If your oncologist believes you will benefit from chemotherapy, he / she will discuss the best treatment plan options with you.
You may be prescribed one drug or a combination of drugs. Depending on the stage of your bowel cancer, you may also be recommended treatment with targeted therapies (also referred to as biological therapies or monoclonal antibodies).
The chemotherapy drugs licensed for treatment of bowel cancer in the UK are:
- 5FU (5-fluorouracil)
- Aflibercept (available in Scotland only)
- Raltitrexed (for people who cannot tolerate 5FU).
A combination of two or more drugs is common, for example:
- FOLFOX ( 5FU + oxaliplatin)
- FOLFIRI ( 5FU + irinotecan)
- FOLFOXIRI (5FU + oxaliplatin + irinotecan)
- CaPOX or XELOX (capecitabine + oxaliplatin)
- CAPIRI or XELIRI (capecitabine with irinotecan)
- DeGRAMONT/modified DeGRAMONT (combinations of 5FU and folinic acid)
If you have advanced (secondary) bowel cancer, your oncologist may recommend that a targeted therapy is added to your chemotherapy treatment. Targeted therapies are explained here.
Side-effects of chemotherapy
Each drug dose is calculated initially according to your body surface area. Each drug has certain characteristic side-effects to be aware of. These side-effects can be ‘risk assessed’ for likelihood by your oncologist, and dosages can be altered to suit your own circumstances.
These standard drugs are considered to have a moderate risk for developing common side-effects associated with bowel cancer chemotherapy, including nausea and vomiting, diarrhoea and febrile neutropaenia. In addition, patients who are prescribed oxaliplatin are likely to experience peripheral neuropathy.