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  • Writer's pictureBen Green

What the FLOT?!?!

Updated: Jan 10, 2020

You may have been told that you are about to start FLOT treatment or you may have just read about it as a possible medication to treat eosophageal cancer. It’s a weird name, I grant you, but studies have shown that FLOT can have better results for people with Oesophageal and or Gastric cancers than other available forms of chemo. These studies looked at both ‘progression-free survival’ (where an individual isn’t cured of cancer but the cancer is stopped from growing by the ongoing use of chemo) and ‘overall survival’.


So, what the FLOT is FLOT?!?! FLOT is a combination cancer treatment, meaning they use a combination of four different medicines – Fluouracil (a medication used to treat a number of cancers including esophageal cancer, colon cancer, stomach cancer, pancreatic cancer, breast cancer, and cervical cancer); Leucovorin (a medication that is given to protect against bone marrow suppression or gastrointestinal inflammation); Oxaliplatin (a medication used to treat cancer. Oxaliplatin is often used together with Leucovorin in advanced cancer) and Docetaxel (which is a medication used to treat a number of types of cancer including breast cancer, head and neck cancer, stomach cancer and prostate cancer. It’s this bad boy that will potentially make you lose your hair).


FLOT is administered into a vein and you will either be given a PICC line, which starts just above the bend in your elbow; or a central line, which starts at the top of your chest.


Everyone’s treatment regime will be different but my pre-surgical FLOT will be given over an eight week period – four lots given every two weeks. When I’ve asked around it seems that this is a common regime for FLOT but everyone’s treatment will be different and you will need to wait to speak to you oncologist as they will tailor your treatment to meet your specific needs.


One of the bonuses of FLOT is that part of it can be given by a pump, which you can take home meaning that you can sit in the comfort of your own home whilst receiving the meds. The pump isn't exactly a 'pump' as you would imagine it with whirring parts powered by batteries or hooked up to the mains. It's a clear plastic ball with a 'balloon' inside of it, the balloon is filled with the medication and as the balloon slowly deflates it pushes the chemo meds out and into your PICC line. I've made it sound super simple but this advanced practice will make such a difference to people's lives and how cancer can be treated in the future.


Like all medications FLOT can cause side effects. Some of the side effects are less serious, for example it can change the way you taste certain foods but some side effects can be more serious, so it is important that you get up-to-date and relevant information from your oncologist and Macmillan nurse. The three main side effects that I was informed about by my oncologist was that FLOT can stop your bone marrow producing blood cells, which will negatively effect your immune system meaning you could be more susceptible to infections. FLOT could cause chest pain so if this is experienced you should call the team in charge of your care immediately. FLOT can also make you infertile. You will be given an option to freeze your gametes if you think you may want children in the future. So it's good to have a think about this option as soon as possible so you can give the oncology team notice if you want this service. This is a free service.


Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you have a temperature, feel unwell or have severe side effects, including any that I have not mentioned above.


I was unsure whether to mention the above side effects as I didn’t want to scare people but I think it’s important that everyone should know these side effects, whether you have cancer or not.

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