Anybody Get FOLFOX Chemo After Metastatic Diagnosis?

@mmott - Early intervention is key to managing symptoms and preventing progression. Your oncologist’s dismissal of cold packs aligns with mixed evidence on cryotherapy’s effectiveness for symptom relief, though some patients try warm compresses for comfort. However I will say that the chemo nurses at Mayo Clinic kept a large supply of cold packs, so that was evidence enough for me to try it and it certainly worked.
Management Options:
Medications: Discuss gabapentin, pregabalin, or duloxetine with your oncologist to reduce neuropathic pain. Topical lidocaine or capsaicin may help, though capsaicin can initially increase burning.
Non-Drug Approaches: Acupuncture shows promise for CIPN relief; seek a licensed practitioner. Physical therapy can improve circulation and nerve function. Gentle massage may help, avoiding aggressive pressure.
Lifestyle: Wear cushioned shoes and loose gloves to reduce nerve irritation. Ensure adequate B vitamins (especially B12) through diet (eggs, fish) or supplements, after checking with your doctor. Track symptoms in a journal to share with your care team.
Monitoring: Ask about dose adjustments or less neurotoxic chemo drugs if symptoms worsen. A neurologist or pain specialist referral could provide tailored strategies.
With only four treatments, your neuropathy may be manageable or reversible with prompt action. Advocate for a multidisciplinary approach and consider support groups for patient insights. Consult your oncologist before trying new interventions. Can you please share your complete chemo regimen? It might help you to keep a journal so that you can share onset severity and specific symptoms with your oncologist. Could that possibly work?

@mmott - I forgot to add that in addition to my what I would call mild neuropathy it was more concerning was early symptoms of ataxia.... Such that I had difficulty hiking in the woods and had to carefully place my steps. Thankfully that resolved after chemo finished but be on the lookout for those symptoms as well. Good luck to you

@predictable, that must've been an extra blow to learn that the cancer had spread. What did you and your oncologist decide regarding chemotherapy?

Has your oncologist considered Histotripsy as an alternative liver treatment? Excerpt below from recent post at this forum.

"... What is Histotripsy?: Histotripsy is an FDA-approved, non-invasive ultrasound-based technology that uses focused sound waves to mechanically break down targeted tissue (like tumors) without incisions or heat. It’s being studied for liver tumors, including metastases and primary cancers like hepatocellular carcinoma. The procedure creates microbubbles in the tissue, which collapse and destroy cancer cells with precision, sparing surrounding healthy tissue. It’s appealing because it avoids surgery and often doesn’t require general anesthesia.
Use at Mayo, MD Anderson, and St. John’s: Mayo Clinic and MD Anderson have been involved in histotripsy trials, particularly for liver cancer, with promising early results..."

Thanks for the hug @gbm, however I'm no longer involved with this forum

Good morning, Colleen. Nice to hear from you in these grueling times.

My oncologist and I haven't met on a chemo decision yet, thanks to a positive turn in the diagnosis of the small tumor on external lining of my liver. It's pending a classification by pathology -- originally a Stage 2 within my colon, but as a metastatic tumor, now a Stage 4.

However, additional tissue analysis -- using HER2 staining techology -- comes out with a zero risk assessment of malignancy. Oncologist and I have that at the top of the agenda for our next discussion.

I've learned enough about FOLFOX chemo to avoid it in favor of single-agent chemo options, but both of those are pretty old traditional treatments, and I'll inquire about technologies in use over the past couple of years. I'll keep you apprised!

Martin

@predictable, I look forward to hearing what you learn and what you and your oncologist decide. Is age part of the decision-making criteria? Co-existing conditions? What else?

Hi, Colleen. I'm awaiting the oncologist returning to the office to schedule a discussion with him. My age is a decision-making factor, but perhaps in an unusual way in my mind. Nearing age 90, I feel in good health despite a history of hypertension and cancer. Removal of most of my colon reduced benefits from my digestive system, and that has led to loss of musculature to the tune of a quarter of my body weight. My urinary system lacks efficiency from my kidneys and clearance through my prostate. And atrial fibrillation is an inconvenience for my heart but without any conscious symptoms. My blood pressure improved to normal levels for me after my PCP and cardiologist agreed I should drop use of a beta-blocker heart med after several years.

The age factor weighs in favor of focusing on using the lifetime I have left to help build public and political support for the new treatments and cures emerging from medical research over the last couple of years. Some of those are exciting and promising, and I'd enjoy being a guinea pig in making them safe and effective. Martin