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1/2 Of The Way Through FOLFOX/Labs In The Toilet

TheLadySkye's picture
Posts: 195
Joined: Oct 2013

As of today, I am 1/3 of the way through FOLFOX treatment.  It's been pretty miserable, but it's nice to "celebrate" these small benchmarks.

Alas, my labs are pretty much in the toilet this morning, and while they went ahead with the chemo today, they said they might postpone the next one a week if my labs drop even lower.  Needless to say, I have questions.

- Is the treatment still as effective if it's postponed a week? (I currently go every two weeks and have the pump for two days after the initial infusion)

- Is it normal at this stage for my entire CBC (hemoglobin, red cells, white cells, platelets, neutrophils) to be low except for the RDW which is high?

- They mentioned the possibility of an injection of some sort to try to stimulate white blood cell production.  This doesn't sound like a very good idea to me since I thought white blood cells formed in response to infectious agents, but I'm certainly not a medical professional.  Does anyone have any idea/experience with what they could be talking about?

- My liver enzymes (bilirubin and aspartate) are both high.  I am told they'll be watching them and that some raising is expected as the liver works harder to process the chemo, but certainly they do not want to venture into the realm of danger.  Does anyone know if this is of concern and where those cutoffs might be?  It's worrisome.  Poor liver!

So I'm feeling kind of bummed about the labs and was wondering if anyone had any wisdom, experience, or information to impart.  Thank you!

lp1964's picture
Posts: 1240
Joined: Jun 2013

Chemo is very unpredictable and not two people are the same. I was gonna do two more Foldox, but my fingers and toes got so numb, the oncologist said no more, only the 5FU or the Xeloda. I had no major side effects and the blood looks good. 

You and your doctors have to be creative and flexible, there is no coockie cutter treatment here. Watch your blood work and pay attention to your body and adjust. Things will be fine.

All the best,


Trubrit's picture
Posts: 5462
Joined: Jan 2013

My bloods were all over the place, and I had three different cheno sessions cancelled because of it. 

I also had the shots, Neupogen, if its the same. I had them every week day for several weeks. They didn't hurt, it was just a pain going down to the hospital each day. 

I also had a transfusion of blood, two bags. 

All of that and here I am, five months out and looking pretty good, so I'd say the cancelled chemo sessions didn't hurt for me. 

Good luck!


Annabelle41415's picture
Posts: 6711
Joined: Feb 2009

While most of what you mentioned I've been through and asked the same questions.  My blood tests has tanked before as well and although they do and you might be missing a week or two, you will be fine as the chemo lasts in your body for longer than you think.  The first time that mine was delayed, cryed all afternoon thinking that now I'm not going to be getting the treatment that was needed, but was surely wrong.  You will be fine missing one week and it might give you renewed energy as well.  My white count tanked so I've also taken the injections of Nupugen (sp).  My husband gave it to me but be aware that every part of your bones might hurt because it is overproducing cells which causes your body to hurt.  You are normal going through all we have been through.  Wishing the best for you.  And keep asking away - you have excellent questions.


thxmiker's picture
Posts: 1282
Joined: Oct 2010

Folfox and toxicity


When I received the Folfox treatment, I dipped after the thrid treatment.   The Oncologist told me to wait a week, and then we will try again.   My labs had bounced back into good results and I received the next treatment.   The Oncologis told me they were trying to maintain a toxicity over a period of time, not necessarily get every treatment on the two week schedule.


Taking chemo is  aprocess and not a time schedule.  It would also be wonderful if a Doctor would just tell us what is going to happen and the real point of the chemo. (Toxicity over time vs schedule) The Oncology nurses seemd to be better at explaining the process.  The Forum has also been a wealth of information.


Best Always,  mike

TheLadySkye's picture
Posts: 195
Joined: Oct 2013

Thank you all for the input.  I did a bit of research after you all provided me the name of the injection they use to raise the platelets and white blood cell counts.  While I see that it is used quite regularly with chemotherapy patients, I would have to have a talk with my doc beforehand.  I saw that one of the dangerous side-effects (sometimes fatal) is an enlarged spleen.  I'm not sure what causes that as per se, but since I was a teenager, my doctors noted off and on during my physicals that my spleen seemed a bit enlarged.  Tests showed nothing of concern, and it seemed to resolve, but has been a sort of ongoing thing all my life.  And so I would worry if I am at higher risk for this particular effect.

While it stinks that my labs have been quite effected by the chemotherapy, it is comforting to know I am not alone in this experience and that effective management exists.  Thank you all so much for sharing your stories!

abrub's picture
Posts: 2167
Joined: Mar 2010

There is some good evidence that taking regular Claritin (Loratadine) every morning when getting these shots helps to minimize the bone pain.  The bone pain is from your bone marrow being stimulated to produce white blood cells.  Supposedly that causes a histamine reaction as well, which can be controlled by Claritin or Zyrtec (none of the others have been tested.)  These drugs do not adversely affect the effect of the neupogen/neulasta.

My daughter just received a series of neupogen shots because she was part of a research protocol that involved gathering her platelets (for cancer research.)  She took the claritin, and felt only a little achy.

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