Chemo Changes - Still Effective?

TheLadySkye Member Posts: 203 Member

My doctor wants to make some changes to my chemotherapy, and I'm wondering if it will still be effective.  A small bit of background - My 6th FOLFOX treatment was delayed a week due to low lab counts (specifically neutrophils).  My 8th one (the current one) was also delayed a week due to low counts.  This time they gave me a shot of neupogen to help, and Light, the pain that evening and the next day had me in tears.  I have a pretty high tolerance for pain, but only a combination of oxycodone, benadryl, and flexeril was able to keep it under control.  Regardless of the pain, my doctor did not want to continue the shots because she was concerned of long-term effects of forcing the bone marrow to work harder for a prolonged period of time.  So no more shots.  I can't say I complain.

However, what she DOES want to do is take the 5-FU bolus out of my FOLFOX regimen.  She says that 15 minute push is actually the hardest on the blood counts, and feels that at this point the chemotherapy has likely already targeted any remaining cancer cells, but we will still proceed for the 12 course duration.  She still wants me to use the 5-FU fanny pack for two days following the oxaliplatin infusion.  

So my questions.  Will the chemotherapy still be effective?  Does 5-FU still need that initial bolus push to bring it up to therapeutic levels?  I know tweaking the chemotherapy is to be expected (they warned me they might pull the oxaliplatin if neuropathy became a substantial issue), but am I receiving any benefit from the lower spread out dose of 5-FU in the pack?  I know I can't keep crashing my blood counts, but I'm quite worried about the effectiveness of the chemotherapy with the bolus removed.  

Does anyone have any insights?


  • lp1964
    lp1964 Member Posts: 1,239 Member
    Dear Friend,

    I went through the same treatment as you and had many adjustments on the way. They took out Oxalyplatin from the mix and lowered my Xeloda, because it tore me up. Chemo is not an exact science. Small adjustments may effect the outcome slightly in statistics, but every  individual is different. 

    Hang in there and see you at the finish.


  • herdizziness
    herdizziness Member Posts: 3,624 Member

    Many do the fanny pack, or many of us do it in the form of the Xeloda pills, so I wouldn't worry about it, the fanny pack or the pills might be  more annoying To you (Wearing the fanny pack or as with the pills trying to remember to three pills twice a day for two weeks) then what you previously were doing but either of those should be just effective.

    Here's to your chemo's working well and doing their job quickly.

    WintER Marie

  • annalexandria
    annalexandria Member Posts: 2,571 Member
    I too had adjustments

    along the way.  The dosage was cut by 20% because I was getting so sick from the side effects.  By the end the reduction amounted to missing one cycle, which my doctor said doesn't make a significant difference.  And I've read that there is some debate about whether there is any real improvement to prognosis with the number of cycles presently recommended (it's possible that fewer cycles would have the same outcome).  So I think taking your doc's advice is probably what I would do.

    Good luck, and keep us posted!

  • TheLadySkye
    TheLadySkye Member Posts: 203 Member
    Thank You

    Thank you all for your feedback.  I find myself terribly frightened these days, and am even more afraid when things happen to impact the treatment.  I know there is no way even with treatment to predict recurrence.  I try to be optimistic, but I'm really very scared :(

  • Phil64
    Phil64 Member Posts: 838 Member
    My experience is that chemo

    My experience is that chemo may have a different effect on different people.  I was treated with FOLFOX / Oxciliplatin for 11 treatments.  Treatment 12 was witheld due to rising CEA levels. We later found a tumor was growing in my liver while receiving FOLFOX and Oxciliplatin.  FOLFIRI with Erbitux was a different story for me.  This regimend was very efective at shrinking the tumor in the liver.  After four treatments I had a liver resection.  I received eight more FOLFIRI with Erbitux treatments after that surgery.

    I guess I'm saying that chemo may affect different people differently.  My impression is that chemo therapy is a very organic/complex proess and each of us are unique cases. For some a particular chemo treatment can have awesome impact. I'll be praying for maximum success for you.