Fluorouracil, 5-FU, 5 Fluorouracil

Fluorouracil, 5-FU, 5 Fluorouracil

Patient-friendly review of 5-Fluorouracil (5-FU) which is a chemotherapy agent first approved by the FDA in 1956 and is usually used as part of a package of drugs to treat breast cancer, colorectal cancer, oesophageal cancer, pancreatic cancer and cervical cancer.

5-FU is rarely used on its own. 

In breast cancer it is used after diagnosis either following surgery or to reduce tumour size prior to surgery. In these cases it is used with other old drugs, like Eprirubicin and Cyclophosphamide for 3 rounds; then Docetaxel (or Paclitaxel, Taxol) is added for 3 more rounds.

In colorectal cancer it is used with Folinic Acid and Oxaliplatin as FOLFOX; or with Folinic Acid and Irinotecan as FOLFIRI.

In pancreatic cancer it is used with Folinic Acid, Irinotecan, Oxaliplatin as FOLFIRINOX. French research showed this increase survival times over standard therapy by one year.

Fluorouracil Cream can be used topically for skin cancer.

Clinical trials have also shown that it can help in a number of ways from improving survival in head and neck cancers, esophagael and stomach cancer, where it is used prior to surgery, to reducing liver metastases in colon cancer cases. 

There are a variety of trade names, the most common being Adrucil. Other trade names include Fluoroplex, Efudex, Carac and Tolak.  

Fluorouracil is an 'antineoplastic' or 'cytoxic' drug, is classified as an 'antimetabolite' and is part of a group of drugs called Fluoropyrimidines. It is used in a number of different dosages, and in different patterns. Its oral 'prodrug' is capecitabine.

Side-effects of 5-FU: can include: mouth ulcers, taste changes, diarrhoea, skin darkening, lowered resistance to infection, eye discomfort, fatigue, bruising or bleeding, and anaemia. According to a meta-analysis by the American College of Cardiology, 5-FU is one of the most common chemotherapy agents to cause cardiotoxicity, second only to anthracyclines.

Warning: The Internet is littered with tales of horrendous side-effects from this old-style chemotherapy drug, The ACC report stated that cardiovascular events could be observed in as little as 12 hours from the start of the use of the first dose.

Test for DPD: Most importantly, there is a test you can be given to see if your body possesses the necessary enzyme in the liver (DPD, or Dihydropyrimidine Dehydrogenase) to deal with the drug. According to Medscape 80% of people possess the enzyme and can fully detoxify the drug in their liver, while at least 5% of people have a total deficiency of the enzyme. These people, and remainder with a deficiency, must not be given 5-FU (or capecitabine) as it can result in death. There is a simple test all patients should be given prior to any treatment. For example, in the USA from Labcorp.

Curcumin - there are multiple studies that curcumin (turmeric) can improve the effectiveness of 5-FU, helping its action to kill cancer cells, while protecting healthy cells.

Go to: Curcumin improves Fluorouracil and Capecitabine effectiveness

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Other articles that you may find interesting are:

  1. 10 ways to improve your chemotherapy and reduce side-effects.
  2. Diet for Chemotherapy;
  3. Beneficial bacteria;
  4. A-Z guide to complementary therapies;
  5. Your cancer, where you can read about everything from causes to cancer treatments to complementary therapies for your cancer.
  6. How to boost your immune system.

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