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Stage 2A- Chemo or no chemo after surgery??

Posts: 4
Joined: Apr 2018

Hi Everyone


 I am new to this board and to posting online. On March 14 I had surgery to remove a T3 size tumor and colon resection. 33 Lymph nodes were removed with ovaries and tubes and all were clear. Did not Metasisize. The tumor had gone to the bowel wall so  Dr is recommeding chemo.  but observation is an option as well.  Considering Xeloda for 6 month treatment, however, very conflicted since all is clear. Really considering no chemo and seeing nauropath alternatives to build up immune system and lifestyle changes.


I looking for any input on Xeloda and going with observation.   Any information would be apprecited.




Trubrit's picture
Posts: 5530
Joined: Jan 2013

And, as much as we can give advice, you will be the one making the ultimate decison, and it will be hard. 

Let me just say though, when you make your decisoin, don't look back and play the 'what if' game.  

Stage II is a good stage for observation.  

After my liver resection, my Oncologist debated mop up chemo. We decided against it (he also called a collegue in San Francisco) and now I am approaching my 4th year post surgery and being NED. 

Good luck as you move forward. 


Posts: 4
Joined: Apr 2018

Thanks so much!!  I appreciate the response about Stage 11 being a good stage for observation. I feel that way too.  Much appreciated.


SandiaBuddy's picture
Posts: 1200
Joined: Apr 2017

It strikes me as being a very difficult decision and one that is entirely up to you.  I was in a similar situation and tried chemo, but did very poorly with it.  In fact, I wish I had not tried.  It is well worth reviewing the various postings on the board about capecitabine (Xeloda) and making the most educated decision possible.  Best of luck to you.

Posts: 4
Joined: Apr 2018

Thanks for the input and the advice to review the postings.  Very much appreciated !!


Annabelle41415's picture
Posts: 6733
Joined: Feb 2009

This is a very personal decision and you must weigh all your options before you decide.  Don't ever look back and think "what if".  Sometimes at that stage it is tricky.  You just have to make sure that you get the doctor's opinion and then you make the decision that you can be comfortable with.  Let us know how you are doing.


Tunadog's picture
Posts: 235
Joined: Mar 2017

The side effects of Xeloda are very minimal for me. A little fatigue but not to bad.

I’ve been taking it for two years. The past year taking it along with Avastin.

Best of Luck in your journey 

tanstaafl's picture
Posts: 1303
Joined: Oct 2010

Chemo intensity for 3 months, and molecular factors rather than the longer 6 months chemo duration appear most important for adjuvant treatment (ie. stage 2a). So some stage II patients might go for 3-4 months of chemo, while avoiding dangerous synthetic folic acid in enriched foods and lower quality multivitamins (see the label); natural type folate(s) or even trace leucovorin for vitamin B9 folate are ok in multivitamins.  Also we checked 25 hydroxyvitamin D levels, a common gross deficiency for CRC associated with problems.

Some of the most important CRC survival statistics are actually altered by baby aspirin and 800 mg cimetidine targeted by tissue tests, targeted by PIK3CA mutation and CA199 respectively.  It is hard to get medical support for this informal targeting (check back in 5-10 years...), so we just went bare (without a tissue test) with 81 mg aspirin for advanced CRC, and used a CA199 blood test before surgery, to best approximate the CA199 information, along with chemo.  These factors are so important we used them for stage 4 colon cancer with oral chemo.

After surgery, the CA199 blood test likely is more limited in information content but still may find important information shifting odds and use. If the result is extra low,  CA199 under 2 means no cimetidine, it biologically cannot be useful for long term CRC treatment use, or statistically, serum CA199 over CRC patients median, about 19, has statistical potential rather than a 37 cutoff, misquoted for pancreatic cancer's initial detection.  The higher the CA199, more the possibility of recur although other markers or conditions may alter the odds of usefulness.  In specific molecular cases, these off label drugs turn off specific kinds of deadly cancer processes when added to chemo.      These markers are lower and less common in stage II patients, but when the markers are there higher, it is important because those are the specific patients statistically most likely to recur.

Since drs typically haven't done their homework beyond the basics, we usually order tests for advanced purposes ourselves, and pay cash.  Sometimes we've had mainstream medical support or had insurance pay for them, but that is less common and more discussion.

These Life Extension articles on   colorectal cancer specifically; and cancer generally; and special report were particularly  helpful in the weeks between diagnosis and surgery but may be still useful on aspirin, cimetidine and supplements.

Posts: 56
Joined: Dec 2017

what is synthetic folic acid and what is its role in colon CA my fathers oncologist has prescribed him tablet of folic acid and iron to improve his hb please explain synthetic folic acid 

Posts: 88
Joined: Nov 2017

i had stage 2 t3 as well, and it was recommended i take the chemo- there was abotu a 7-10% improvement chance for survival with the chemo, and while not huge, it was in my opinion large enough to warrent the chemo- but that is just me- 10% is pretty significant- had it only been around say 3%-4% or so i would have personally opted not to get the chemo- we only get one chance to 'get thigns right' in this life- and it semed to me that doing all i could to ensure greatest success was the right thing to do- I don't htink i could have lived with myself if i had refused chemo and cancer grew back- I'd have always wondered/worried that my decision contributed to it- however, IF the cancer grew back after gettign hte chemo- my thought process woudl be "I at least did my best to prevent it- this is now just a result of fate"


but that's just me- it's a tough decision- T3 generally warrents chemo- T2 not so much

JanJan63's picture
Posts: 2482
Joined: Sep 2014

We're not supposed to give medical advice on here but I'll just say this one thing. Your body doesn't recognise cancer. It won't go after it so trying to boost your immune system is likely not going to help. I'm on an immunotherapy chemo and it has to be given to me so that it will detect certain protein in the cancer cells and it tells my body to target that. Otherwise it won't do anything. And even with that it will only work on certain colon cancers that are vulnerable to this chemo. 

That being said, I'm with you on wondering if there's any point to it. I was very reluctant to do mop up chemo after my surgery and mine was stage three at that time. I did it but didn't finish the regimen and I did have my cancer spread. If I hadn't done it and had it spread I'd be furious with myself. It's a tough call. I have tried Xeloda and had very little for side effects from it.



abita's picture
Posts: 1073
Joined: Dec 2017

I am doing the mop up chemo for the same reason. Although, being stage 4, I don't feel like I have a choice. Were you on FOLFOX?

JanJan63's picture
Posts: 2482
Joined: Sep 2014

I was. I had all but two of the treatments but kept getting bllod clots in my legs. My doctor told me to just take aspirin and then one broke off and went to my lung. Almost killed me.  Or should have killed me. I survived but will never be on FOLFOX again. I still have some neuropathy in my feet as well and that was December of 2014.


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