IV chemo versus oral

I received 2 rounds of chemo with the drugs that were standard at that time (2008), Mitomycin by infusion at the cancer center and 5FU via pump for 96-hours.

02021992 said:

Thank you very much for

Thank you very much for sharing, I talked to radiation oncologist today, he told me that Xeloda? pills are for colon cancer rather then anal cancer, but I haven't talked to oncologist in details yet,  I remember 10 days ago he said IV 5FU and Mitomyicin C. I'm so worried about toxicity...but what choice do I have?

I don't think I'm brave enough to go to Mexico for alternative treatments, not even talking about cost involved. 

While your rad oncologist is correct that it is a standard treatment for colorectal cancer, he is definitely not correct in saying that it isn't used for anal cancer also.  This might be a question better addressed to the medical oncologist, if you have one (the one in charge of chemo). Here are a few links:

An abstract on a study of 237 cases compared between IV 5FU and Capecitabine:

http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.680

(short quote: "Conclusions: This population-based study demonstrates a preference for capecitabine use in place of 5-FU in the curative management of anal cancer. Survival outcomes are similar between the two treatment groups, but capecitabine may be better tolerated."  "patients who received capecitabine were less likely to report adverse effects (51% vs 26%, p < 0.001) than those who underwent 5-FU.")

From what I've read, both these treatments are very effective.  Our radiation oncologist kept emphasizing that this treatment is very effective, the key is to finish it.  Having less side effects might help.

NCCN standards of diagnosis, staging, treatment, and followup for 2016:

http://www.tri-kobe.org/nccn/guideline/colorectal/english/anal.pdf

Our docs constantly referred to this document, you can see from the listing of institutions on the first page that these are heavy hitters.  Capecitabine is discussed throughout this document, starting on page 5 listed as a primary treatment along with 5 FU.  page 19 specifically addresses similar results of capecitabine and lower toxicity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963381/  300 patient study similar results for %FU and capecitabine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453727/

This is a lot of reading, and there's a lot more out there.  I know my wife didn't want to read any more about it than she had to, she understandably didn't want to dwell on it.  I'd been through a previous cancer myself, and wanted to know as much as possible.  If you just read this forum, you'll find quite a few people that have done the pill form.  It is really the same drug targeting the tumor.  It is DEFINITELY a standard treatment, not a "WAY OUT THERE" or "now for something completely different" treatment.  You should not have to go to Mexico for this treatment.  As far as I know, no one on this forum did.  Not that there is anything wrong with a Mexican visit, but I think I would save it for after you've finished the treatment/1

Whichever way you choose, they are both effective. The real key I think is to commit to finishing the treatment as well as you are able.

This forum really helped me help my wife.  She didn't want to read it, but she was glad to have me tell her about others making it through, and ideas that helped ease the treatment effects.  You'll find a lot of those here.

 Best of luck to you! You can do this!

Like Pat's wife, I opted for Xeloda/capecetabine( which is 5FU in pill form).  I thought it would be easier taking pills than having infusions via a fanny pack.  I was also influenced by an abstract of a presentation from  ASTRO(major radiation society). Study was done at Sloan Kettering where they have been using Xeloda for several years.  Outcome was similar to MitomycinC/5FU and there was less toxicity. 

also, the nccn.org guidelines for anal cancer, list MitomycinC on Day1 and 29 or on day 1 only and capecetebine 5 days a week concurrent with radiation, as one of 3 recomended protocols.

.  I had no appetite...NO mouth sores or nausea or vomiting; I only lost about 3 lbs and my white counts did not plummet and I was not hospitalized. Others on this site, did have some problems with xeloda....everyone is different.

I was told to eat what ever I wanted ...protein was important.  Active treatment is only about 6 weeks , and if you had a desire for "forbidden goodies" forget it...eat what you want and can...I also ate puddings and mashed potatoes (which I rarely ever eat) yoghurt, The dieticisn discouraged supplements, altho a probiotic was optional

It's the radiation that is difficult; but we all did it and it is usually very effective.

tanda said:

02021992

Like Pat's wife, I opted for Xeloda/capecetabine( which is 5FU in pill form).  I thought it would be easier taking pills than having infusions via a fanny pack.  I was also influenced by an abstract of a presentation from  ASTRO(major radiation society). Study was done at Sloan Kettering where they have been using Xeloda for several years.  Outcome was similar to MitomycinC/5FU and there was less toxicity. 

also, the nccn.org guidelines for anal cancer, list MitomycinC on Day1 and 29 or on day 1 only and capecetebine 5 days a week concurrent with radiation, as one of 3 recomended protocols.

.  I had no appetite...NO mouth sores or nausea or vomiting; I only lost about 3 lbs and my white counts did not plummet and I was not hospitalized. Others on this site, did have some problems with xeloda....everyone is different.

I was told to eat what ever I wanted ...protein was important.  Active treatment is only about 6 weeks , and if you had a desire for "forbidden goodies" forget it...eat what you want and can...I also ate puddings and mashed potatoes (which I rarely ever eat) yoghurt, The dieticisn discouraged supplements, altho a probiotic was optional

It's the radiation that is difficult; but we all did it and it is usually very effective.

 

 

In the last week or two I did get hand and foot disease, which is quite painful; it resolved after treatment with Xeloda ended.  Not everyone gets this side effect; in fact, some

breast cancer patients take Xeloda for many months with no significant problems because the dosing is different.