I have stage 4 goblet cell carcinoma of the appendix, spread to ovaries and peritoneum.
My Oncologist has given me the choice between Irinotecan with 5FU and folinic acid or CAPOX. Apparently they are equally effective.
I was initially leaning towards to CAPOX because I won't have to have PICC line or pump with that one and it's possible I might keep my hair but I'm concerned about neuropathy and I read somewhere the tablets can make you really tired and at least with the other one the break is longer so possibly more time to feel a bit better? Also, they always have trouble getting into my vein (and they can only use one side as I've had lymph nodes removed on other side from another cancer) so I'm wondering whether with 6 months of chemo a PICC line or similar may be inevitable anyway?
Does anyone have any insights or words of wisdom to help me decide please?
Hi LoobyLou
Tricky decision. My mum opted for Oxaliplatin and cap tablets . Partly so she could leave the building that day with only the tablet . After two years of treatment it was a bit tough on her veins but she managed . She was tired on treatment so you could be right about the tablets . The most notable sad stomach cramps on her off week . She used buscopan. She does have neuropathy but she does manage quite well with it . Depends if you enjoy a lot of fine finger activities . Some musicians have avoided it as some artists .
The up side was the freedom of finishing the infusion and leaving the building . The big plus for her was keeping her hair . She also had a small reduction the second year in her dose and that was a big help . She still gets an infusion and still uses a cannula .
Hope that helps . It was tough but effective .
Court
Helpline Number 0808 808 0000
I’ve just seen my oncologist as I started on Capox back in May this year. I only managed two cycles before she withdrew it. I suffered extreme reaction which she believes was caused by the oxaliplatin. It caused the capecitabine tablets to become more potent. I completely trust my oncologist to have my best interests at heart, so I have made the decision to now go for palliative treatment. It wasn’t an easy decision, but quality of life is one of the most important things I have taken into consideration. Wishing you the very best of luck in whatever treatment you choose. Only you really know what you can cope with.
Hi LoobyLou.
Could a Portacath be an option for you? If you'd like to read more about them, this link maybe helpful: https://www.macmillan.org.uk/cancer-information-and-support/treatment/types-of-treatment/chemotherapy/implantable-ports
Just a heads up, for some people 5FU can also cause quite impactful neuropathy.
I'd recommend another discussion with oncologist to discuss you health background, your desired lifestyle during treatment and any priorities for you. They should be able to help pinpoint the true best fit for you.
Thanks. I haven't seen any info suggesting 5fu causes bad neuropathy. It doesn't mention it in the Macmillan fact sheet. Where can I find that info?
Hi LoobyLou.
Don't know what literature captures it or come to think of it, whether it was in the risks i was warned about.
All I know I had (and still have) bad neuropathy from 5FU , so it is very real!
I'm sorry you're dealing with that Crumpets. How long ago did you finish the 5FU?
Hi LoobyLou.
I finished chemo in spring this year
Hello!
My late husband was on CAPOX he managed 4 sessions after which it had to be stopped it completely floored him and then after a break of a couple of months he was put on 5FU which included having the PICC line in but unfortunately he only managed one session of that before he took severe dehydration and low kidney function. This resulted him having to be hospitalised and found that the chemotherapy had damaged his kidneys and was therfore withdrawn immediately. But please don't let what my husband went through scare you everyones cancer journeys are different and some can tolerate it better than others. At the end of the day it's your own personal decision and only you can decide what you want to do. My best wishes to you for the future.
Vicky x
Whatever cancer throws your way, we’re right there with you.
We’re here to provide physical, financial and emotional support.
© Macmillan Cancer Support 2025 © Macmillan Cancer Support, registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Also operating in Northern Ireland. A company limited by guarantee, registered in England and Wales company number 2400969. Isle of Man company number 4694F. Registered office: 3rd Floor, Bronze Building, The Forge, 105 Sumner Street, London, SE1 9HZ. VAT no: 668265007