Chemotheraphy Consultation - FOLFOX regimen

In between my stricture appointment and my takedown sugery, I made an initial appointment with a/the local Cancer Treatment Center (CTC). It was as expected, a review of what had been done so far. Then the FOLFOX regimen was explained to me.

I would have eight(8) treatments, one every two (2) weeks, so the whole regimen should take four (4) months. The two weeks are for the chemo to work, but also to give me time to recover somewhat between treatments. Each treatment would take about four (4) hours with blood tests, waiting for results, and the chemo would be delivered in stages, some taking more than an hour each.

So, we set my schedule. I needed to set aside 12:30 PM to about 4:30 PM every other Wednesday afternoon, beginning on May 9th, allowing two weeks for recovery from my takedown surgery (4/24). I would be ready. To start means I'll be one step closer to having it finished.

As for the details of the treatments:
FOLFOX is a nickname for the chemo drugs: Oxaliplatin, Fluorouracil aka 5FU, and Leucovorin. For more detail about these drugs, and what they are intended to do, consult the Internet. There's a world of information available from very reliable sources.

During this consultation, I was shown the CTC's chemotherapy suite, which is a brand new facility and very nice. There are several individual 'rooms', actually separated from each other by curtains. Each patient has their own large deluxe recliner with a little side table for reading material, drinks, snacks, etc. There is at least one extra chair for a companion. They've piped in cable to individual flat screen TV's and supplied a remote control plus a channel list, per patient.

Every chair has a view out the window, or shades if you want to cut out the light and sleep. Every chair is visible to the control desk so all the patients are always in view in case anything is needed. In addition to the technical services, the staff will also bring patients juices, soups, crackers, etc. It's really a very comfortable, very casual and friendly atmosphere, yet obviously the medical services are nothing but professional and exacting.

Each time I arrive for a treatment (my schedule is every other Wednesday afternoon), my vitals are recorded (weight, BP, temperature, etc). Naturally my current weight is vital for calculating my chemo volumes. Then I go to the chemo suite and pick out which chair I want from those available. My port is accessed and blood taken for a Complete Blood Count (CBC). Once the blood work results come back from the lab, then the delivery of the FOLFOX can begin. Thankfully, because I have a port, I get the one stick to access it and the rest is added through IV drip into that single line.

First is anti-nausea (anti-emetic) medicine, Decadron and Zofran. Although not everyone experiences nausea, statistically a majority will unless they receive preventative medicine. These meds don't harm people who would not have had any trouble, so it's protocol to give them to everyone. I have to wait until the anti-nausea meds are finished before we begin the first FOLFOX drug.

Second is the Oxaliplatin, which takes an hour or two to drip. Delivered concurrently is a bag of Leucovorin. When those are finished, I receive a megadose of 5FU via IV push. Lastly, I'm hooked up with a portable pump of more 5FU to be delivered continuously over the next 46 hours. When that's empty, by Friday afternoon, I return to the CTC to have the pump unhooked, ie, my port is deaccessed. Thus I am free of it for the weekend and until the next treatment.

Then, it's all about the side effects, which is what I will report in subsequent posts. Unless something unusual or additional happens, each treatment goes as described above.

Although the CTC personnel were friendly, good with explanations, and forthcoming as they fielded my questions, I did what I always do, I went to the Internet for verification and more information as available. What I found what that the CTC plan was exactly as is recommended. I also found the lists of possible side effects. As always, I'd just wait and see what happened for me and deal with those effects as they occurred.