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Colorectal Cancer Patient Support

Anyone who is dealing with colorectal cancer faces a whole range of issues. Medical, emotional, or financial aspects of your life can be affected. Here you’ll find support for these daily life challenges.

Emotionally coping with colorectal cancer

If you have been diagnosed with colorectal cancer, coping with your disease will require patience and determination. These may be new skills that you will develop. If you are having trouble coping with your diagnosis, or if you have already undergone treatment and still have strong emotions to deal with, you may need to surround yourself with family, friends, and colleagues. You may also find it helpful to speak with a therapist. This is the time to create a support system of people who will nurture you and respect your feelings.

Coping with colorectal cancer means managing a number of personal, professional, and financial demands and choices. Prioritize. Start from the simplest affirmation, "If I can get through today, then I can get through tomorrow."

The manner in which you handle these challenges and any other major life events—can be key to your well-being. Many of us are used to finding our way through a crisis the best way we can.

Feeling confident about your ability to cope—to stand up for yourself and your needs—can help you feel more in control, even in the midst of the fight. Even better, mastering these skills may make you feel more hopeful!

Your family

As you go through treatment for your colorectal cancer, you may encounter unexpected physical, emotional, and practical challenges, especially in your relationships with your family. Your diagnosis may affect the lives of those closest to you.

Family matters

You may be greatly comforted knowing you have a healthy, supportive family. Your loved ones can help you feel more hopeful and better prepared for the rigors of treatment.

How you and your family cope with your colorectal cancer will be determined to a great extent by how your family has functioned as a team in the past. Consider how your family typically handles problems: Are you all comfortable sharing feelings? Or do some family members tend to avoid talking about or handling serious issues and emotions?

The ways in which your family perceives and accepts your colorectal cancer can have a strong influence on everyone’s adjustment to the experience. All of your family members—your spouse/partner, your parents, your children, your siblings—may be impacted by the diagnosis at different times and in different ways. You also can expect their roles, reactions, and responses to vary, which may cause difficulty in the way family members interact as you all try to adjust. Please try to remember that it is normal for you and your loved ones to feel frustrated and lost. It may help if you can maintain your routine as much as possible. Part of that routine may include setting goals and making plans.

It’s also important to let each person deal with the impact of your cancer in their own way and to have personal time for themselves. Here are some suggestions for helping your family:

  • Talk and get feelings out in the open. Sharing feelings instead of hiding them can free people to offer support and allow you all to focus on the issues behind the feelings.
  • Discourage false cheerfulness. This is a common response from well-meaning family members who mistakenly believe they should cheer you up and keep you happy. Instead, it may discourage you from talking about things that need to be said and keep you from getting the emotional support you need from your family.
  • Start the conversation. Everyone may be waiting for you to bring up the subject. If it’s not easy for you to talk about your feelings, consider writing in a daily journal.
  • Keep a log to help stay organized. Keeping a log of things you need to do may help to reduce stress, for you and your family. This log can make it easier to remember appointments and medication schedules, too.

Please keep in mind that being able to recognize problems within your family is an important first step to solving them. For many families who are trying without success to feel better or change things, counseling may also be beneficial.

Learn how diet and nutrition can help.

INDICATIONS

Eloxatin® (oxaliplatin injection), used in combination with infusional 5-FU/LV, is indicated for

  • Adjuvant treatment of stage III colon cancer patients who have undergone complete resection of the primary tumor.
  • Treatment of advanced carcinoma of the colon or rectum.

Clinical Safety Considerations

Anaphylactic-like reactions to ELOXATIN have been reported and may occur within minutes of ELOXATIN administration. Epinephrine, corticosteroids, and antihistamines have been employed to alleviate symptoms.

  • ELOXATIN should not be administered to patients with a history of known allergy to ELOXATIN or other platinum compounds. Hypersensitivity and anaphylactic/anaphylactoid reactions to ELOXATIN have been reported and were similar in nature and severity to those reported with other platinum compounds (ie, rash, urticaria, erythema, pruritus, and, rarely, bronchospasm and hypotension). These reactions occur within minutes of administration and should be managed with appropriate supportive therapy. Drug-related deaths from this reaction have been reported.
  • ELOXATIN may cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised not to become pregnant while receiving ELOXATIN. It is not known whether ELOXATIN or its derivatives are excreted in human milk.
  • ELOXATIN has been associated with pulmonary fibrosis (<1% of study patients), which may be fatal. The combined incidence of cough and dyspnea was 7.4% (<1% grade 3, no grade 4) in the ELOXATIN plus 5-FU/LV arm compared to 4.5% (no grade 3, 0.1% grade 4) in the 5-FU/LV alone arm in the adjuvant colon cancer study. In this study, one patient died from eosinophilic pneumonia in the ELOXATIN combination arm. The combined incidence of cough, dyspnea, and hypoxia was 43% (7% grade 3 and 4) in the ELOXATIN plus 5-FU/LV arm compared to 32% (5% grade 3 and 4) in the irinotecan plus 5-FU/LV arm in patients with previously untreated colorectal cancer. In case of unexplained respiratory symptoms, ELOXATIN should be discontinued until pulmonary investigation excludes interstitial lung disease or pulmonary fibrosis.
  • ELOXATIN is associated with two types of primarily peripheral sensory neuropathy: an acute, reversible type of early onset and a persistent type (>14 days). In patients with advanced colorectal cancer paresthesias occurred in 77% (all grades) and 18% (grade 3/4) of previously untreated patients. In previously treated patients, acute neuropathy occurred in 56% (all grades) and 2% (grade 3/4) of patients; persistent neuropathy occurred in 48% (all grades) and 6% (grade 3/4) of patients. In patients with stage II and III colon cancer, paresthesia was seen in 92% (all grades) and 13% (grade 3/4) of patients; 21% (all grades), 0.5% (grade 3/4) had residual paresthesia at 18-month follow-up.
  • Hepatotoxicity, as evidenced in the adjuvant study by increase in transaminases and alkaline phosphatase was observed more commonly in the ELOXATIN combination arm. The incidence of increased bilirubin was similar on both arms. Changes noted on liver biopsies include: peliosis, nodular regenerative hyperplasia or sinusoidal alterations, perisinusoidal fibrosis and veno-occlusive lesions. Hepatic vascular disorders should be considered and, if appropriate, investigated in case of abnormal liver function test results or portal hypertension not explained by liver metastases.
  • Monitoring of white blood cell count with differential, hemoglobin, platelet count and blood chemistries (including ALT, AST, bilirubin and creatinine) is recommended before each ELOXATIN cycle.
  • The safety and effectiveness of ELOXATIN plus 5-FU/LV in patients with renal impairment have not been evaluated. Since the primary route of platinum elimination is renal, this combination should be used with caution in patients with preexisting renal impairment. Clearance of these products may be decreased by coadministration of potentially nephrotoxic compounds, although this has not been specifically studied.
  • The incidence of diarrhea, dehydration, hypokalemia, leukopenia, fatigue and syncope were higher in patients ≥65 years old.
  • Extravasation may result in local pain and inflammation that may be severe and lead to complications, including necrosis. Injection site reaction, including redness, swelling and pain, has been reported.
  • There have been reports of prolonged prothrombin time and INR occasionally associated with hemorrhage in patients receiving ELOXATIN plus 5-FU/LV while on anticoagulants. Patients receiving ELOXATIN plus 5-FU/LV and requiring oral anticoagulants may require closer monitoring.
  • The most common adverse reactions in patients with stage II or III colon cancer receiving adjuvant therapy were peripheral sensory neuropathy, neutropenia, thrombocytopenia, anemia, nausea, increase in transaminases and alkaline phosphatase, diarrhea, emesis, fatigue, and stomatitis. The most common adverse reactions in patients with advanced colorectal cancer were peripheral sensory neuropathy, fatigue, neutropenia, nausea, emesis, and diarrhea.

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