FOLFOX or FOLFIRI

pilarica
pilarica Member Posts: 44 Member
in Colorectal Cancer #1

Dear all:

 

I just came back from my oncologist and my head is spining......... I was diagonosed with colon cancer stage IV  with mets on the liver, november 2013. Did 1 year of FOLFOX every other week. I had surgery 2 months ago, they removed my primary tumor (the size of a greapfruit) from my sigmoid colon. I am feeling great right now because I have not had chemo for the past 3 months. 

Did a MRI Monday and today was the appointment with my oncologist. Well as expected the mets in the liver are acting up, they are gowing so she said she would like to start chemo again and then do liver - directed treatment. I have had Folfox (some side effects) and this time she asked me if I would like to try Folfiri. I really don't know which one to do, she said that both are good and that I could choose.

Any advise?????

 

Thanks,

Pilar

Comments

  • jen2012
    jen2012 Member Posts: 1,607 Member
    #2
    Sorry you need to go back to

    Sorry you need to go back to treatment.

    My husband had to chose last year and we decided it made sense to stick with folfox since he did well on it and he knew what to expect.  He did well with it the second time too.  Now they are probably going to start folfiri for him, but we will discuss with his onc tomorrow.  If it were me, I'd probably ask her to try folfox again to see if it would work again for him.

  • LindaK.
    LindaK. Member Posts: 506 Member
    #3
    Decisions

    Hi, my husband had Folfox in 2013 when he was first diagnosed stage II.  He did OK on that, but the oxaliplatin was removed after 5 treatments.  He finished the remaining 7 without it.  He had extreme constipation throughout and even had another obstruction because of it.  He started Folfiri last March after his reoccurrence in January.  Part of that cocktail is Irinotecan which the infusion nurses call "I ran to the can" since it usually causes diarrhea.  Sometimes it happens during infusion and sometimes a day or two later.  If it is extreme, you have to go into the hospital to get it under control.  The Irinotecan seemed to even my husband out (with bowel movements) so he did better on Folfiri that way.  He usually had some diarrhea day 2 which was controllable with Imodium.  Also, the steroids did not seem to affect his moods as much as when on Folfox.  They were treating his lymph nodes with Folfiri.  He had several complications and never could get on a Folfiri routine for more than 3 or 4 sessions at a time.  In the end, it did not work for him.

    If Folfox worked for you, you could tolerate it and the oncologist thinks it will work again, I would say stick with it.  They could always change it up if need be.

    Linda

  • Easyflip
    Easyflip Member Posts: 588 Member
    #4
    This

    is just my 2 cents but I think you might want to try Folfiri because the folfox didn't really take out the liver mets. Why not the direct treatment now? Are you thinking HAI pump or Y90 spheres? If you try folfiri and see how it works it might give insight into what to put into the pump, if that's in your future. Good luck and best wishes!

    Easyflip/Richard

  • Phil64
    Phil64 Member Posts: 838 Member
    #5
    If it were me I would want my

    If it were me I would want my Onc to choose...  I'd would expect that they would have an intuition as to which might work best for me...  If they didn't I think I'd be looking for a new Onc.

     

    As for considerations, assuming both worked equally.  I know the Oxciliplatin that came with the Folfox was a nasty drug for me..  I didn't like the neurapahty I got from this and the cold sensativity.  Folfiri (which I also had) seemed to have less enduring side-effects for me...

     

    I also had Folfox-Folfiri (basically both at the same time).  Tha was a tougher treatment. Definitely whipped me worse than when receiving the individual mixes on separate occasions.

    But good news for me is that I am now NED (after having had primary tumor in colon, mets in Lungs, Liver, and again in colon).  So 30+ chemo treatments and 7 surgeries later I'm NED with CEA under 1.0.  Although I'm still receiving Erbitux to help "clean up" any persistent cancer cells lurking around inside of me.

    Good Luck.

  • peterz54
    peterz54 Member Posts: 341
    #6
    Phil64 said:

    If it were me I would want my

    If it were me I would want my Onc to choose...  I'd would expect that they would have an intuition as to which might work best for me...  If they didn't I think I'd be looking for a new Onc.

     

    As for considerations, assuming both worked equally.  I know the Oxciliplatin that came with the Folfox was a nasty drug for me..  I didn't like the neurapahty I got from this and the cold sensativity.  Folfiri (which I also had) seemed to have less enduring side-effects for me...

     

    I also had Folfox-Folfiri (basically both at the same time).  Tha was a tougher treatment. Definitely whipped me worse than when receiving the individual mixes on separate occasions.

    But good news for me is that I am now NED (after having had primary tumor in colon, mets in Lungs, Liver, and again in colon).  So 30+ chemo treatments and 7 surgeries later I'm NED with CEA under 1.0.  Although I'm still receiving Erbitux to help "clean up" any persistent cancer cells lurking around inside of me.

    Good Luck.

    Rotate chemo regimes ??

    Doesn't make sense to me for your doctor to just toss the decision to you without explanation.  Your oncologist should explain the pros and cons of each regime as applied to your case and why it doesn't matter which you choose, if that is actually the case.    

    But.....It's my understanding that chemo regimes are changed after completion of the first course due to the adaptive behavior of the cancers, and the National Comprehensive Cancer Network guidelines bears this out.     The 2014 patient version is here:     http://www.nccn.org/patients/guidelines/colon/index.html#1   But if you register (no cost) you can see the  physician version.   

     

    Peter

  • pilarica
    pilarica Member Posts: 44 Member
    #7
    peterz54 said:

    Rotate chemo regimes ??

    Doesn't make sense to me for your doctor to just toss the decision to you without explanation.  Your oncologist should explain the pros and cons of each regime as applied to your case and why it doesn't matter which you choose, if that is actually the case.    

    But.....It's my understanding that chemo regimes are changed after completion of the first course due to the adaptive behavior of the cancers, and the National Comprehensive Cancer Network guidelines bears this out.     The 2014 patient version is here:     http://www.nccn.org/patients/guidelines/colon/index.html#1   But if you register (no cost) you can see the  physician version.   

     

    Peter

    Thanks

    Thanks all for taking the time to give me your opinion, it is very valuable!!

    The Dr. did explain to me the pros and cons of each treatment, the fact that Folfiri produces diarrhea was a concern and she also said that Folfox did a really good job before my surgery, by las november when we had to stop treatment the liver mets had shrunk 80% so we know it works. Anyway I am getting Folfox treatment today!!! Don't like the idea of going back to chemo but the idea of staying with a growing cancer in me is worse. So let the battle begin Cool  WE will get them unguarded.

     

    Last month I had the chance to fly to Japan with mi family, it was wonderful we had a great time, it is an amazing country !!!!!!

     

    Thanks again, it is so comforting to be able to share with people that really understand !!!

    xoxo

    Pilar

     

     

  • Easyflip
    Easyflip Member Posts: 588 Member
    #8
    pilarica said:

    Thanks

    Thanks all for taking the time to give me your opinion, it is very valuable!!

    The Dr. did explain to me the pros and cons of each treatment, the fact that Folfiri produces diarrhea was a concern and she also said that Folfox did a really good job before my surgery, by las november when we had to stop treatment the liver mets had shrunk 80% so we know it works. Anyway I am getting Folfox treatment today!!! Don't like the idea of going back to chemo but the idea of staying with a growing cancer in me is worse. So let the battle begin Cool  WE will get them unguarded.

     

    Last month I had the chance to fly to Japan with mi family, it was wonderful we had a great time, it is an amazing country !!!!!!

     

    Thanks again, it is so comforting to be able to share with people that really understand !!!

    xoxo

    Pilar

     

     

    Good luck

    Pilar and best wishes as you embark on your next round of chemo. You did it once and you can do it again, piece of cake!

  • Yolllmbs
    Yolllmbs Member Posts: 360 Member
    #9
    Easyflip said:

    Good luck

    Pilar and best wishes as you embark on your next round of chemo. You did it once and you can do it again, piece of cake!

    Good luck

    I'm glad you're doctor explained everything to you. Many prayers and giid thoughts. 

     

    Yolanda

  • NewHere
    NewHere Member Posts: 1,428 Member
    #10
    pilarica said:

    Thanks

    Thanks all for taking the time to give me your opinion, it is very valuable!!

    The Dr. did explain to me the pros and cons of each treatment, the fact that Folfiri produces diarrhea was a concern and she also said that Folfox did a really good job before my surgery, by las november when we had to stop treatment the liver mets had shrunk 80% so we know it works. Anyway I am getting Folfox treatment today!!! Don't like the idea of going back to chemo but the idea of staying with a growing cancer in me is worse. So let the battle begin Cool  WE will get them unguarded.

     

    Last month I had the chance to fly to Japan with mi family, it was wonderful we had a great time, it is an amazing country !!!!!!

     

    Thanks again, it is so comforting to be able to share with people that really understand !!!

    xoxo

    Pilar

     

     

    Best Of Luck

    Go get 'em...

     

    Very cool about the trip.  I do want to get there.  Both my brother and Dad had made it there at various times, their photos and accounts have made me jealous :)

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