Folfiri treatment

Hi ,

Welcome to our online community. Thanks for posting your question. I’m sorry to hear about your friends’ recent stage 4 bowel cancer diagnosis. It’s unfortunate you aren’t having any of the details shared with you, especially when you will be helping with the practical and day to day support. But it’s great you are trying to prepare the best you can ahead of chemotherapy starting.

Chemotherapy is often given in combination of 2 or more types. You can read more about Folfiri here. Each chemotherapy drug has different side effects, but there are some common ones that can happen with most types. And I’ll explain them in a bit more detail below. You may also find our understanding chemotherapy booklet useful.

Chemotherapy can sometimes deplete the body’s natural immune system and blood cells, meaning there is an increased risk of infection and this becoming more serious (sepsis) and also an increased risk of bruising or bleeding. It is important to know the signs to look out for and report any potential infection straight away. Your friend should be given a 24hr treatment hotline number should she (or you) have any concerns.

Other common side effects are mouth problems (mouth ulcers and/ or taste changes), nausea and vomiting, diarrhoea, loss of appetite and tiredness. Most of these symptoms can be managed well with a combination of medication, rest, and diet changes. 

Keeping the mouth clean by brushing teeth and using mouth wash regularly (morning/ night and after eating), as well as making sure to stay well hydrated can help reduce any mouth problems. The cancer doctors will sometime suggest a visit to the dentist before starting treatment too.

This treatment can cause severe diarrhoea and/ or constipation. The increased stoma activity can sometimes cause irritation to the surrounding skin or stoma itself as the bag may need to be changed more often than normal. If this does happen, your friend can speak to the chemotherapy nurses/ bowel cancer specialist nurse or stoma nurse for extra support.

A short course of anti-sickness medication is usually given as standard to help manage nausea and vomiting. For most people this is long enough, but if symptoms persist then this prescription can be extended, you just need to ask the cancer team or GP about this.

When appetite is affected, we usually recommend eating little and often and choosing higher calorie options. We have lots of hints and tips about The Building-up Diet you may find useful. 

We often find the further into treatment someone gets, the more tired they become and even carrying out simple tasks can be overwhelming. Getting a balance between resting and keeping active can be tricky. Again, our coping with fatigue and physical activity and cancer information has lots of hints and tips.

Cancer treatment can also have an emotional impact. And there are lots of ways to get help and support with your emotions.

Looking after a close friend and loved one can be really rewarding but it can also be physically and emotionally draining. So it’s really important that you look after yourself too.

We often find we can help more by having a chat on the phone. If this is something you feel up to doing, please don’t hesitate to give us a call. We are open 7 days a week, 8am – 8pm on 0808 808 0000. 

I hope this helps and that everything goes OK with your friend’s treatment.

Best wishes, 

Amy C, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref/ RH

Amy thank you so much for your help, advice and compassion - it's very much appreciated. I will certainly be looking at the information you have provided & feel that mouthwash could become a high priority on my shopping list in future! Thank you too for the phone number, I will make contact with someone after having read the details on your links as I am bound to have more questions once I start looking into things.

So grateful for your prompt response.

Diane