What is Folfox Chemotherapy?

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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 09 October 2019
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FOLFOX chemotherapy is a promising treatment option for some types of colon and rectum cancers. Three drugs, folinic acid, fluorouracil, and oxaliplatin, are used in combination to destroy existing tumors and stop the spread of cancer to nearby cells. FOLFOX chemotherapy is generally administered when surgery to remove the colon is deemed too risky because of a patient's health, but it may also be used as a first-choice treatment option in some cases. There are risks of major side effects from the medications that doctors need address as they occur.

Fluorouracil and oxaliplatin are used to treat many different kinds of cancer, and they have proven especially effective against malignant colorectal tumors. Folinic acid is added to the combination because it enhances the positive effects of fluorouracil. After the drugs are administered through an intravenous catheter, they migrate through the bloodstream and attach to cancerous cells. They elicit a chemical reaction that disrupts DNA and RNA synthesis inside cells. As a result, cells are unable to replicate or metabolize the proteins needed to survive.


Doctors carefully tailor individualized FOLFOX chemotherapy regimens based on patients' specific conditions and overall health. For most adult patients, an initial dose of oxaliplatin and folinic acid is delivered intravenously through a vein in the arm over the course of about two hours. Fluorouracil is then administered with a slow drip line or infusion pump for about 22 hours. The procedure is repeated the next day, and then no drugs are given for about two weeks. Patients may need as few as three cycles of FOLFOX chemotherapy or as many as 12, depending on the response of tumors.

Most patients who are in poor condition are kept in the hospital throughout FOLFOX chemotherapy treatment. A person who is stable and has the proper care resources may be allowed to leave and receive dosages at home from a trained nurse. Even stay-at-home patients need to attend frequent medical checkups at the hospital, however, to monitor progress and make sure complications do not arise.

The drugs used in FOLFOX chemotherapy can cause significant side effects and health problems because they cannot specifically target cancerous cells; white blood cells and other important immune system ingredients are also affected. As a result, a patient's immune defenses are poor during treatment and he or she is at an increased risk of infections. Other side effects may include diarrhea, nausea, fatigue, and temporary numbness in the extremities. A doctor can usually minimize the negative effects of treatment with other medications.


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