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Mortar_and_pestel

Regimen Information

For FOLFOX, including Side Effects

FOLFOX

Drugs in this Regimen:

For the treatment of Colon Cancer

How FOLFOX chemotherapy is given and possible side effects.

FOLFOX for the treatment of Colon Cancer

FOLFOX is the acronym for a chemotherapy regimen used in the treatment of colon cancer.

DRUGS IN THE FOLFOX COMBINATION:

FOL

= Leucovorin Calcium (Folinic Acid)

F

= Fluorouracil

OX

= Oxaliplatin

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

MOST COMMON SIDE EFFECTS OF FOLFOX

  • Risk of Infection

  • Diarrhea

  • Mouth Sores

  • Hand Foot Syndrome

For more information, see the 'Expert Resources' tab below.

Community Responses

Often, the most helpful information regarding treatment side effects comes not from clinical brochures, but rather from other patients like you. We've collected the most helpful community resources to help you prepare for the side effects and coping tips for your chemotherapy regimen.

What side effects did you experience while on this medication?

The following have been voted the 3 most helpful responses to this question.

I'm tankee, and I'm a survivor of Stage 3 Colon Cancer

First two days of cycle are tolerable with the steroids and antinausea drugs given with chemo but neuropathy has become worse each time. The runs on days 3 and 4 are not too severe and appetite loss on those days also just keep me pumping fluids alone. Then the stomach acid burning starts and I crave fat. The fat actually seems to coat and protect from the burn. First thing I eat then is usually bacon or fried chicken. Weird intolerance to cold is present and I keep gloves near the fridge to handle food till it’s heated. More tired and weak each treatment, seems cumulative. Vertigo and neuropathy became so severe that after my fourth cycle they increased the chemo interval from two weeks to three. One thing that has helped with the neuropathy is Recancostat. It contains a precursor of a chemical neurotransmitter. It is available OTC and pricey but it does help. I took two before starting my last cycle and it seemed to prevent the severe swelling in my throat that had inhibited breathing after the last two cycles and previously required emergency oxygen. It had helped before but I had taken it after the symptoms started. It took about a half hour to start to work when symptoms were in progress. I also take “Calm,” a magnesium supplement that seems to help with vertigo and relaxes muscles. B-12 shot also seemed to help. If you have a bad taste in your mouth from chemo, try using plastic utensils rather than metal. I was exercising regularly when I started chemo but am too compromised currently to do much. This is problematic. I am sleeping well and in little pain, blessings. It’s been 2 weeks since last cycle started and I will have one more week to recover before starting my number 6 cycle. Previous to starting chemo I had my ascending colon with 6.5 cc mass removed. 22 biopsies of surrounding lymph nodes showed 2 with stray cancer cells. They say I’m stage 3.5-3.75. I think this whole regimen is a dice roll but it’s the best chance we have right now. I’m pretty sure, down the road, we’ll all be saying, “Can you believe we used to treat cancer by slowly poisoning people.” Hoping some of the new treatments using the immune system to target the cancer will be available soon to all, in case we need another round. I’m sure there has to be a better way than this. Good health to you all from a well traumatized patient trapped in her frozen north country prison.

  • Tue Dec 2, 2014
I'm Shane, and I'm a survivor of Stage 3 Colon Cancer

I am about to do treatment #6 of 12, so far I get a sore mouth with lots of watery saliva that is difficult to spit out because it is so thin. A bad taste and a feeling toxins are leeching out of my mouth and tongue, I don’t like to swallow this as I believe if it’s coming out why swallow it back again. Pins & needles when I hold something cold and pins & needles in my throat when I drink a cold drink although these symptoms usually last about a week and I feel god for a few days then it’s time for another treatment and start feeling sick all over again. My hair is still intact and there may be some slight thinning but it is not noticeable.

  • Sat Feb 9, 2013
I'm Fred in Seattle, and I'm a survivor of Stage 3 Colon Cancer

Dizziness/fuzzheadedness are a significant side-effect I’ve had and the best thing to do I’ve found is hydrate, hydrate, hydrate!

  • Wed Nov 14, 2012
Dee
Dee
I'm Dee, and I'm a survivor of Stage 3 Colon Cancer
Dee

I found constipation as main problem with this medicine and my soft piles become active.I am trying to resolve this problem by eating Prunes,figs and more fiber.It is working but upto 70%.Also found numness in all fingers top portion,can’t drink normal water.

  • Mon Dec 3, 2012
Dee
Dee
I'm Dee, and I'm a survivor of Stage 3 Colon Cancer
Dee

I found wheat grass juice availble through Booster juice very helpful.I also do breathing excercise every morning and feel very good.

  • Mon Dec 3, 2012
I'm Suzybee, and I'm a survivor of Stage 2 Colon Cancer

I had stage 2 colon cancer with a mass, no lymph nod. And just about every side effect from chemo. I ended up in the hospital 10 days after my first treatment because of fatigue and a fever of 101.9. I’m on an antibiotic and have been instructed to missed my 2nd chemo treatment because my body is not handling it very well. I feel like its gonna kill me before any rogue cancer cell..is anyone else going through this? I’m thinking I may stop chemo.

  • Thu Jan 31, 2013
I'm mikem1, and I'm a survivor of Esophageal Cancer

Have had two cycles of the treatment and will have the third in three days. So far, the side effects have been minimal. Fatigue the first few days after the treatment, metallic taste, slight hair loss and mild constipation cured with prune juice. I know everyone reacts differently but if the side effects remain the same this is very tolerable. I have had some chemo brain that is bothersome but tolerable. At times very irritable and unfair the way I treat my family. I exercise 1 1/4 hours every day and I think that helps.

  • Sat Feb 9, 2013
I'm Shane, and I'm a survivor of Stage 3 Colon Cancer

I am about to do treatment #6 of 12, so far I get a sore mouth with lots of watery saliva that is difficult to spit out because it is so thin. A bad taste and a feeling toxins are leeching out of my mouth and tongue, I don’t like to swallow this as I believe if it’s coming out why swallow it back again. Pins & needles when I hold something cold and pins & needles in my throat when I drink a cold drink although these symptoms usually last about a week and I feel god for a few days then it’s time for another treatment and start feeling sick all over again. My hair is still intact and there may be some slight thinning but it is not noticeable.

  • Sat Feb 9, 2013
I'm Joan greenberg, and I'm a survivor of Stage 4 Colon Cancer

I get horrible runs. Limotil and imodium ad are magical. To prevent this, take 2 limotil 1hr prior to start of chemo sessions. Also drink lots of tonic water,diet, mixed w fruit juice. Replenishes potassium.
I also fight fatigue. I take the day after chemo off from work to rest rest rest, and I take long naps on the weekends. Sometimes I sleep and read in bed all day on Saturday. But I am still working!!!!

  • Thu May 23, 2013
I'm manyhats, and I'm a survivor of Colon Cancer

Am about to do round 5 of 6. No mouth sores. Thinning hair, CBC’s every week come back normal. Can’t pick up ice right after treatment and feels like a piece of metal is in throat when I drink anything cold. These feelings go away after 24 hours. Only nausea is when pump is removed and I’m down for about 36 hours.

  • Mon Jul 1, 2013
LGH
LGH
I'm LGH, and I'm a survivor of Stage 4 Colon Cancer
LGH

I have completed 7 of 12 treatments. My side effects have been:
Diarrhea- lots and lots of it.
Cold sensitivity- last for about 6 days.
Mouth and nose sores- regularly
Nausea- frequently
Peeling hands and feet: on and off
Hair thinning- have lost about 2/3 of my hair.
Menopause ?- Haven’t had a period in 3 months.
Fatigue – lots
Chemo Brain- off and on
Nose and Rectal bleeding- frequently
Hemorroids-

  • Mon Jul 22, 2013
I'm Michelle F, and I'm a survivor of Colon Cancer

I have completed 2 out of 12 treatments. Side effects have been; fatigue, neuropathy, constipation, brain fuzziness. These are the side effects that I can see/feel, my biggest concern is what I can’t see and what damage is being done. I have decided to not return to chemo and monitor/treat with an herbal regimen. Any others using herbs?

  • Mon Jul 29, 2013
MM
MM
I'm MM, and I'm a survivor of Stage 3 Colon Cancer
MM

I just completed 4 of 12 treatments.. The first 2 was very tolerable but after the 3rd therapy I almost decided to quit. #4 was easy again. I feel fatigueness the first week but I exercise for an hour each morning. I think it is the best way to handle the fatigue, somewhat it restores energy.
The taste in my mouth is a big problem. I feel I have to suck candies, Halls all the time and I chew a gum. Food is a problem as well, I never know what I am in the mood for and how it will taste.

Drinking water became difficult but I force myself, I know I have to hydrate my body and get rid of toxins. I eat tons of fruits each day, I do not get constipated or diarrhea.
My strongest advise is to cope with this chemo therapy is #1 you must EXERCISE, go for a.walk 1 hour each day, eat lots of fruits and vegetables, no matter what drink lots of liquid

  • Sat Sep 28, 2013
I'm Daryl, and I'm a survivor of Stage 2 Colon Cancer

2 down, 10 to go. Rash on face morning after chemo. Infusion pump for 44 hours, happy to get taken off. 3rd day nausea sets in, little appetite. Well hydrated, depressed, tired. Walk smile several times a week. Getting stronger. Learning experience everyday. Board! Wish I could go back to teach soon.

  • Thu Oct 31, 2013
I'm Natural1, and I'm a survivor of Colon Cancer

I haven’t started chemo yet, but am taking notes on what to do when I have to deal with side effects. Thanks for all your comments for me to learn from. One question I have is: Are the side effects worse on day one, two, or three? I’m trying to plan my work week.

  • Mon Jan 13, 2014
I'm LTAI, and I'm a survivor of Colon Cancer

I actually took 6 sessions of a light chemo, every Thursday for 2 hours, because I was skeptical about this Leucovorin chemo that doctor insisted that I needed even though I was told that the stage 3 colon cancer was no longer in my body after the surgery, by the surgeon and the chemotherapist. I felt perfectly heathy and all my vitals we great, CT Scan, PET Scan all negative. Well last week I began this new more aggressive chemo on a Tuesday. After 3.5 hours I was then connected to my port and given addition chemo to take home for 2 days. After being disconnected and receiving more fluids and released. That evening I had severe diarrhea, nausea, cracked hands, and feet, dry mouth. I was ill the whole weekend and on Monday I called my chemotherapist and was told to come into office. I was then administered additional fluids of Dextrose and Saline and sent home feeling fair. That evening the diarrhea did return, and now blooding nostrils. Tuesday I was sicker that sick. Wednesday during the early am about 3, I decided it best to go into the emergency room at my doctors hospital. They immediately admitted me and began giving me fluids because my body was totally dehydrated. I spent 2 days in the hospital and released Friday afternoon and told to rest and drink plenty of fluids. Well I’m done with chemo and will now take a more holistic, juicing and vegetarian approach. I can’t take another 5 sessions of this.

  • Sat Mar 1, 2014
Hi, I'm Mike Behnke, and I'm a Stage IIIC Colon Cancer Survivor
Finished FOLFOX regimine in June 2011, Xeloda+ targeted radiation (for 2cm hot spot node) in Dec 2011, and have been clear since. CEA leavels remain below 2, with semi-annual CAT and PET scans showing no recurrance. Main side effect was the neuropathy caused by the Oxaliplatin. Effects started almost immediately with cold surfaces, food and liquids causing severe shooting pains, almost like being impaled with needles. Cleared within 2 days of first chemo session, but got worse and lasted longer until oncologist stopped the Oxaliplatin after sixth session. Second worse side effect was Hand and Foot syndrome. Severe, but treatable, cracking on palms and soles, wherever creases in skin occur. Helped immensely with copious applications of Silvadene (Silver Sulfadiazine). Antibacterial and moisturizing. Weekly pedi’s and mani’s also helped. Little to no digestive issues. Mainly just loose, but controllable BM’s (with OTC anti-diarrhea meds). IV Compazine and Zofran included with each session. Rx for both also available at home, but seldom needed. Major loss of taste. Food needed to be highly spiced, but little sodium added. Swallowing got difficult, but manageable. Large quantities of fresh fruit, vegetables and protein (GT 200 gr/day) for diet. Lots of whey protein shakes made with whole milk, which were easy to swallow, especially after Oxaliplatin was stopped. Little, if any, hair loss noted, much to the chagrin of my wife, who calls me her “monkey man”. Did notice body hair became finer over time, but has since returned to normal coarseness. Added 2g Fish oil, 2g Niacin, 100mg B6, 1000mcg B12, 4000IU D3, high potency men’s multivitamin, 40mg Acidopholous and 81mg aspirin to daily diet. Maintained 2-3 miles/day on treadmill for cardio health and low level weight training for muscle toning. Added 5 lbs over course of treatment. Also maintained 40 hour work week, except for my “Chemo Fridays”.
  • Sat Apr 26, 2014
I'm tankee, and I'm a survivor of Stage 3 Colon Cancer

First two days of cycle are tolerable with the steroids and antinausea drugs given with chemo but neuropathy has become worse each time. The runs on days 3 and 4 are not too severe and appetite loss on those days also just keep me pumping fluids alone. Then the stomach acid burning starts and I crave fat. The fat actually seems to coat and protect from the burn. First thing I eat then is usually bacon or fried chicken. Weird intolerance to cold is present and I keep gloves near the fridge to handle food till it’s heated. More tired and weak each treatment, seems cumulative. Vertigo and neuropathy became so severe that after my fourth cycle they increased the chemo interval from two weeks to three. One thing that has helped with the neuropathy is Recancostat. It contains a precursor of a chemical neurotransmitter. It is available OTC and pricey but it does help. I took two before starting my last cycle and it seemed to prevent the severe swelling in my throat that had inhibited breathing after the last two cycles and previously required emergency oxygen. It had helped before but I had taken it after the symptoms started. It took about a half hour to start to work when symptoms were in progress. I also take “Calm,” a magnesium supplement that seems to help with vertigo and relaxes muscles. B-12 shot also seemed to help. If you have a bad taste in your mouth from chemo, try using plastic utensils rather than metal. I was exercising regularly when I started chemo but am too compromised currently to do much. This is problematic. I am sleeping well and in little pain, blessings. It’s been 2 weeks since last cycle started and I will have one more week to recover before starting my number 6 cycle. Previous to starting chemo I had my ascending colon with 6.5 cc mass removed. 22 biopsies of surrounding lymph nodes showed 2 with stray cancer cells. They say I’m stage 3.5-3.75. I think this whole regimen is a dice roll but it’s the best chance we have right now. I’m pretty sure, down the road, we’ll all be saying, “Can you believe we used to treat cancer by slowly poisoning people.” Hoping some of the new treatments using the immune system to target the cancer will be available soon to all, in case we need another round. I’m sure there has to be a better way than this. Good health to you all from a well traumatized patient trapped in her frozen north country prison.

  • Tue Dec 2, 2014
I'm Mary Ellen, and I support someone with cancer

My fiancé is having severe, unrelenting diarrhea x 8 days now (following treatment #5). Also bad nausea. We have been in for IV fluids twice this week. We cannot get on top of this. He’s lost 11 lbs in a week. In a day he’ll have a half banana, 1-2 spoonfuls of applesauce or canned peaches. Can’t drink more than a sip of anything every so often. He’s terribly weak (surprise!).
Any tips???

  • Thu Jan 15, 2015
I'm Mary Ellen, and I support someone with cancer

Addendum…
Lomotil, Immodium, Zofran, Compazine, Marinol not cutting it!

  • Thu Jan 15, 2015
I'm rajiv, and I'm a survivor of Stage 2 Colon Cancer

I had my sigmoid colon removed,and few sections of my large intestine also,along with46 lymph nodes.lymph nodes showed negative,and my pathology report says stage2c.I have been taking folfox chemotherapy,I completed 7 cycles,only side effect I have is severe diarrhea,now I have planned to take oral chemotherapy for the balance cycles.

  • Tue Aug 18, 2015
I'm Jazz Mouse, and I'm a survivor of Stage 3 Colon Cancer

I’ll second the majority of the post made on Dec 2, 2014, except that I didn’t need / experience anything requiring emergency oxygen, and I personally haven’t tried the Recancostat (the poster is right — it is PRICEY).

As of a few days ago, I’m halfway through a 12-cycle treatment with the modified FOLFOX6. I’m trying to maintain my normal full-time job but it’s tough with the fatigue and majorly severe tension (???) headaches that I get from the Oxi and also the Zofran I take to combat nausea.

  • Thu Aug 27, 2015

This discussion needs your voice!

What were the specific side effects that you experienced while taking this medication? How did you manage them?

What coping tips would you give to new patients on this regimen?

Hi, I'm Mike Behnke, and I'm a Stage IIIC Colon Cancer Survivor

- Maintain a positive mental attitude.
- Consider joining a meditation or hypnosis group for relaxation and stress relief.
- Keep yourself informed. Be a part of your treatment.
- Make your oncologist and their staff your new best friends. Tell them of any, and all, complications your are having with your treatment. They literally have your life in their hands.
- Concentrate on yourself, but don’t isolate yourself.
- Keep your family and close friends in the loop as much as your feel comfortable with. They will understand. You need as much support and encouragement you can get. Don’t be afraid to ask for support, physical or emotional.
- Now is a good time to rid yourself of toxic relationships through relationship reduction. Toxic relationships will just drag you down.- Stay as active as possible, but don’t drain yourself.
- Eat well and get lots of rest.

  • Sun Apr 27, 2014

This discussion needs your voice!

What do you wish you had known before taking this medication? What information would you like to pass on to patients who are beginning this medication?

Treatment Overview

This chemotherapy regimen is commonly used to treat:

Other chemotherapy regimens for the treatment of Colon Cancer:

See Expert Resources

The Navigating Cancer Library includes articles about cancer, chemotherapy regimens and drugs from the the National Cancer Institute and other experts.

Specific Facts for Your Diagnosis

Learn about treatment options and managing side effects from experts.

Get Support on Your Cancer Journey

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