After some conversation, Dr. G and I have decided to start me on intravenous 5-FU (Fluorouracil). Here's why.
Xeloda (capecitabine) would have been the chemo of choice. It's more than an oral form of 5-FU, and thought to be more effective because of the way it bonds to an enzyme that affects the cancer cells. But 60% of the people taking it develop some form of hand-foot syndrome (Palmar-Plantar Erythrodysesthesia) as a side effect. The hands and feet turn red and itchy, crack and are tender.
Given my lymphedema flare up that still hasn't subsided, the thought of a greater than 1 in 2 chance of developing something that would trigger even more edema was hard to bear. I can imagine all too clearly what it would be like to wear a compression glove over such sensitive skin. I wouldn't be able to, and that would trigger more edema, and the vicious cycle of not being able to do for myself would start.
Also, given my recent hospital stay to treat a staph infection, the risk of getting another infection from a virus or bacteria that entered via a crack in my cuticles seemed like an even greater risk.
Living with mets is all about QOL -- quality of life. And if my QOL goes down too far, it's a short slide from "why bother?" to giving up. Which I am nowhere near ready to do.