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RE: Stage 3 Colorectal Cancer

michelg
Posts: 1
Joined: Dec 2004

My dad was diagnosed in August with Colon Cancer.
He had surgery in Sept. The pathology reports showed 9 of 30 lymph nodes postive for mets. The exact result were TNM stage T3b, N2, MX or Duke's C2. He has just finished his first cycle of folfox and begins his next this Monday. They plan on doing this for 6 months but after this round ending Dec 23rd they plan on having him go to 5 days straight of 5-FU and radiation every day for 5 to 6 weeks.
My question is has anyone gone through this regimen of radiation? He currently has no tumors although they have not done a PET SCAN. I am worried about the side effects of the radiation. I have been unable to find any studies that show it is advantageous for his particular situation. The doctor even said that they think it may help the cancer not come back but was unsure of what if any results it may produce. It just seems crazy to me to have radiation for 5 to 6 weeks because it "might" help. After the surgery he was really starting to do well without any issues. He has tolerated the chemo pretty well a few times getting sick, tired and a bit of the cold sensation issues. I am just starting to look into the alternative route in regards to nutrition. My dad spent the last 4 years on the Atkins diet which based on what I have read was clearly not the best thing to do. Any input that anyone can give would be great.

Thanks
Michel

neon356
Posts: 137
Joined: Mar 2004

Hi Michel,
I was diagnosed in '93 with stage 3, and had surgery, permanent colostomy, then very aggressive chemo along with the same regimen of radiation. 11 of 15 nodes were positive for mets. There's no doubt that the chemo and radiation can make a person feel pretty miserable, it's not fun by any means. My own feeling was at the time, and still is, that I'd rather hit my cancer with everything available, rather than exclude treatment in the fear that it might make me sick. There's never any guarantee that treatment will cure the disease, but if it were to return I'd rather feel that I did everything possible rather than to wonder if I should have taken advantage of some of the treatment that was offered to me. Six weeks of radiation isn't pleasant, nor is the chemo, but the side effects are temporary, we feel better after a while, and the discomfort eventually becomes a distant memory. It certainly tests your mettle, and I think you end up a better person for it. Getting a second opinion is always a good idea, but personally if I had to go through it all over again I'd opt for every treatment available to me, including the radiation.
Carl

alihamilton's picture
alihamilton
Posts: 344
Joined: Jan 2004

Hi Michel,

Sorry to hear about your father. They do say that radiotherapy does reduce the chance of local recurrence by making sure there are no residual cancer cells in the area of the original tumour. Chemo mops up any cells that may be throughout the body, including the lymph nodes. So it is probably worth your father having the radiotherapy. The effects of the radiotherapy do not normally kick in until around the third week and are not usually too bad....maybe some diarrhoea, tiredness, nausea, etc. By the time, the effects are really being felt, it is finished! It will be interesting to see what others on this board think, but this is my opinion.

Good luck to your father.

MJay's picture
MJay
Posts: 132
Joined: Aug 2004

You didn't say where the cancer is located in the colon and that may have an effect on the chemo/radiation effects.

I had stage 3 rectal cancer with a 5cm tumor located at the base of my rectum. I went through a chemo/radiation for 5 weeks. The doctor used a kind of radiation that strikes at the whole tumor by hitting it many times around the tumor area. I think I was hit over 100 times each day when I went in for radiation. I know I was on that table for over 20 minutes each time. I was also wearing a pump that would adminster chemo 24/7 that was meant to enhance the effect of the radiation.

In the end it did work. It totally obliterated the tumor. Unfortunately I still had to have the surgery leaving me with a permanent colostomy, a rebuilt vagina and complete hysterectomy.

The worst thing about the radiation were the burns. I was very badly burned in the bum and vaginal area. I will never ever forget the bowel movement when the burn had moved to the inside of my bum. I am sure the kids will never forget my scream. But after I new what to expect it was easier to work through and would envision the radiation burning the tumor and would chant to myself "Burn baby burn." It didn't last too long.. maybe a couple of days.

One piece of advice if your dad does get the burns... Aloe. Not the "100% Pure" kind from the pharmacy but the kind straight from the plant. My poor hubby had to squeeze the aloe from the leaves on my badly burned bottom. That and baking soda sitz baths were the only things that "put out the fire".

They only found microscopic traces of live cancer cells remaining in the tissue they took out during surgery. At the moment I am going through four months of chemo to obliterate any cells that may be remaining. I am having a hard time going through this phase... part of it is that I think I am just at my limit of what I can take. I thought surgery was going to be the worst part about this whole journey... looking back I will probably say that it was... but I am finding that where ever you may be in this cancer journey... that is the worst part.

Good luck and I wish you both well. Cancer doesn't strike the patient... it strikes the whole family.

MJay

aspaysia's picture
aspaysia
Posts: 257
Joined: Nov 2003

I had a similar regime of continuous 5fu and daily radiation for a month to shrink the tumour (low rectal) with surgery after a month's rest. The colostomy was done before anything else so I did not have that problem of pooping through burned tissue. Ouch!
My troubles began when it should have been all over. I was sensitive to the radiation and it caused serious wound management issues. My skin was so fried inside and out it would not heal. A plastic surgeon spent the next year fixing me up with various treatments listed on my website.
You need to be wary of radiation and chemo. Try to get all the info you can from the docs about side-effects. The radiologist said nothing to me except that I was doing well. But down the road...in my case chemo/readiation was the gift that keeps on giving.
Aspaysia, who still needs lots of pillows to prop her up.

andreae
Posts: 238
Joined: Sep 2003

Dear Michel,

Was the tumor in the colon or rectum? Rectal cancer is normally treated with 28 cycles of radiation with continuous 5FU (sensitizes the cells to the radiation). I know that for rectal cancer, radiation is clearly beneficial. Years ago, local recurrences were very common (given that the lower the tumor, the harder it is to access). Recent advances in surgical techniques and radiation has really benefited rectal cancer survivors. For colon cancer, I don't believe that there is data showing a clear benefit (but I could be wrong). Perhaps you should ask the doctor what data he is using to support his recommendation. If he/she is a good physician, they will be glad to direct you to the empirical evidence. As for the diet, I would definitely go for a switch. I realize Atkins is the rage, however, I think everything in moderation is the key. Lots of fruits, veggies, the occasional helping of meat and carbohydrates, good portion control... Perhaps our resident nutritionist, Emily, can help you out! Or perhaps ask for a consult with a nutritionist at your hospital.

Good luck to you and your father!

Andrea

taraHK
Posts: 1961
Joined: Aug 2003

Hi Michel,
I was diagnosed with rectal cancer. My regime was 6 weeks chemoradiation, then surgery, then post-surgical chemo. As others have indicated, radiation is certainly indicated for many cases of rectal cancer. I am not so up-to-date with benefits of radiation for colon cancer. Your doctors should be able to answer this -- ideally with evidence from recent research studies. In terms of side-effects: the radiation made me tired. The fatigue started about 2 weeks after the radiation started, but lasted about 2 weeks after it ended. The fatigue wasn't very bad, but I did have a nap/rest almost every day And, like several others who have replied, I had some skin burns (for me, around my anus). The burn did eventually go away - and there were some things which helped (creams, and sitz baths -- you should get your doctor or nurses's permission for any creams -- apparently some can interfere with the radiation). Oh, I also had diarrhea. It was a little difficult to separate what was due to the radiation and what was due to the chemo, as I had both at once.
Of course it is up to each individual to choose what treatments to accept. I went for as aggressive an approach as I could tolerate - and I have no regrets about my decision. There were certainly some low moments. I am happy to be 100% healthy today (19 months after surgery - and counting each month as it goes by!).

steved
Posts: 836
Joined: Apr 2004

Your father is having a slightly unusual regime if he has colon cancer- it is more common for rectal to be treated with radiotherapy as it is an immobile cancer fixed int eh body whereas the colon is free to move around more (so is harder to zap with radiation). It is also more common to have the radiotherapy before the surgery but if not given preop it is sometimes used postop.
I would agree with above about getting a second opinion about this.

I have stage 3 diagnosed this year and because it was rectal had preop 6 week s radiotherapy and chemo togehter. Wasn't too bad- worked full time til the last two weeks when the diarrhoea stopped me working. Did get tired and had some skin burns but overall was tolerable- not a lot worse certainly than the folfox regime. It is all individual though and is a 'wait and see' kind of thing.
Is it worth it when it isn't guaranteed to work? In my opinion yes- anything that improves the odds in your favour that isn't too intolerable is worth it as it is all a game of odds. If you dont do it and it comes back then you will question yourself about not having done everyhting possible to prevent it. This isn't the conclusion all come to but is my way of approaching what is a tough decision.
Let us know a bit more about your dad if possible and he is alway welcome here anytime himself.
Best of luck,
Steve

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