectal rather than colon cancer.

You really need to see a benefit to go along with the risk you take, to make sure it is worth it. I'd get a second opinion, and I'd ask to see the numbers. What are the numbers with NO chemo? What are the numbers with XELODA? What are the numbers with XELOX (or FOLFOX - same difference as far as outcomes)? Then decide what you can live with.

Also, please keep in mind that if you start something and it is too much for you, you do NOT have to finish the original number of treatments set up for you. Studies are showing that 6-8 rounds of adjuvent chemo might be just as good as 12. This is especially showing true for how many rounds of Oxaliplatin to do. Personally knowing what I do now, and experiencing what I have, I would not do more than 6-8 treatments that include Oxaliplatin. The neuropathy generally gets worse after stopping it, before it starts to get better. It is very hard to know when to stop so that you do not deal with permanent neuropathy. Mine is quite severe and I've not had Oxaliplatin for 2 years, so we do not expect it to ever get any better than it is now. (I've been on other chemos since then.)