What are the different treatment plans?

You will be randomised to one of five different treatment plans. In each plan there is an initial chemotherapy (known as first-line treatment). The first line treatment is followed by different chemotherapy (second-line treatment) if the cancer starts to develop again.

The treatment plans are described below and further on we explain how the drugs are given. To make things clearer, once you are randomised, it may be helpful to put a mark by your treatment plan. If you are not sure which plan you are having ask your nurse or doctor to explain.

Plan A

Your treatment will start with 5-fluorouracil (5FU) and folinic acid.

Folinic acid and a single dose of 5FU will be given on the first day of treatment followed by a drip (infusion) or portable pump of 5FU for 46 hours. This treatment is repeated every fortnight.

If your cancer starts to develop during, or after this treatment, your doctor will assess you and consider starting treatment with irinotecan. Irinotecan is given as an injection into the drip every three weeks.

If the cancer starts to develop after irinotecan treatment, further treatment will be based on your doctor’s own assessment. This may involve stopping the chemotherapy or changing to another form of chemotherapy. You will continue to have medicines or treatment to help with any symptoms you experience.

Many doctors regard this treatment (plan A) as the standard treatment for your cancer.

Plan B

Your treatment will start with 5-fluorouracil (5FU) and folinic acid.

Folinic acid and a single dose of 5FU will be given on the first day of treatment, followed by a drip (infusion) or portable pump of 5FU for 46 hours. This treatment is repeated every fortnight.

If your cancer starts to develop again irinotecan will be given in addition to the treatment with 5FU and folinic acid. Irinotecan is given as an injection into the drip every fortnight.

If your cancer starts to develop during, or after this treatment, further treatment will be based on your doctor’s assessment. This may involve stopping the chemotherapy or changing to another form of chemotherapy. You will continue to receive medicines or treatment to help with any symptoms you experience.

Plan C

Your treatment will start with the new combination treatment of irinotecan plus 5-fluorouracil (5FU) and folinic acid.

Irinotecan, folinic acid and a single dose of 5FU will be given on the first day of treatment, followed by a drip (infusion) or portable pump of 5FU over 46 hours. The treatment is repeated every fortnight.

If the cancer starts to develop again treatment will be based on your doctor’s assessment. This may involve stopping the chemotherapy or changing to another form of chemotherapy. You will continue to receive medicines or treatment to help with any symptoms you experience.

Plan D

Your treatment starts with 5-fluorouracil (5FU) and folinic acid. Folinic acid and a single dose of 5FU will be given on the first day of treatment, followed by a drip (infusion) or portable pump of 5FU over 46 hours.

If the cancer starts to develop again oxaliplatin will be added to treatment with 5FU and folinic acid. The treatment is repeated every fortnight.

If the cancer starts to develop again after this treatment, further treatment will be based on your doctor’s assessment. This may involve stopping the chemotherapy or changing to another form of chemotherapy. You will continue to receive medicines of treatment to help with any symptoms you experience

Plan E

Your treatment starts with the new combination treatment of oxaliplatin and 5-fluorouracil (5FU) and folinic acid from the start.

Oxaliplatin, folinic acid and a single dose of 5FU will be given followed by a drip (infusion) or portable pump of 5FU over 46 hours. The treatment is repeated every fortnight.

If the cancer starts to develop again treatment will be based on your doctor’s assessment. This may involve stopping the chemotherapy or changing to another form of chemotherapy. You will continue to receive medicines or treatment to help with any symptoms you experience.