FOLFOX Chemotherapy

FOLFOX chemotherapy comprises of Folinic acid, Oxaliplatin and 5-Flurouracil treatment for advanced stomach cancer & pre-surgical neoadjuvant therapy.

It is normally given through a central or Hickman line as it can cause a condition known as phlebitis, a painful condition that causes inflammation of the vein.

A cycle of this therapy normally lasts 14 days and you can have repeated cycles for a maximum of 10 treatments.

Like any drug regimen, it is not without side effects which you can read about later.

What Is FOLFOX Chemotherapy?

The two cancer killing agents in FOLFOX chemotherapy are 5-Flurouracil or 5-FU and Oxaliplatin, also known as Eloxatin.

The 3rd drug, Folinic acid (also known as Leucovorin)  is not a chemotherapy agent, rather it works to potentiate the effect of 5-FU on your cancer.

It does this by inhibiting the enzyme called Thymidylate Synthase, which is required to produce Thymidine Triphosphate, a substance needed in the production of your DNA or deoxyribonucleic acid.

It therefore helps in the repair of your DNA when 5-Flurouracil is causing damage to your stomach cancer cells.

It is quite time consuming to have in comparison to EOX treatment as you have to have the Oxaliplatin infusion over 2 hours and then the 5-Flurouracil over nearly 24 hours (this can sometimes be given at home).

It is FOLinic acid, Fluroracil (Adrucil, Efudex, Fluoropex) and Oxaliplatin (Eloxatin)  that gives FOLFOX its name.

Does It Have Side Effects?

FOLFOX chemotherapy side effects are similar to other chemotherapy drugs. These include:

Allergy to the medicines

Neutropenia – a drop in your white blood cell count is likely to occur around day 10 to 14 with this treatment and place you at risk of severe infections

Fatigue and Tiredness

Hair loss or ‘alopecia’

Bruising – due to a drop in your platelet count as it can cause suppression of your bone marrow production of these cells

Anemia – causes tiredness, breathlessness, muscle aches, headaches and fatigue

Nausea, Vomiting and Diarrhea

Peripheral Sensory Neuropathy – causes numbness or “pins and needles” in your hands and feet particularly with the Oxaliplatin

Mucositis – ulceration and inflammation in the mouth. This can make it quite difficult to eat

Infertility issues

Photosensitive – your skin can be sensitive to light causing sunburn.  Swallowing difficulty and sensitivity to cold drinks

Precautions You Should Take On FOLFOX Treatment

  • You need to make sure that you cover up in the sun and wear a hat to protect your head when having this treatment because of your skins sensitivity to light.
  • If you are a young female and on FOLFOX chemotherapy, discuss with your oncologist before starting as you may need to consider egg harvesting before commencing this therapy if you wish to consider having children when you have recovered from stomach cancer.
  • Equally, if you are a young male, you may wish to consider sperm storage in case you are rendered infertile from this treatment.
  • Your doctor should know not to give you any ‘live’ vaccinations and you should also avoid anyone with an infection.
  • Make sure you keep yourself clean and care should be taken with brushing your teeth and oral hygiene in general.
  • If you develop a fever or any new symptoms, please seek urgent medical advice.

FOLFOX Success Rates

FOLFOX chemotherapy has a 45% response rate and complete regression in about 4.6% of people that have this form of treatment.

It is best as a neoadjuvant chemotherapy option before surgery in those amenable or have only local invasion of their stomach cancer.

It is better tolerated better than EOX chemo, but not quite so effective although it does take longer to give and is also more frequent (every two weeks instead of three).

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