Ask the Nurse

Posts in this section can only be replied to by the nurses. If you wish other users to respond to your question you will need to post it in another topic on the forum as well.

Polly68

Lines of treatment

Hi, I was just hoping for clarification on what it means by first, second and third lines of treatment. I had FOLFOX as adjuvant chemo, then after lung recurrence I had FOLFIRI. Now after liver recurrence I'm back on FOLFOX for 6 treatments. My onco said this was 2nd line treatment, but my confusion is that it's my 3rd lot of chemo and 2nd go at FOLFOX. Also, if I were to have further recurrence will I be able to have FOLFOX or FOLFIRI again?
TIA Paula :x::x::x::x:

Charlotte Nurse Advisor

Hi @Polly68,

When you have had surgery for bowel cancer (with no secondary disease seen elsewhere) the chemo that you have following this is called adjuvant chemotherapy.

If you go on to develop secondary / recurrent disease the first round of chemotherapy you have then (even if you had adjuvant chemo) is called 1st line Chemotherapy (in that it is the 1st line of chemo to treat the secondary disease). If this treatment fails or for some other reason the regime is changed then it is called 2nd line and so on.

I hope that helps!?

Kindest regards,

Charlotte

Polly68

@Charlotte Nurse Advisor thanks for your reply. Is it possible to keep revisiting chemo regimes you've had before? I.e. I've already had FOLFIRI and it worked well on my lung mets, but when the liver mets appeared they have given me FOLFOX. I'm just worried that should I get further recurrence I'll just be moved to third line, even though previous chemo has worked. TIA Paula :x::x:

Charlotte Nurse Advisor

Hi @Polly68,

The decision about whether to repeat chemotherapy which has been given before does depend a bit on how quickly further disease develops after completion of the course. For example if a regime of Folfox was given and there was initially a good response but recurrence developed fairly soon after treatment ended it is usually considered that the treatment has not been effective and so a different regime is tried.

If however there has been a significant disease free period then it is possible to treat further secondaries with treatment that has been previously effective.

I hope this answers your question but please get back to me if I can help further.

Kindest regards,

Charlotte