When the issue of chemotherapy is raised with patients, most patients tend to have dramatic images of the expected toxicity. Specifically, nausea, vomiting and hair loss are felt by many to be uniformly associated with all kinds of chemotherapy. As mentioned earlier, traditional adjuvant chemotherapy for colorectal cancer has been 5-FU based. These regimens are usually reasonably well tolerated. The most common adverse effects are diarrhea, stomatitis, neutropenia and leukopenia. However, these side effects are actually seen in a minority of the patients, generally in the range of 20%. Older patients seem particularly vulnerable to these toxicities. As such, an individualized risk/benefit ratio is particularly appropriate when considering adjuvant therapy for patients with advanced age.
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