Adjuvant and Xeloda

funnyguy

Question for others out there. I was dx with Stage II Colorectal last oct 05. Since then I've had pre-op radiation and Xeloda. Now Post Op I'm working towards completing 6 more complete cycles of Xeloda for Adjuvant follow up (2 weeks on, 1 week off).
It seems there is discrepancy in the medical community over how much to actually do? Between 4 and 6 months total.

Does anyone have any experience with this decision?

KathiM

I had NO post-surgical chemo. BUT my 'beast' was squamous cell, in the rectum, stage III..cisplatin and 5FU along with 5 weeks rads.

I was confused, too...but here I am, 2 years post-treatment, still NED (No Evidence of Disease).

My friend, stage III, adenocarcinoma of the rectum, Xeloda and rads pre-surgical, will have 6 weeks of 'regular' 5FU (Xeloda is metabolized as this, you already know) after she recovers...she had her rectum removed, also. She is cancer-free...none of the removed tissue had cancer left...

Sorry if I blurred the pot...but I think there is much difference between each person...I feel that if you trust your treatment team, well, that's what made the difference for me...
Hugs, Kathi

claud1951

Hi Funnyguy,

I am stage III colon adenocarcinoma in Acsending colon. Surgery took out 12 inches of colon.

I did not have pre-surgery treatment. Started Oxaliplatin (once every 3 weeks) then Xeloda for 14 days on..1 off. My Onc said it would be 6 months.

I had to get off the Xeloda (pills) because I had the hand/feet syndrome of peeling to much. He was afraid it would cause infection.

I am now on the Pump 5-FU (after my treatment of Oxaliplatin for 2 days after...Go in, now , every 2 weeks with that.

So far I've had 5 treatments. If I go 6 months, that would make it 12 treatments.

I'm seeing the ONc this week and going to ask if I have to go that long..

Hope this helps? Good luck to you and let us know how you are doing

Claudia

robinvan

Hi Funnyguy,
I'm currently on Xeloda,Irinotecan, and Avastin for a recurrence in the liver. The recurrent met was eliminated with RFA and the chemo is to clean up and micro-metasteses. My onc said he usually does this mix for 6 cycles. Same as yours, 2 weeks on, 1 week off. I'm half way through.
Bye for now... Rob

kmygil

I'm confused. If you were stage II, why was there radiation? I was stage II, dx'd last August, and had surgery followed by Folfox (oxaliplatin, leucovorin and 5FU). I did the oxaliplatin/leucovorin plus antinausea at the chemo center & went home with the 5FU pump for the next 46 hours. I had 9 of 12 rounds (side fx stopped me at 9.) There was never any mention of radiation, since the tumor was small enough to be removed right away. I thought all Stage II was small enough to be removed immediately. Am I an idiot?:)

funnyguy

claud1951 said:

Hi Funnyguy,

I am stage III colon adenocarcinoma in Acsending colon. Surgery took out 12 inches of colon.

I did not have pre-surgery treatment. Started Oxaliplatin (once every 3 weeks) then Xeloda for 14 days on..1 off. My Onc said it would be 6 months.

I had to get off the Xeloda (pills) because I had the hand/feet syndrome of peeling to much. He was afraid it would cause infection.

I am now on the Pump 5-FU (after my treatment of Oxaliplatin for 2 days after...Go in, now , every 2 weeks with that.

So far I've had 5 treatments. If I go 6 months, that would make it 12 treatments.

I'm seeing the ONc this week and going to ask if I have to go that long..

Hope this helps? Good luck to you and let us know how you are doing

Claudia

These answers all help a little. It really comes down to no one really knows for sure when 'enough is enough'.
Faith and hope need to take over as primary treatment at some point.
Like all of you; I don't wish to take this path again.

I'm open to hearing any more stories and thoughts on the topic.

vinny3

kmygil said:

I'm confused. If you were stage II, why was there radiation? I was stage II, dx'd last August, and had surgery followed by Folfox (oxaliplatin, leucovorin and 5FU). I did the oxaliplatin/leucovorin plus antinausea at the chemo center & went home with the 5FU pump for the next 46 hours. I had 9 of 12 rounds (side fx stopped me at 9.) There was never any mention of radiation, since the tumor was small enough to be removed right away. I thought all Stage II was small enough to be removed immediately. Am I an idiot?:)

No you are not an idiot. There is some discrepancy in how Stage 2 is treated. It depends upon how aggressive your onc is for one and where you go. I had Stage 2 rectal cancer treated initially with radiation/with 5 FU for about 5 weeks and then a local excision. There was no sign of the cancer at surgery. However I had a local recurrance at about 8 months after and then had an abdominal perineal resection followed by 9 cycles of Folfox (was supposed to be 12 but just tolerated 9-onc then said Sloan was doing just 9). Just need to ask questions, do the research as much as possible and then choose, if possible, the course that seems best for you.

****

funnyguy

vinny3 said:

No you are not an idiot. There is some discrepancy in how Stage 2 is treated. It depends upon how aggressive your onc is for one and where you go. I had Stage 2 rectal cancer treated initially with radiation/with 5 FU for about 5 weeks and then a local excision. There was no sign of the cancer at surgery. However I had a local recurrance at about 8 months after and then had an abdominal perineal resection followed by 9 cycles of Folfox (was supposed to be 12 but just tolerated 9-onc then said Sloan was doing just 9). Just need to ask questions, do the research as much as possible and then choose, if possible, the course that seems best for you.

****

He's right. It's all in how agressive the Onc is and also the surgeon.
I had numerous surgical opinions and went with abdominal surgery and resection. I also had the 5 weeks of pretreatment.
Post Treatment is where things go funny. Multiple onc opinions. These were split between do nothing and do up to 6 months of Xeloda (between 6-8 cycles).
My personal choice was to be very agressive with this - I'm a spry and young 38. No need to underwhelm the situation. but now I'm reaching the point where I'd really like to get on with my life.

No easy decisions in this process.

I thought we were supposed to learn all we needed in Kindergarten??? ;}

LOUSWIFT

funnyguy said:

He's right. It's all in how agressive the Onc is and also the surgeon.
I had numerous surgical opinions and went with abdominal surgery and resection. I also had the 5 weeks of pretreatment.
Post Treatment is where things go funny. Multiple onc opinions. These were split between do nothing and do up to 6 months of Xeloda (between 6-8 cycles).
My personal choice was to be very agressive with this - I'm a spry and young 38. No need to underwhelm the situation. but now I'm reaching the point where I'd really like to get on with my life.

No easy decisions in this process.

I thought we were supposed to learn all we needed in Kindergarten??? ;}

I had six weeks of rads and low dose Xeloda (2000 mg per day) pre-surgery. 10 inches of colon removed. Since my tumor was low grade (slow growing) after surgery my surgeon felt my treatments were at an end. My onc had different ideas. So 5 cycles of heavy dose xeloda was decided. He quoted numbers like 80% chance of NED now but if more Xeloda 92% NED. Xeloda is nasty stuff on high dose very bad hand and foot syndrome along with some other goodies I don't care to remember. As I understand it the standard treatment is 5 cycles with the standard two weeks on and one week off. It took a lot to stick to it through the 5 cycles. I never want to go thru that again and I'm not sure I would. BUT 18 months later and I'm still NED. I think being aggressive is the best way. Be aggressive now while you're physically in the strongest position to face it. As Dennis Miller says "It's just my opinion, I could be wrong" But it worked for me.

funnyguy

LOUSWIFT said:

I had six weeks of rads and low dose Xeloda (2000 mg per day) pre-surgery. 10 inches of colon removed. Since my tumor was low grade (slow growing) after surgery my surgeon felt my treatments were at an end. My onc had different ideas. So 5 cycles of heavy dose xeloda was decided. He quoted numbers like 80% chance of NED now but if more Xeloda 92% NED. Xeloda is nasty stuff on high dose very bad hand and foot syndrome along with some other goodies I don't care to remember. As I understand it the standard treatment is 5 cycles with the standard two weeks on and one week off. It took a lot to stick to it through the 5 cycles. I never want to go thru that again and I'm not sure I would. BUT 18 months later and I'm still NED. I think being aggressive is the best way. Be aggressive now while you're physically in the strongest position to face it. As Dennis Miller says "It's just my opinion, I could be wrong" But it worked for me.

Thanks for your feedback. Your situation sounds very similar to mine - even the medical team advice.
I'm on track to complete 6 cycles of post surgery Xeloda. But haven't experienced the major side effects that you describe. The big decision on the table is whether to add 2 more cycles to round out the treamtent.
As you say, I rather do this now and kill the beast forever!