Monday, February 15, 2010

Chemo II: Return Of The Pump

5-FU is back and he's brought some friends!

I'm about to start the next set of chemo.  There are 12 treatments in all and each lasts three days.  This regimen differs from the previous in a couple of ways: I'll be on three drugs instead of one and the treatment will be for two days every two weeks instead of five days per week.  On day one, I'm hooked up to my old friend, the 5-FU continuous infusion pump.  I'll also get an leucovarin and oxaliplatin infused over three hours.  On day two, I'll continue to wear the pump and on day three it will be disconnected.  I should be finished in mid-July.  Here's more on the drugs:
  • 5-FU (5-fluorouracil), which I was on last time, inhibits RNA and DNA synthesis.
  • Leucovorin is a derivative of folic acid.  It enhances the effect of 5-FU and prevents neural tube defects in developing embryos (another way colon cancer is like pregnancy).
  • Oxaliplatin also inhibits DNA synthesis, maybe by alkylating the DNA (the FDA approves drugs based on efficacy, often without knowing exactly how they work in vivo).
Oxaliplatin has some miserable side effects.  There's the run-of-the-mill stuff, nausea, diarrhea, reduced white blood cell counts.  Then there's the neuropathy. I'll have an extreme sensitivity to cold, such that I won't be able to take anything out of the refrigerator without wearing gloves.  I shouldn't take things out of the fridge anyway because if I ingest something cold I'll feel like I'm suffocating.  Then, as the weeks go on, I'll start losing the feeling in my fingertips and toes.  I'll have a hard time buttoning a shirt, tying my shoes, and doing other fine motor skill tasks that we take for granted.  Basically, I'll fail a field sobriety test without drinking.  Another side effect is hearing loss.  So, if I were to have a field sobriety test, I wouldn't even hear the policeman's instructions.

I've been a little disappointed in my therapy so far - not the efficacy, but its age.  5-FU, radiation, and surgery have been used against cancer since the 1950's. In practical terms, this is like driving a car with manual windows and door locks, no A/C, and an AM radio (in other words, Pasco, like your last rental car).  Sure, it will do the job, but it's boring and unsexy.  Other cancer patients are getting interferons, interleukins, and things that end in "mab" and "ux," while I was getting grampa's chemo.  Oxaliplatin, however, was approved in 2002.  So, finally I'm getting a 21st century drug.


  1. And we are to believe it is a coincidence that this 24 week period of inability to do anything but watch TV (with Mrs. 270 having to get things from the fridge for you)occurs during the knock-out stages of Champions League and the World Cup.

    I wasn't born yesterday.

    In fact I was born in the 1950's. So I guess that makes me BaRRD- FU . At least for that grandpa comment. ;-)

  2. Actually, Mrs. 270 has been insisting that we buy a 42" (or larger) flat-panel TV for the World Cup - the things we do for love.

  3. So, my mother's battle with breast cancer got her a new boob, and is yours is getting you a new tv...

    I can't come up with a punchline here. OWNTF, 270, somebody find it for me!

  4. My elderly generation referred to the TV as the Boob Tube. But can your Mom claim 42"?

    270: I am totally out of my league on anything electronic, but Mr. BaRRD says make sure you get HDMI cables. On the ESPN Hi Def games you will duck if Rooney kicks a ball towards the camera.

  5. Boobs, tubes, ducks... this is getting weird.

    As a conservative, I must say that EVERYTHING that came out of the 50s is great, so you're good to go, I-270. Rockin' and a rollin' all night long!

  6. No feelings in fingers and toes, sounds like this winter in Florida.