In August 2005, NICE (National Institute for Health and Clinical Excellence) issued guidance for doctors on the use of certain chemotherapy drugs for advanced bowel cancer; including oxaliplatin.

They recommend that people with bowel cancer that has spread have either 5FU (fluorouracil), 5FU with oxaliplatin or 5FU with irinotecan. For people who have had 5FU before (or for whom 5FU is not suitable), Irinotecan can be used on its own.

Oxaliplatin is a clear, colourless fluid and is usually given as an infusion through a fine tube (cannula) inserted into a vein (intravenously) via a drip. It may also be given through a central line which is inserted under the skin into a vein near your collarbone. The treatment is normally repeated every two to three weeks. Like other chemotherapy drugs oxaliplatin works by interfering with the process of cell division. Whilst this can help control cancers it also interferes with the growth of normal cells and so leads to some side effects. With oxaliplatin the following are some of the commoner problems that people can have:

• numbness or tingling in the hands and/or feet can develop whilst you are having irinotecan. This is because the drug has an effect on the nerves, which can get progressively worse as treatment continues. The symptoms may be made temporarily worse by exposure to cold weather. If you do notice any change in sensation in your fingers or toes do mention this to your medical team so they can take appropriate action to help. They may consider slightly reducing the dose of the drug.
• sickness is possible with oxaliplatin for a day or so after the infusion, but with modern day anti-sickness drugs this can often be completely prevented or kept to a minimum and is not usually troublesome.
• Less commonly, temporary reduction in bone marrow function can develop a few days after each infusion and last for a week or two. You will have a blood test before each infusion to check the bone marrow has fully recovered. The reduced bone marrow function lowers the number of white blood cells in your blood and this makes you more liable to develop infections. You will be warned to contact the medical team immediately if you develop a temperature above 38°C (100.5°F) during the time you are having treatment.