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Chemotherapy: FOLFOX


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Following is a brief overview of the chemotherapy generally known as FOLFOX followed by a table of contents of information to read as and when important to you. 

FOLFOX is the common name for a combination of three different drugs used to either eliminate colorectal cancer, to keep it from spreading, or to minimize side effects such as pain. The drugs have been combined because together they are more effective than any of the individual drugs alone. 

The Treatment

  • Treatment consists of a series cycles of infusions over time at a cancer center or a doctor's office and time such as a week until the next infusion.
  • During the time between supervised treatments, treatment continues either through a port which is inserted under the skin or through pills which are taken by mouth. 
  • Chemotherapy results do not generally happen overnight. It takes time for chemotherapy to be effective.

Side Effects

  • FOLFOX affects healthy cells as well as cancerous cells. This results in a variety of side effects. 
  • Most side effects can be controlled with other medications or self-help methods such as diet. 
  • People can generally go about all their daily activities, including work. Sometimes this takes planning.
  • Most side effects disappear over time.

How To Maximize Effectiveness Of The Treatment And Minimize The Effects On Your Day-to-day Life

During FOLFOX treatment, what you do day-to-day can work to help or hinder the treatment. Time with doctors and nurses is generally short, so there may not be time to discuss all the parts of life affected by treatment and what you can and should do about it - as well as what to avoid. How you handle the aspects of your life affected by treatment can determine how well you get through treatment and even whether you complete treatment. 

For time tested "do's" and "don'ts" about living in the new normal of treatment and recovery from treatment, we recommend that you read Life During a Continuous FOLFOX Infusion: Do's and Don'ts.

Health Insurance/Uninsured

  • If you have health insurance:
    • Learn how to maximize your benefits. 
    • Keep in mind that even with the best coverage, there is generally a large bill to be paid. Maximizing use of health insurance minimizes the amount you have to pay - and helps obtain the medical care you need.
  • If you are uninsured, or if paying for FOLFOX treatment or daily living expenses is difficult for you,  there are options to consider.


  • If you had surgery and are considering undergoing FOLFOX treatment, remind the doctor of the date of your surgery. A delay of 3 – 8 weeks is usually advised in order to assure that the chemotherapy will not interfere with healing from the surgery.
  • When you go to important meetings with doctors, nurses or patient navigators, such as the first meeting about treatment, it is advisable to take a family member or friend with you to act as a patient advocate to help ask questions and help remember what was said. Record the session if the medical professional will let you. Recording devices are not expensive. You may even be able to record the session on your smartphone. 
  • If the FOLFOX delivery method is a problem for you, ask about the form of 5-FU called Capecitabine (Xeloda.). Capecitabine is administered via oral pill instead of through a continuous pump.
  • If you haven’t decided about which of several treatments to take, and are looking for tools to help make a decision, click here. 
  • If a medication doesn’t achieve your goals, ask your doctor about other options which may be available for you including cutting edge treatments available through clinical trials. Also consider getting a second opinion from a NCI designated Comprehensive Cancer Center.

For more information about each of the above subjects, see the below links. If you are interested in all the information, please consider reading in parts. Trying to read everything at once can be overwhelming.

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