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Dying from 5-FU Therapy

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According to the article linked below, dying from 5-FU therapy doesn’t happen often. But when it does, it can be an awful death. Please understand that the chemo regimen fluoropyrimidine, usually called 5-FU, is an FDA approved, “safe and effective” medication for treating cancer.

5-Fu treatment adverse events can be awful.

I am a long-term cancer survivor. Since my active therapies in ’94,’95 and ’96- both chemo and radiation- I have gotten a great deal of experience with long-term and late stage side effects. 


What are the possible adverse events attributed to fluoropyrimidine chemotherapy?

  1. Myelosuppression: This refers to decreased production of blood cells, leading to anemia, thrombocytopenia (low platelet count), and leukopenia (low white blood cell count). This can increase the risk of infections, bleeding, and fatigue.
  2. Mucositis: Inflammation and ulceration of the mucous membranes lining the digestive tract, particularly the mouth and intestines. This can cause pain, difficulty swallowing, and diarrhea.
  3. Hand-foot syndrome (Palmar-plantar erythrodysesthesia): This condition causes redness, swelling, numbness, tingling, and sometimes blistering on the palms of the hands and/or the soles of the feet.
  4. Nausea and vomiting: Common gastrointestinal side effects of chemotherapy.
  5. Diarrhea: Increased bowel movements and loose stools, which can lead to dehydration and electrolyte imbalances.
  6. Fatigue: Persistent tiredness and weakness, which can significantly impact daily activities.
  7. Dermatologic reactions: Skin reactions such as rash, itching, and increased sensitivity to sunlight.
  8. Neurotoxicity: Some patients may experience neurological side effects, including peripheral neuropathy (numbness, tingling, or pain in the hands and feet) and less commonly, central nervous system toxicity.
  9. Cardiotoxicity: Although rare, fluoropyrimidines can sometimes cause chest pain, arrhythmias, or myocardial infarction (heart attack).
  10. Hematologic toxicities: Rarely, severe hematologic toxicities such as neutropenic fever, thrombotic microangiopathy, or hemolytic uremic syndrome may occur.

Conventional oncology does not consider evidence-based non-conventional therapies to be legitimate. My research and personal experience tells me otherwise.

If you would like to learn more about evidence-based non-conventional therapies and your cancer, email me at David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Pathogenic DPYD Variants and Treatment-Related Mortality in Patients Receiving Fluoropyrimidine Chemotherapy: A Systematic Review and Meta-Analysis

Background: Pathogenic variants of the DPYD gene are strongly associated with grade ≥3 toxicity during fluoropyrimidine chemotherapy. We conducted a systematic review and meta-analysis to estimate the risk of treatment-related death associated with DPYD gene variants…

Results: Of the 2,923 references screened, 35 studies involving 13,929 patients were included. DPYD variants (heterozygous or homozygous) were identified in 566 patients (4.1%).

There were 14 treatment-related deaths in 13,363 patients without identified DPYD variants (treatment-related mortality, 0.1%; 95% confidence interval [CI], 0.1-0.2) and 13 treatment-related deaths in 566 patients with any of the four DPYD variants (treatment-related mortality, 2.3%; 95% CI, 1.3%-3.9%).

Carriers of pathogenic DPYD gene variants had a 25.6 times increased risk of treatment-related death (95% CI, 12.1-53.9; p < .001). After excluding carriers of the more common but less deleterious c.1129-5923C>G variant, carriers of c.1679T>G, c.1905+1G>A, and/or c.2846A>T had treatment-related mortality of 3.7%.

Conclusion: Patients with pathogenic DPYD gene variants who receive standard-dose fluoropyrimidine chemotherapy have greatly increased risk for treatment-related death…”

A quick test could protect against fatal chemo overdose, yet few doctors use it

“One January morning in 2021, Carol Rosen took a standard treatment for metastatic breast cancer. Three gruesome weeks later, she died in excruciating pain from the very drug meant to prolong her life.

Rosen, a 70-year-old retired schoolteacher, passed her final days in anguish, enduring severe diarrhea and nausea and terrible sores in her mouth that kept her from eating, drinking, and, eventually, speaking. Skin peeled off her body. Her kidneys and liver failed. “Your body burns from the inside out,” said Rosen’s daughter, Lindsay Murray, of Andover, Massachusetts.

Rosen was one of more than 275,000 cancer patients in the United States who are infused each year with fluorouracil, known as 5-FU, or, as in Rosen’s case, take a nearly identical drug in pill form called capecitabine..

Those patients essentially overdose because the drugs stay in the body for hours rather than being quickly metabolized and excreted. The drugs kill an estimated 1 in 1,000 patients who take them — hundreds each year — and severely sicken or hospitalize 1 in 50. Doctors can test for the deficiency and get results within a week — and then either switch drugs or lower the dosage if patients have a genetic variant that carries risk.

Yet a recent survey found that only 3% of U.S. oncologists routinely order the tests before dosing patients with 5-FU or capecitabine. That’s because the most widely followed U.S. cancer treatment guidelines — issued by the National Comprehensive Cancer Network — don’t recommend preemptive testing…

“FDA has responsibility to assure that drugs are used safely and effectively,” he said. The failure to warn, he said, “is an abdication of their responsibility.”

Oncologists are accustomed to chemotherapy’s toxicity and tend to have a “no pain, no gain” attitude, he said. 5-FU has been in use since the 1950s…

The fluoropyrimidine enzyme deficiency numbers are smaller — and people with the deficiency aren’t at severe risk if they use topical cream forms of the drug for skin cancers…

Murray senses momentum toward mandatory testing. In 2022, the Oregon Health & Science University paid $1 million to settle a suit after an overdose death…”

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