5FU and Leukovorin ?

tkd3g · November 2004

Anyone on this program post surgical ? I had the 6 weeks chemoradiation, surgery then 3 treatments of the oxyplatin/5FU/Luek. Changed to just the 5FU push with 2 hour Luek drip. My original oncologist set me up for 4 cycles of 6 weeks on ( 1 day) and 2 weeks off.

I switched oncologists and treatment centers ( 2 minutes from my home!) and the new oncologist thought that was a bit excessive. Said he was going to call the other doc and discuss it.

If you are on this treatment program, how many cycles are you up for?

Just curious.

Thanks.

Won't see my oncologist till next Thursday for his explaination.

Have a wonderful day.

Barb

Unknown · November 2004

Hi Barb, my husband Bert was diagnosed stage III right colon cancer with four nodes involved back in July 2003. Post surgery, he was placed on just the 5fu/leuc protocol for six months, once a week for three weeks, then one week off.

In all the research I have done, I noticed that more and more oncologist who treated colon cancer aggressively, which in my humble opinion, is the only way any cancer should be treated, were using either CPT-11 or Oxaliplatin in conjunction with the 5fu/leuc mix.

In December 2003, I was finally able to get Bert on to my insurance (a PPO rather than his HMO) and the first thing we did was get a second opinion at a major cancer center with a colorectal oncologist who came extremely highly recommended and whose creditials and credits are from "here to kingdom come." First words out of his mouth were "why aren't you on 5fu/leuc/oxal" and "if you switch to me, I will put you on additional chemo with this combo for six months or as long as you can handle it because you've already had six months of 5fu/leuc." As it turned out, Bert tolerated the entire six months with scans being done every eight weeks. He has been off chemo now five months and all scans have continued to show no evidence of disease.

That's my story. However, on November 5, the FDA approved Oxaliplatin as being added to the 5fu/leuc combo for the treatment of stage III colon cancer. I recently read an article that indicated four year disease free survival on patients treated with the three components was 70% as opposed to 61% for those just treated with 5fu/leuc. European oncs have been doing the three component combo for quite some time.

My theory is the same as my husband's oncologist....cancer does not allow us the luxury of saying oh well, if this doesn't work, I'll go back and try the other. Fight it with all you've got from the get-go and keep fighting hard.

A friend of mine whose husband is stage II received the three part combo right after surgery as well. While the side effects of adding oxaliplatin can definitely be more severe, again my personal, humble opinion is that they are well worth adding the plus points to a cure by using the drug.

Hugs,
Monika

tkd3g · November 2004

unknown said:
Hi Barb, my husband Bert was diagnosed stage III right colon cancer with four nodes involved back in July 2003. Post surgery, he was placed on just the 5fu/leuc protocol for six months, once a week for three weeks, then one week off.

In all the research I have done, I noticed that more and more oncologist who treated colon cancer aggressively, which in my humble opinion, is the only way any cancer should be treated, were using either CPT-11 or Oxaliplatin in conjunction with the 5fu/leuc mix.

In December 2003, I was finally able to get Bert on to my insurance (a PPO rather than his HMO) and the first thing we did was get a second opinion at a major cancer center with a colorectal oncologist who came extremely highly recommended and whose creditials and credits are from "here to kingdom come." First words out of his mouth were "why aren't you on 5fu/leuc/oxal" and "if you switch to me, I will put you on additional chemo with this combo for six months or as long as you can handle it because you've already had six months of 5fu/leuc." As it turned out, Bert tolerated the entire six months with scans being done every eight weeks. He has been off chemo now five months and all scans have continued to show no evidence of disease.

That's my story. However, on November 5, the FDA approved Oxaliplatin as being added to the 5fu/leuc combo for the treatment of stage III colon cancer. I recently read an article that indicated four year disease free survival on patients treated with the three components was 70% as opposed to 61% for those just treated with 5fu/leuc. European oncs have been doing the three component combo for quite some time.

My theory is the same as my husband's oncologist....cancer does not allow us the luxury of saying oh well, if this doesn't work, I'll go back and try the other. Fight it with all you've got from the get-go and keep fighting hard.

A friend of mine whose husband is stage II received the three part combo right after surgery as well. While the side effects of adding oxaliplatin can definitely be more severe, again my personal, humble opinion is that they are well worth adding the plus points to a cure by using the drug.

Hugs,
Monika

Thanks for the response, Monika.

I did have a difficult time deciding whether or not to stop the Oxy. Unfortunately, the side effects were just too much for me.

Then there is the " we are just doing this (chemo) to make sure everything is gone." statements the docs give me. I had no lymph node involvement and they got it all with very clean margins.

I am the last to say stop with anything. But I know I made the right decision with this.

fedester · November 2004

hi barb,
i do this combo, but once a week and by iv. so far no problem. just finished my 18 of 26 treatments.
have a great holiday
bruce

alihamilton · November 2004

Hi Barb,
This is an interesting debate as I was very concerned that my husband was getting only 5Fu/Leukovorin for his stage 111 rectal cancer. Here, in the Bahamas, they do not give the more advanced meds for Stage 111. Neither in the UK and I think not in Canada. Of course, there may be exceptions. My husband had a fairly rigourous routine though with treatment every day for a week, then two weeks off and every day again for a week. He did this for three cycles and then had treatment once a week while he had radiotherapy. Thereafter, he had to have a reduced regimen but was able to complete the course. It is too early to know if it has done the trick but I have read posts from persons treated years ago before these newer drugs were on the market...and they are doing well. There are no certainties in this game and I agree with Monika that we have to be aggressive. However, you also have to treat each case on an individual basis.

Best of luck!

taraHK · November 2004

I had a similar regime, but less post-surgical chemo. I had 6 weeks chemoradiation, then surgery, then 4 cycles of chemo. The schedule was one week on (every day), then 3 weeks off. I was told this was the 'Mayo clinic regime' - and because I'd had the presurgical chemo, I only needed 4 cycles post-surgery. I was on 5FU/Leuk. I was offered oxaliplatin in a clinical trial, but turned it down (that was presurgically -- when I didn't know my stage for sure). Were I making the decision today, I'd go for the oxal. But, as we know, everyone reacts differently to the various drugs. I did ok on the 5FU/leuk. Had an allergic reaction to levamisole, which I started on presurgically, but that's another story! My diagnosis is stage III rectal - one node positive.
Tara

grandma047 · November 2004

taraHK said:
I had a similar regime, but less post-surgical chemo. I had 6 weeks chemoradiation, then surgery, then 4 cycles of chemo. The schedule was one week on (every day), then 3 weeks off. I was told this was the 'Mayo clinic regime' - and because I'd had the presurgical chemo, I only needed 4 cycles post-surgery. I was on 5FU/Leuk. I was offered oxaliplatin in a clinical trial, but turned it down (that was presurgically -- when I didn't know my stage for sure). Were I making the decision today, I'd go for the oxal. But, as we know, everyone reacts differently to the various drugs. I did ok on the 5FU/leuk. Had an allergic reaction to levamisole, which I started on presurgically, but that's another story! My diagnosis is stage III rectal - one node positive.
Tara

Tara, I had pretty much the same regime you did. I had chemo and radiation, then surgery and will have 4 rounds of chemo, 1 week on, 23 days off, 1 week on, 23 days off, for 4 rounds. But.. I'm only having 5FU. Hope it does the trick.
Love and prayers, Judy(grandma047)

aspaysia · November 2004

tkd3g said:
Thanks for the response, Monika.

I did have a difficult time deciding whether or not to stop the Oxy. Unfortunately, the side effects were just too much for me.

Then there is the " we are just doing this (chemo) to make sure everything is gone." statements the docs give me. I had no lymph node involvement and they got it all with very clean margins.

I am the last to say stop with anything. But I know I made the right decision with this.

I had no lymph node involvement and clean margins with my first surgery (after chemo/radiation to shrink the tumour) Before I could have the clean-up chemo there was a re-currance and another op. This time I had 5Fu/Oxaliplatin/Leucovorin once every three weeks with Xeloda pills twice per day for two weeks. One week off and start over again for six months. I was also followed agressively with ctscans and labs every three months. It seemed to do the trick and I am now checked every six months. If you cannot tolerate the 0xaliplatin try something else but don't take any chances. There is a window for the chemo and they would not let me wait more than six months to do the regime. After that it is not as effective.

steved · November 2004

I am stage three with 2 nodes involved and am three months post op.I am still on this regime with the MAyo clinic routine- 5FU and Leuk every day for a week followed by three weeks off. There is no clinical difference between this routine and the once a week routine it is jsut differrent centres that have different protocols. I will be having six cycles of it. I am finding it okay with some nausea each week that I am on it and a bit of tiredness the week after. My white cells drop prior to the next cycle so I have to be careful of infections (easier said than done with a six month old baby in teh house!) I am still working full time through it and jsut take an hour off for the actual treatments.

The addition of oxaliplatin as Monikaz has rightly said is a new recent finding from the Mosaic trial- a large multicentred trial taht showed improved outcomes. It is not routine to add it to the usual regime yet here in the UK but is likely to come in- it is certainly something worth discusssing with your oncologist as the results of teh trial were quite impressive.

Hope this helps,
steve

alihamilton · November 2004

I suspect that oxaliplatin and the other more advanced meds are not used automatically in the UK or Canada because of the high cost of these meds to the National Health Service. Here, in the Bahamas, we get private medical treatment but as I said before, it was not an option.

nanuk · November 2004

You would have to include the dose of each to compare; I think that can vary..bottom line seems to be how much can we tolerate before the stuff either kills the cancer or us.. Bud

Kanort · November 2004

Hi Barb,

Welcome back! I was on the oxal., 5 FU, leuc. protocol and was able to to complete the 12 rounds. However, they did lengthen the oxal from two to three hours for the last few treatments. I finished my treatment in July and so far so good. Let us know what your new oncologist decides.

Wishing you well.

Kay

PS You'll love being so close to the treatment center. I'm a couple of minutes away from mine!:)

ron50 · November 2004

Hi Barb,
I started on 5fu leucovorin. I'm in Australia , the regime was 5 days on 3 weeks off, I did that for two months but I had severe diahorea and had to go onto a weekly regime of 5fu enhanced every second week with levamisol. I finished up having 10 teatments of 5 fu leucovorin and 38 of 5fu and levamisol. I was orig dx with stage 3 colon ca with involvement to 6 nodes . The chemo really did give me a hard time but on the up side this January will be the end of year seven completely cancer free. Good luck with your treatment ,best wishes Ron.

5FU and Leukovorin ?

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