The fluoropyrimidine 5-fluorouracil (5-FU) and its prodrug capecitabine are cytotoxic agents that have been widely used in the treatment of solid tumors. In the United States alone, an estimated 275,000 patients with cancer receive 5-FU each year. Despite its lifesaving/life-prolonging potential, 5-FU causes severe early-onset toxicity in up to one-fourth of patients, and more than 1300 die each year as a result of this toxicity.
Although administration and toxicity may differ between the 2 agents, they share the same risks for early-onset toxicity and overdosage, the signs of which are easily dismissed by patients and providers as expected chemotherapy-related adverse events.
Many healthcare providers who work in gastrointestinal oncology may feel blasé about the administration of 5-fluorouracil (5-FU), which is certainly the most commonly used chemotherapy in this setting.