(CAPEOX) capecitabine-pill vs. 5FU IV

Carrying over from your other thread, I tried the CAPOX.  I saw no reason in the world to do the port/pump scenario.  I hate needles.  I had one oxaliplatin infusion and I found the side effects unacceptable.  For me, the chemo was only supposed to give me a 10% increase in overall survival chances.  The capecitabine alone was supposed to give about a 7.5% advantage.  I then did 4 months of capecitabine only, and that at a reduced dose.  Capecitabine itself is not too horrible, but it is no picnic either. 

If you have not already had this conversation, you might want to have your doctor describe your husband's chances of recurrence with or without chemo, with a three or a six month course, and any other variations that you think you might consider.  Having these statistics in mind can help make a decision whether to engage in or continue a therapy easier.  

As for me, when evaluating the oxaliplatin, I decided I would rather have one good day off oxiliplatin, rather than 10 days on it.  Using that quality of life formula, I decided I was better off without it.  Fortunately, I am two years out from surgery with no current evidence of disease.

Also, be aware that there are many non-chemo strategies in which you can engage to optimize your chances of survival.

Cheers.

shu273 said:

CAPEOX

That is great to know. I will take that information with me to the Oncogist tomorrow morning!!

Let us know how it works out.

My husband took capox for a month or so and it was terrible.  Nausea, diarrhea, and he lost a lot of weight rapidly.  He had to switch over to the 5fu and have a port installed.  He hates needles too.  Once he switched, he was fine.  Gained weight etc.  

Thanks for this post, as we are meeting with the oncologist tomorrow re my partner's Stage 3b diagnosis. It is so hard to know which one to choose - Folfox or Capeox... We actually met with one doctor at Medstar in this process as well and really liked them but the location wasn't convient for us for treatments. Did he give you any statistics about the effectiveness or comparison between the two that you can share? Success rates or pointing to any studies?  Thank you!

shu273 said:

CAPOX

Thank you for your reply. We decided to try the Capox and are only 1 week in. So, will see how he progresses. How was your experience throughout your chemo and how are you now? Did you experience any Nueropathy and if so have those issues subsided? Also, did you ever experience your lungs burning when you exerted yourself (such as walking)?

Thanks,

Andrea

As I posted above, I thought I should respond with an update. We just had the appointment with the medical oncologist yesterday and asked about the two drugs, especially after reading about the IDEA study. The doctor (at Cleveland Clinic) recommended Folfox given the harsh side effects of CAPOX and increased toxicity, which can often result in hospital time. He said that it would be more of a discussion if my partner was lower risk as 3 months with CAPOX would be better for lower risk patients, whereas FOLFOX they recommend for higher risk patients. My partner had 6 nodes affected at Stage 3b so it looks like we will go with Folfox.  Again, this is just one update of a medical opinion so please do take with a grain of salt, I am sure your doctor knows best for your case, but I just wanted to share for other readers. 

Best of luck, and please keep us posted on his progress

It appears that I’m late to this party as the last discussion was in 2019. Nonetheless, Capeox vs Folfox is the topic I’m interested in, and I hope there’s more current threads.

My husband was dx with stage 2b esophageal cancer last April and was treated with radiation and chemo. He was not a candidate for resection. Now the cancer’s recurred in a lung, along with node involvement, and the recommended treatments are Capeox or Folfox. He’s starting Capeox later this morning, but is wondering if he made the right choice. I was interested to read that several folks here switched from one to the other.

Once you make the choice, second guessing has little value, unless you are looking to change strategies. Everyone is different, some do better on one approach or another, but from my perspective the advantages of Capox outweigh Folfox. Hopefully, others will chime in.

My son was diagnosed with stage 4 colon cancer with liver mets and nodules on the bottom of his lungs. He is 34 years old and was diagnosed 16 months ago. He had a colectomy and started with FolFoxIri plus bevacizumab for nearly a year (infusion thru port every 2 weeks). After 2 CT scans it was determined that the nodules in his lungs were resolved and the mets in his liver had shrunk to +35%. After that, his oncologist felt his body needed some rest (the side effects were strong at that point) so he took away the oxaliplatin. After a couple of months, he also took away the irinotecan. He is now on infusions (thru port) every 3 weeks of bevacizumab and leucovorin and 2 weeks on and 1 week off of Xeloda (pills). The side effects are tolerable with the worst being neuropathy and hand-foot disease. He prefers the pills, he is an ER nurse and works full-time. It has been hard on his feet and hands though. When he was doing the infusion only, the worst side effect was diarrhea and anal pain and itching and he hated that because it was debilitating. We have a meeting with the oncologist tomorrow so we'll see what he says about neuropathy. He is on palliative chemo and we are not too happy about that, I want the tumors to keep shrinking so he can be a candidate for liver resection even though the oncologist said he would never be a candidate. We are requesting a surgeon referral.

thank you for your response. May I ask if the surgeon didn't think surgery was necessary then you continued with chemo? If so which?

We finally changed oncologists (same hospital) and he sent a referral to the surgeon. Surgeon and team decided he was a good candidate for a liver transplant or an operation where they basically "burn" the mets. They think a transplant would be better but i am a bit scared of that option. The burning method is also pretty invasive and it might not work.