Update on Hubby **Update**

oxaliplatin... maybe take Gemzar
Hi Carolyn,

Sorry your husband and you are going through this. Interesting to me though, because I am kind of in a similar spot as your husband, except I've had more types of chemo already.
I went to my Dr. and got the talk about how I've used up the approved treatments for colon cancer. I also originally responded very well to the Folfox & asked about going on that again. Since I had an allergic reaction to the oxaliplatin in spite of it working well for me, I was told by three different oncs I saw that it could be done, but would be very risky due to the allergy. I had this allergic reaction the first time I got it. After that, I would take steroids for two days beforehand, get more steroids and benadryl during the infusion, and they stretched out the infusion time of the oxy to 6 hours so that it went into me very slowly and they could monitor me. Made for a heck of a long tortuous day, but it enabled me to take a drug that worked very well on the tumors. Without the allergy issues involved in your husband, my thoughts are why not go back to the Folfox? If I could, I would! I believe there are now different versions of Folfox with different doses (Folfox 6 vs. Folfox 4).
I know that the oxaliplatin is rough with all the neuropathy side effects, but if it works-do it!

Also- wanted to mention gemcitabine- also known as Gemzar. It is what my doctor is working on getting approved for me & is what I will be starting on next. I'll have Gemzar with Xeloda, and they might also add in Avastin again.
Gemzar is FDA approved for a few other cancers, but not colorectal. But there have been a couple of clinical trials looking at how gemcitabine with xeloda affects colorectal cancer. According to Dr. Lenz at USC, the results were that about 50% had a good response to it. There is no clinical trial for it going on right now, so I'm at the mercy of the insurance if they'll cover it for me right now. I actually spoke to the insurance yesterday (an HMO) to check on the status & was told that if my onc sends in the request along with a list of what I've already taken, reasons why I can't take the currently approved drugs, the fact that I don't qualify for any clinical trials within a 500 miles radius, and the data from a former clinical trial on Gemzar- then I'll have a very good chance of getting it approved. I'll report back when I know if I get it approved- I should hopefully know within a couple of days.

I think I'd go with the folfox though for now- the response rate is better and it worked for him before and the insurance should have no problem covering it since it's "standard care" for colon/rectal cancer. I just wanted to let you know about Gemzar/gemcitabine with Xeloda and Avastin. This is what Dr. Lenz from USC in L.A. also suggested that I go on & so now my doctor is working on getting it for me. It might be something to consider down the road. Never accept that there's nothing more that can be done- that's when it gets to be more of a pain because you really have to go to different oncs farther away (and you need to go to oncs who are at major NCI centers and are into all the latest research on colorectal cancer- the others won't know what to do after "standard" treatments have been used up).

Take care & I'd also immediately ask for a PET scan to check for cancerous activity and so you can get another PET a couple of months into treatment to compare and check if the treatment is working.

God bless,
Lisa