Side Effects Kick In

Willie has is first Chemo round on Friday, 7/11. He had to be there from noon to 4:45pm and left with a pump. He had to go back on Saturday at 4:45pm to remove the pump after 24 hours. By Sunday morning he was feeling pretty good. No notable side effects to complain about except maybe an annoying sensitivity to cold. He tested that out with an ice cube and it shocked his tongue and also fingers. They warned him about this (see below for list of chemo drugs).

Increased sensitivity to the cold

Oxaliplatin can make you more sensitive to the cold. It can affect your throat causing it to feel as though it is difficult to breathe and swallow. This can happen whilst you have oxaliplatin or within a few hours of it finishing. It’s only temporary but can feel quite frightening.

Opening and closing the fridge or freezer, touching metal, eating or drinking cold foods and changes in temperature from the weather can trigger this.

It can help wearing gloves and avoid very cold food and drink before and after oxaliplatin.

Let your nurse know straight away if it's affecting your breathing and swallowing.

So…. That happened for sure but he was doing pretty good running around, mowing the orchard and feeling pretty good.

Then Monday, he started complain about his ankles hurting. Then Tuesday was a pretty bad day, didn’t feel well. His ankles and legs hurt and neuropathy is setting in more than his already numb left side. Today, Wednesday he pretty much felt like crap Taking Tylenol and trying to take it easy. Good news is eating is okay. He’s been trying hard to take in calories and healthy food I’m hoping he feels more better tomorrow. Thanks to the Kramer’s for the hard boiled eggs and tons of homemade tapioca pudding (twice! He loves it), Cindy Lee for the lovely zucchini bread with pecan’s, and Ashley Stanaway for the amazing potato soup with cheese and bacon toppings (on the day he got his port put in). Love and support by friends is amazing during this complicated and stressful time. Thank you!!

now for the copied technical part …

How do you have FLOT?

You have FLOT into your bloodstream (intravenously).

You have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

1. central line
2. PICC line
3. portacath

If you don't have a central line 

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.

Fluorouracil (5FU) pump

You might be able to have the infusion of 5FU at home through a small pump (if you have a central line ). You can keep the pump in a small bag, or a bag on a belt (like a bum bag). You’ll need to go back to the hospital after the second day of treatment, to have the pump disconnected. Or sometimes a chemotherapy nurse may be able to do this at your home.

How often do you have FLOT?

You have FLOT chemotherapy as cycles of treatment . Each cycle lasts 2 weeks (14 days). 

You usually have 8 cycles altogether. You have surgery to remove the cancer after cycle 4. Then you usually start the 5^th cycle 6 to 12 weeks after the operation.

You will usually take steroid tablets for 3 days. You start taking them the day before you start your chemotherapy.

You have each cycle of treatment in the following way:

Day 1

1. You have docetaxel as a drip into your bloodstream (intravenously) over an hour.
2. You have oxaliplatin as a drip into your bloodstream over 2 hours.
3. You have folinic acid as a drip into your bloodstream over 2 hours.
4. You have fluorouracil as a drip into your bloodstream over 24 hours. 

Day 2

1. Your nurse removes the fluorouracil drip.

Day 3 to 14

1. You have no treatment.

You then start a new cycle of treatment.

Tests 

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Before starting treatment with fluorouracil (5FU) you have a blood test to check levels of an enzyme called dihydropyrimidine dehydrogenase (DPD). A low DPD level means you are more likely to have severe side effects from this chemotherapy, so you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor, nurse or pharmacist will talk to you about this.

FLOT

FLOT is the name of a chemotherapy combination. It includes the drugs below. How to pronounce the drug names are in brackets. 

1. F – fluorouracil (floor-oh-yoor-uh-sil), also known as 5FU (this is the one in the pump he took home for 24 hours)
2. L – leucovorin (loo-koh-vor-in), also known as folinic acid or calcium folinate
3. O – oxaliplatin (ox-ali-pla-tin) (sensitivity to cold)
4. T – docetaxel (doe-see-tax-el)

It is a treatment for cancer of the:

1. stomach
2. food pipe (oesophagus)
3. area where the stomach joins the food pipe (gastro oesophageal junction)

You usually have FLOT before and after surgery to remove the cancer.