DPD enzyme test for 5FU toxicity

azgal said:

I hope so, too, for her sake
Yes, and I believe all the major AC tx facilities are very open to consultations like that. Sometimes the inexperienced treating oncs need determined prodding from the patient for sure, some more than others, to go outside for expert input. It's not always easy but it's always well worth the effort. The Mayo oncs that examined/tested me were more than happy to consult with oncs involved in my tx, as was Chicago, and Chicago has specific mapping info available online for onc teams that request it, which was utilized for me. I learned that long distance consults were a fairly routine option (especially when requested/pressed for by the patient) over 4+ years ago when I was going through it, but I would never have known that when it counted without experienced input from other AC group members that had more collective information than 99.9% of oncs. Way back then, as a new AC patient armed at first with little to no knowlege, I felt apologetic when asking anything of my docs. I hope the woman on the other blog will turn the tide on her behalf when armed with knowledge. I know for a fact that it's an exhausting battle but it's well worth it.

toucheole said:

DPD Deficiency
I am through with the first phase of treatment (chemo - 5FU and 28 days of radiation) for a Stage II anal cancer with no known lymph node involvement. I'll have surgery in February. My doctors have been great, but I think the test for DPD deficiency should be an automatic done before treatment starts. We are still waiting for the results to find out how deficient I am in the enzyme, but my over-reaction to 5FU started the 2nd week with mouth sores and diarrhea and I was taken off chemo entirely during the 4th week because the reactions were so severe. We are still trying to get the electrolytes in my body back to normal - almost all there except the magnesium levels are being stubborn. Since the number of people who are missing the enzyme or are at least deficient in the enzyme seem potentially to be relatively high, and the toxicity can be so severe, it seems to me that it should be a standard test. And this is particularly true because 5FU is such a staple of treatment for colo-rectal cancer. I've had some discussions already with my chemo oncologist (BTW, the radiation was a piece of cake compared to the chemo) about recommended chemo after surgery because all of the standard recommended treatments include 5FU in some form. On the other hand, one of my oncology nurses, who has been at this for 10 years, had never seen a reaction like I had to 5FU so maybe it's not that prevalent. The only thing I can say to others is that I have been told it is a Caucasian genetic abnormality, and, since cancer does not run in my family, it'll probably only impact me. However, I'm sure my brothers are glad to know so that if, by any chance, they end up with a similar cancer, they can request the test before theraqpy.

mp327 said:

Thanks for sharing
Perhaps you are right in that this test should become standard for anyone about to receive 5FU, given the severe reaction you had. In my case, it was really the radiation that knocked me on my butt. I had some unpleasant side effects from the chemo, but nothing severe.

I am curious and would like to know what type of surgery you are having following chemo/rad for stage II anal cancer if your cancer was localized to the tumor only. Thank you in advance for sharing.