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Treatment for Stage IV Colon Cancer

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Last Modified: July 25, 2004

Dear OncoLink "Ask The Experts,"

My father was just recently diagnosed with Stage IV colon cancer. His oncologist has given him a good prognosis. He will start chemotherapy soon with 5-FU, Avastin and Oxaliplatin. He is very worried about this. How bad are the side effects? Do these drugs make you very sick? What can be done to lessen any negative effects?

Carolyn Vachani RN, MSN, AOCN, OncoLink's Medical Correspondent, responds:

Chemotherapy works by attacking rapidly dividing cells. Tumor cells divide rapidly. Unfortunately, some of the body's healthy cells also divide rapidly. This can lead to the side effects commonly seen with chemotherapy. For example, 5-FU can cause mouth sores. The cells in the lining of our mouth divide rapidly – think about if you accidentally bite your cheek; it will most likely be healed by the next day. This rapid division makes it a target of some chemotherapies.

Different chemotherapies cause different side effects. Every individual reacts differently to these medications, making it impossible to predict how someone will do on treatment. Some patients have minimal side effects and go about their lives as usual (many even continue to work everyday), while others have a harder time dealing with the side effects. Some side effects occur right after treatment, while others occur a week or so later.

Avastin is a different type of medication called a monoclonal antibody. These are "smart" medications. They are antibodies made to seek out and attach to a substance that stimulates blood vessels to grow in tumors. Once attached, they recruit the body's own immune system to inhibit the growth of these blood vessels. Antibodies are given in combination with chemotherapy. Their side effects differ from chemotherapy and include bleeding, high blood pressure and heart failure.

The following links cover the side effects for the medications your father will be getting, but only time will tell how he will react to these medications. These medication descriptions also give you tips to handle the side effects.

• Fluorouracil (5-FU)
• Oxaliplatin
• Avastin

You should also know that stage IV colon cancer is not generally curable. The chemotherapy is used to keep the cancer from growing and, hopefully, cause it to shrink. If the chemotherapy is stopped, it is likely that the cancer will grow again. Cancer cells are smart, and they eventually start to outsmart the chemotherapy. At that time, the physician would change the medication the person is receiving in the hopes of killing more tumor cells.

I hope this helps you better understand the treatments your father is going to receive.