In approximately every colon cancer consultation, patients demands for the finest and best cure available. However the solution may not be clear-cut.
For the patients with metastatic colon cancer there are numerous treatment and cure options in addition to clinical trials. Most common in the Unites States the combination of 5-FU/LV and Oxaliplatin is being utilized, also know as folfox. There is an another combination is also popular which consists of 5-FU/LV and Irinotecan, also known as folfiri.
Both regimens appear to have similar efficiency and similar extend of toxicity, however the quality of toxicity may vary. For Oxaliplatin the dose limiting toxicity is the
neurotoxicity, which patients portrays as numbness and tingling sensation which may interfere with function such as buttoning of shirts or even in walking.
For Irinotecan the dose limiting toxicity is diarrhea, which is vital to treat mainly when at the same time the white blood cells drop. There is a noteworthy difference between both toxicities, for neurotoxicity it is accumulative which means that with more chemotherapy the likelihood of this ill effect increases.
That is not the case for the diarrhea caused by Irinotecan. For females, if you had no diarrhea during the first two cycles, you will not develop it later on. Your medical history may be very chief in making treatment recommendations. Patients with ongoing diarrhea caused by inflammatory bowel disease need to be watchfully assesses for Irinotecan therapy .
Alternatively, patients with very old diabetic condition, which can cause some neurotoxicity should be not treated with Oxaliplatin.
Both combinations show overall similar response rates meaning the same percentage of patients have tumor shrinkage of 45% or more with chemotherapy. The risks, limitations and side effects profiles need to be consulted with their oncologist.
Irinotecan may lead to some sort of hair loss which for some patients is a reason to consider Oxaliplatin therapy or hair restoration hair replacement treatment. What is also vital is that when a potential surgery of liver metastases is considered, it may be safer with folfox since Irinotecan appears to cause more liver damage than Oxaliplatin therapy.