Starting Chemotherapy

Posted 5 January 2016

Once out of UCSF hospital, we all felt we could no longer wait for their oncologist who specializes in these types of cancers to be available. So I went to see a local cardiologist on the 25th, just before Thanksgiving.

Dr. Dean was blunt in his assessment, that chemotherapy would probably help but that it would be palliative, not curative. It nevertheless seemed the right thing to do, so the wheels were put in motion. After Thanksgiving I had a port installed in my chest, so they can infuse drugs into me more easily. Then I had a training session with a chemo nurse so I’d know what to expect and what I needed to do.

I had my first chemo session on December 7. I’m on a regimen called FOLFIRINOX, which is a combination of:

Each cycle starts on a Monday, when I go in for a nearly full day of infusions. It starts with some anti-nausea meds, and then 2 hours of oxaliplatin. This platinum-based drug is the source of my most annoying side effect, peripheral neuropathy (more on that later).

Then I get 90 minutes of a double feed, both leucovorin calcium and irinotecan hydrocloride.

And for the grand finale, I get a “push” (a modest dose over a 5-minute period) of flourouracil, and then get hooked up to my take-home pump, which continues to deliver that drug at a much slower rate for 46 hours.

So Tuesday is my day at home with my pump (though I can certainly go out with it), and on Wednesday after lunch I go in to have it removed (“pump down”, in chemo lingo).

Generally Thursday and Friday I feel lousy, and I then I get a better week before the next cycle begins, two weeks after the start of the previous one.