Folfox is a combination chemotherapy regimen that can be used to treat patients with colon cancer, says the National Cancer Institute. The drugs included in this combination are folinic acid or leucovorin, fluorouracil and oxaliplatin. Folinic acid is a vitamin that enhances the activity of the fluorouracil but does not usually cause side effects itself, notes Cancer Research UK. The fluorouracil and oxaliplatin components of the Folfox regimen both cause some general side effects, but oxaliplatin can cause specific side effects as well.
Fatigue
Patients who receive the Folfox regimen often develop fatigue and shortness of breath, says Cancer Research UK. These symptoms are caused by the decrease in red blood cells, called anemia, caused by changes in the bone marrow during treatment with fluorouracil and oxaliplatin. For some patients, the symptoms become so serious that the patient may need a blood transfusion. The anemia usually resolves after the chemotherapy drugs have been stopped.
Nausea and Vomiting
Some patients may become nauseous a few hours after receiving the Folfox regimen, says Macmillan Cancer Support. The nausea and vomiting may last for a few days after administration; the oncologist may prescribe medication to manage these symptoms. According to Cancer Research UK, about 70 percent of patients who receive oxaliplatin develop symptoms of nausea and vomiting.
Increased Risk of Infection
Fluorouracil and oxaliplatin can cause the bone marrow to stop producing sufficient numbers of white blood cells, notes Macmillan Cancer Support. The decreased numbers of white blood cells place patients at an increased risk of developing an infection. The levels of white blood cells will rebound after the administration of the chemotherapy drugs and will be at normal levels at the time of the next chemotherapy treatment. However, sometimes the doctor will administer medications that encourage white blood cell production like filgrastim or pegylated filgrastim, says Cancer Research UK.
Increased Bruising
Another effect of the changes in the bone marrow is a decrease in the number of platelets, according to Cancer Research UK. Patients on the Folfox regimen may have bleeding from the nose or gums; others may develop bruises from minimal trauma. If necessary, platelet transfusions can be given to manage this side effect, suggests Cancer Research UK.
Numbness and Tingling
Numbness and tingling of the fingers and toes occurs in a majority of patients who receive oxaliplatin chemotherapy, says Cancer Research UK. Oxaliplatin affects the nerve endings, a condition called peripheral neuropathy, notes Macmillan Cancer Support. Patients may have problems with fine tasks involving the fingers and hands. The neuropathy usually resolves a few months after the Folfox regimen is completed.
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