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Chemotherapy: FOLFOX

What Happens During FOLFOX Infusion At The Treatment Center

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Each FOLFOX treatment starts at a cancer center or doctor's office. 

Before the drugs are administered, medical staff will:

  • Ask about side effects you experienced since the last infusion. (Keeping a Symptoms Diary or at least a handwritten journal, helps keep track accurately).
  • Ask if you have any questions you or your caregivers have. (Keeping notes in our Prioritizer helps remember questions. Before a meeting, you can prioritize them with a push of a button).
  • Do a blood draw either the day before infusion is scheduled or the day of the infusion to be sure the port is functioning properly and to check blood levels such as red and white blood cells, platelet count and liver function.
  • Check vital signs such as body temperature, pulse, and blood pressure.
  • Possibly check other indicators.  
    • NOTE: Tell your doctor and/or nurse about ALL side effects you experience and their severity. Side effects may indicate a problem that only the medical team can assess. Keeping symptoms to yourself or underreporting them is dangerous to your health. If a treatment is given when your body is not at optimum health, problems may result to the degree that you end up in the hospital. 
  • There will be a wait while the medical team gets your blood results. (The wait can be anywhere from 15-20 minutes to several hours, depending on the lab and how busy it is,)  You will then meet with at least one member of your medical team.
    • This is the time to discuss coping with side effects and what can be done about side effects going forward.
    • This is also the time to discuss any other matters that may concern you.
  • A medical decision will be made whether to proceed with the planned treatment, whether the dosage of the various drugs need to be varied, or whether the treatment needs to be postponed.

If the treatment proceeds as planned:

  • The nurse will set up the infusion. The port will be washed out with saline solution and with a blood thinning medication such as heparin.
  • It is advisasble that you the patient, or a patient advocate with you, review the premeds and infusions prior to hookup to insure that the correct medications and dosage are being administered. No matter how competent your team, mistakes do happen.
  • Oxaliplatin and Leucovorin are usually delivered together (infused) over a period of two hours. Pre-medications may include a steroid to prevent swelling and nausea, and a medication to minimize nausea. 
  • After the infusion, you will be given a bolus injection of 5-Fu (“bolus” basically means a fast injection.)
  • If you are not feeling well after the infusion, do not leave the treatment area. Tell the medical staff.

Side Effects During The Infusion of FOLFOX

You may feel cold during the initial seconds of the infusion. This feeling rarely lasts more than a few seconds.

Since steroids and anti-nausea medications are usually included in the pre-medications before the infusion at the medical center, people generally feel okay while being infused. In fact, the steroid may make you feel somewhat energized.

It is not unusual for neurotoxicity and nausea to start while drugs are being infused in the treatment center or as soon as the patient walks out of the treatment center. Neurotoxicity is extreme sensitivity to cold and is likely to last for 4 or 5 days in the hands, feet, and mouth. For tips about dealing with neurotoxicity and nausea, see Side Effects

Before leaving the treatment facility:

  • A continuous infusion device will be attached to your port. For information, click here.
  • You will be given a prescription for anti-nausea medication.
    • It is advisable to fill the prescription right away.
    • it is critical to take the pills as prescribed. 
    • Do NOT wait until you feel queasy or nauseous.  It is easier to stay ahead of the nausea than to try to stop it once it starts.  (For information about medications to take outside the medical setting, including purchasing, storing and disposal, as well as insurance coverage, click here.) 
  • It is recommended that you stop in the bathroom before leaving the treatment center to avoid the possibility of having to stop for an urgent need to urinate on the way home.

Side Effects Immediately After FOLFOX Infusion

The majority of patients report feeling sluggish the day the bottle is removed and during the next few days after that. You may also feel irritated while coming off of the steroid. (To help cope, see Emotions While On FOLFOX)

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