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Chemotherapy for Pancreatic Cancer FOLFIRINOX
>> YOUR LINK HERE: ___ http://youtube.com/watch?v=--txIviRWdw
Dr. Michael Pishvaian discusses FOLFIRINOX, a chemotherapy approach to treating Pancreatic Cancer. It has some common side effects, such as nausea, hair loss, and sometimes vomiting. He helps you understand what symptoms you might encounter during the treatment. • • More Videos: https://ruesch.georgetown.edu/rueschr... • Transcript: • So FOLFIRINOX can be a difficult regimen to tolerate. Although in my practice, I've found that as we get more experienced with using FOLFIRINOX, we're able to get most patients through it pretty well. FOLFIRINOX can certainly cause typical chemotherapy side effects such as nausea and vomiting. Although the vomiting doesn't tend to be a big problem. And in fact, I tell my patients I've they've gotten to the point that they're actually vomiting, not just nauseous, then we need to do more to improve their anti-nausea regimen. • Patients are nauseous, and usually for about two or three days out of every two weeks. Certainly not the entire two weeks. The other big side effect to watch out for is diarrhea. The diarrhea tends to hit around day five or six. And that's actually fairly predictable and does respond to over the counter medications such as Immodium AD. But again, there are more supportive medications, more anti-diarrheal medications we can add if the diarrhea becomes a real problem. • Less common side effects and those that are usually responsive to adjusting the dose of the chemotherapy are things like mouth sores, significant fatigue. It can cause in some cases troubles with the hands and the feet. And then over time there are some other side effects that certainly will develop. The oxaliplatin invariably will cause neurotoxicity. And there's two kinds of neurotoxicity. One is an immediate sensitivity to cold, where from the time of the first infusion, the patient will be very very sensitive to ice cold drinks or touching the freezer, or things like that. • And we recommend that they hold off from ice cold drinks for about two or three days. That usually goes away after two, three days. And the second week of the two weeks is usually tolerable. But over time, usually over about four to six treatments with the oxaliplatin, there's a second kind of neurotoxicity called numbness and tingling, or paresthesias that can really start to develop. And if it's not watched very closely, it can really become a long-term problem. • So your oncologist should really talk to you almost every time he or she sees you to see if you're developing significant numbness and tingling type of neurotoxicity. Finally there's things like hair loss, which unfortunately does happen in most patients with irinotecan. And has significant effects on the blood counts, which is why we often give that shot, which is called Neupogen or Neulasta on the fourth day of the treatment.
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