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5 Flurouracil (5-FU)

5-FU is one of the oldest chemotherapy drugs, and has been around and in use for decades.  It is an active medicine against many cancers. 5-FU is a clear and colorless liquid, and is given by intravenous route. It is also available in a crème form for treatment of skin cancer. It is most commonly used in treatment of the following cancers:

• Colon

• Breast

• Stomach

• Pancreas

The type and extent of a cancer will determine the method and schedule of administration of this drug. This decision is made by the medical oncologist. 5-FU may be given as a continuous intravenous infusion, over 4-5 days, or given on a scheduled basis, (e.g. once a week, or once every 3-4 weeks, etc.)

Side effects:

5-FU is normally administered by intravenous route. The life span of 5-FU in blood and body tissues is very short and limited to minutes. 5-FU binds to an enzyme inside of the cancer cells called Thymidilate Synthetase and thereby exerts its anti cancer effect on the cells. Leucovorin enhances the binding of 5-FU to this enzyme and as a result prolongs the life span of 5-FU within the cancer cells, resulting in a greater anti cancer effect. The degree and severity of the side effects depend on the amount and schedule of the administration of 5-FU. Some patients have deficiency of an enzyme (DPD Deficiency) that is crucial for the metabolism and deactivation of 5-FU.  Such patients suffer from sever side effects with smallest doses  and often the very first dose of 5-FU.   

Following are some of the most common and important ill effects:

• Soreness of the mouth, difficulty swallowing

• Diarrhea

• Stomach pain

• Low white blood counts

• Low platelet counts

• Anemia

• Sensitive skin (to sun exposure)

• Excessive tear formation from the eyes

It is imperative that patients relay any side effects or problems to their medical oncologist.