Colorectal Cancer
The neuropathy your patient didn't mention is why he can't button his shirt.
Colorectal cancer treatment produces predictable toxicity patterns — fatigue crashing 3 days post-FOLFOX, neuropathy accumulating across cycles, bowel urgency limiting social life — yet these patterns are invisible between biweekly infusions and quarterly scans. The symptoms that drive dose reductions, ER visits, and quality-of-life collapse happen at home, unreported. Forma captures the daily signal across all 21 treatment domains.
Forecast
Based on prior Topics logging
Topics
How it works
15 seconds of speech. 25 data points.
Forma turns each patient into a continuous data stream. By voice or text, patients log daily bowel function, fatigue with cycle-day context, neuropathy progression, nutritional intake, GI symptoms, immunotherapy side effects, and financial burden in 20 seconds. No forms, no recall bias. The result is a structured, longitudinal dataset across all 21 CRC observation topics — fatigue trajectories mapped to cycle day, CEA and ctDNA trends paired with symptom burden, neuropathy progression visible across cycles before dose reduction becomes necessary, and the financial toxicity data that oncology trials are finally starting to measure.
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Forecast
Based on prior Topics logging
Topics
Structured, coded, longitudinal
- Timing
- Infusion time:2:00 PM yesterdayNausea onset:8:00 PM
- Severity
- Nausea symptom:PresentNausea severity:6/10Emesis count:2 episodes
- Actions
- Treatment:ChemotherapyCycle number:3rd infusionAnti-emetic:ZofranAnti-emetic dose:8 mg
- Outcome
- Appetite:Absent
From data to insights
What the data reveals
Daily voice logs compound into actionable insights — for patients managing their condition and for researchers running studies.
For Patients
When will I feel worst after chemo?
Your FOLFOX toxicity peaks day 3–4 every cycle — fatigue and diarrhea hit together. Dexamethasone insomnia comes night 1. Cold sensitivity is immediate and lasts 5 days. By day 7 you consistently start recovering. Knowing this pattern lets you plan: cancel nothing before day 5, schedule activity after day 8.
Toxicity by cycle day
Is my neuropathy getting worse?
Your tingling score went from 3/10 after cycle 6 to 7/10 after cycle 8. You lost fine motor function (buttoning, mug grip) between cycles 7 and 8 — that's grade 2–3 progression. The dose reduction on day 13 has stabilized it. Your feet numbness is unchanged but not worsening.
Neuropathy by cycle
Am I eating enough?
You averaged only 900 calories on days 2–5 post-chemo — half your target. Nausea kills your appetite despite Zofran. Your weight dropped 4 lbs this cycle. On recovery days 8+ you're eating normally. Protein shakes on bad days would close the gap — you tolerated them last cycle.
Intake by cycle day
Summarize this cycle for my oncologist.
Cycle 8 complete. Peak toxicity day 4: fatigue + 5× diarrhea. CIPN progressed to functional impact (can't button shirt) — dose reduced. Neutropenic fever day 10 — ER admission, ANC 800, 3-day IV antibiotics. CEA 8.5 → 2.1, excellent response. Chemo delayed 1 week. Insurance denied PET scan. Financial burden: $2,000+ copays.
For Researchers
What predicts dose-limiting toxicity in FOLFOX?
Across 83 CRC patients, CIPN reaching grade 2 (functional impairment) occurs at median cycle 7 (IQR 5–9). Daily neuropathy scores predict dose reduction need 2 cycles earlier than clinic assessment. Cycle-day fatigue patterns are remarkably consistent within patients (ICC 0.82) — personalized toxicity forecasting is feasible.
CIPN progression
Trend
How early can we detect febrile neutropenia?
Patients who developed febrile neutropenia showed elevated fatigue scores (mean +2.1 points) and reduced oral intake (mean −40%) 48–72 hours before fever onset. A daily symptom composite flagged 71% of FN events 2 days early. Temperature alone is too late — the prodrome is in the PRO data.
Pre-FN signal
Trend
What is the real financial toxicity burden?
67% of CRC patients report monthly out-of-pocket costs exceeding $1,500. 34% made cost-related treatment decisions (skipped scans, delayed refills). Insurance denials affected 42% of patients. Voice-logged financial burden captures 4.2x more detail than COST questionnaires — patients describe specific barriers rather than rating stress.
Monthly OOP costs
Trend
Can daily data distinguish immune colitis from chemo diarrhea?
Immune colitis onset shows >6 daily episodes with abrupt onset 2–8 weeks post-checkpoint inhibitor — distinct from FOLFOX diarrhea which peaks day 3–4 and resolves by day 7. Daily bowel logging correctly classified 89% of colitis cases at first symptom, triggering corticosteroid evaluation 3 days earlier than standard monitoring.
Diarrhea pattern
Trend
FOLFOX cycle 8 + Avastin today. In the chair about 5 hours. Cold sensitivity kicked in immediately after oxaliplatin. Straw and room temp water only.
Dex insomnia — wide awake at 2am, wired. Nausea building. Took Zofran. Managed about 4 cups of water.
Day 4 post-FOLFOX — completely wiped. Can't get off the couch. Diarrhea 5 times, watery. Had to call in sick — third day this cycle.
Neuropathy in feet getting worse — can barely feel the floor when walking. Threw up twice even with Zofran. Zero appetite, forced crackers and half a banana.
Can't button his shirt — wife helps him dress. Copays over $2000 this month. Chemo brain terrible — forgot what he was saying mid-meeting.
Ended up in the ER with fever of 102.4 — neutropenic fever. Admitted for 3 days on IV antibiotics. ANC was 800.
Discharged. White count recovering. Doctor reduced oxaliplatin dose because of the neuropathy. Next chemo pushed back a week.
CEA dropped from 8.5 to 2.1. Doctor says great response. Managed a 20-minute walk — first real exercise in weeks.
Scanxiety building — CT is Monday. Can't think about anything else. Neuropathy same but tolerating lower dose. Insurance denied the PET scan.
CT scan this morning. Telehealth with palliative care about pain management — really helpful. Wife set up bed downstairs since he can't do stairs.
Finished cycle 8! Four more to go. Rang the halfway bell. CEA holding low. Neuropathy stabilized on reduced dose. Feeling cautiously hopeful.
Key insight
Over four weeks, David's daily logs capture the chemo cycle toxicity pattern invisible to biweekly infusions: peak fatigue and diarrhea hitting day 4 post-FOLFOX like clockwork, CIPN progression from 'can't feel the floor' to 'can't button my shirt' by day 8, and a neutropenic fever ER admission on day 10 that the daily data could have flagged earlier. The oxaliplatin dose reduction on day 13, CEA response from 8.5 to 2.1 on day 16, and neuropathy stabilization by day 25 show treatment adaptation — a trajectory that pairs toxicity management with efficacy data in a single longitudinal view.
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