Pathologic Complete Response

lauragb

Anybody else out there had or know someone that had a pathologic complete response to
neoadjuvant chemoradiation and what they did post surgery treatment wise. I am getting conflicting advice on what to do. As you can guess, oncologist recommends chemo and surgeon does not. The surgeon has been involved in research on this topic so he does have
a lot of knowledge about it.

I am so thankful for my pathology report but am trying to make a decision which has been very stressful.

Thanks.
Laura

janie1

Great news, Laura!
I can't offer any words of experience here. Others will have input, and I would also ask on the Colon Club forum... to get as many replies as possible.
Best wishes!

p.s What is the chemo onc recommends? Saw where you had an earlier prob with the 5FU.

neons356

Had to look that one up
Hi Laura,
I had to do some quick research on the net to get the whole meaning of what neoadjuvant chemoradiation is. From the articles that I found it's pretty much what most of us opt for- chemo and radiation pre surgery, and sometimes also following surgery. The statistics I found suggest that those that opt for it stand a 74% nonrecurrance versus about 8%. So if I'm reading this correctly you're better off with it than without .As for me personally, I went thru it and I'm still NED after several years.
Carl

lauragb

neons356 said:

Had to look that one up
Hi Laura,
I had to do some quick research on the net to get the whole meaning of what neoadjuvant chemoradiation is. From the articles that I found it's pretty much what most of us opt for- chemo and radiation pre surgery, and sometimes also following surgery. The statistics I found suggest that those that opt for it stand a 74% nonrecurrance versus about 8%. So if I'm reading this correctly you're better off with it than without .As for me personally, I went thru it and I'm still NED after several years.
Carl

I did have the pre-op chemo
I did have the pre-op chemo and radiation. Following surgery, my pathology report showed no cancer in 23 nodes that were tested and my tumor was also not cancerous anymore. There was no cancer anywhere in the rectum and sigmoid or near the margins, none.

The disagreement is about post surgery between the medical oncologist and surgeon. As I said, the surgeon is involved in research about adjuvant chemo and this is his opinion. I think most oncologists would recommend chemo because it is standard treatment. I just don't want to expose myself to more assault if the risks and long term side effects outweigh the potential benefits.

tommycat

I did before AND after
I did before AND after chemo, just to be safe. The onc suggested it, and I decided to take his advice, mainly because "x" amount of years down the road I don't want to wish that I would have....
Like you, I showed a complete pathologic response after all the usual trtmts (chemo, radiation, surgeries) but for me, the benefits of 8 more weeks chemo outweighed the health risks of it.
Side note: Cancer notwithstanding, I went into treatment healthy, with no known underlying health issues.

Annabelle41415

Hard
Hard to decide. My surgeon didn't really think I did, but it was my radiologist that was following my case and had taken it to the tumor board and 11 doctors said no and one said yes because he said he knew one patient where it came back and for that one person he would recommend it. So my radiologist, surgeon and oncologist all talked and before they even gave their opinion I said I wanted it. My mom had breast cancer and only did surgery and radiation and I believe today if she did the chemo she would be here today. Can't say either way and it totally has to be a decision that you can live with either way. It's a hard choice to make and because of the chemo I've got permanent neuropathy but I'm glad I did it. Good luck.

Kim

lauragb

I really appreciate
I really appreciate everyone's input. I still don't know what I'm going to do but
I will have to make up my mind by the beginning of next week because I will start chemo then if I'm going to do it....................

swimmer22

lauragb said:

I really appreciate
I really appreciate everyone's input. I still don't know what I'm going to do but
I will have to make up my mind by the beginning of next week because I will start chemo then if I'm going to do it....................

Same here
I too was very fortunate to have a complete response to pre-surgery chemotherapy/radiation. My rectal tumor was reduced to scar tissue and when removed pathology showed no microscopic activity. Likewise, I had 10 lymph nodes removed and they too were cancer free. My surgery was laparoscopic and I do have a temporary ileostomy.

I was presented with the same decision as you. My surgery was September 6, 2011 and I opted to complete the chemotherapy treatments post-surgery. Both my surgeon and the oncologist thought it was a good preventative idea. They also quoted higher success rates for reduced recurrence when chemotherapy was provided.

So far, I have completed 5 of 10 Folfiri treatments. While it isn't the most fun in the world, I'm betting on the added protection that it will kill any other microscopic cancer cells that may be floating around. I have treatments once every two weeks. Three weeks after my last chemotherapy treatment, they will reverse my ileostomy. I pray, once this is over, I will be cured. Best of luck to you!

lauragb

swimmer22 said:

Same here
I too was very fortunate to have a complete response to pre-surgery chemotherapy/radiation. My rectal tumor was reduced to scar tissue and when removed pathology showed no microscopic activity. Likewise, I had 10 lymph nodes removed and they too were cancer free. My surgery was laparoscopic and I do have a temporary ileostomy.

I was presented with the same decision as you. My surgery was September 6, 2011 and I opted to complete the chemotherapy treatments post-surgery. Both my surgeon and the oncologist thought it was a good preventative idea. They also quoted higher success rates for reduced recurrence when chemotherapy was provided.

So far, I have completed 5 of 10 Folfiri treatments. While it isn't the most fun in the world, I'm betting on the added protection that it will kill any other microscopic cancer cells that may be floating around. I have treatments once every two weeks. Three weeks after my last chemotherapy treatment, they will reverse my ileostomy. I pray, once this is over, I will be cured. Best of luck to you!

I appreciate hearing about
I appreciate hearing about your decision. It has been hard for me to decide since my surgeon has been so against chemo. I have seen two recent research papers in which they have shown no benefit to adjuvant chemo for people with pCR. That said, I have been heading back toward the decision to do the chemo. I've come this far (which has not been fun to say the least) and I think I may regret it and worry even more if I don't.

It's hard for me to imagine all that I still have to go through with chemo, takedown and then the adjustment that follows that. Yet, I feel bad complaining when I read what others are going through.

Sending love, light and prayers to all you cancer survivors.
Laura

son of hal

lauragb said:

I appreciate hearing about
I appreciate hearing about your decision. It has been hard for me to decide since my surgeon has been so against chemo. I have seen two recent research papers in which they have shown no benefit to adjuvant chemo for people with pCR. That said, I have been heading back toward the decision to do the chemo. I've come this far (which has not been fun to say the least) and I think I may regret it and worry even more if I don't.

It's hard for me to imagine all that I still have to go through with chemo, takedown and then the adjustment that follows that. Yet, I feel bad complaining when I read what others are going through.

Sending love, light and prayers to all you cancer survivors.
Laura

You gotta know when to hold em and when to fold em...
I don't post much but figured I'd chime in. I had the same situation as others mentioned but my research indicates not enough benefit from chemo after surgery for stage I and stage II. (I was stage2 T3) I did the neoadjuvant six weeks chemoradiation and had a complete response.I took the wait and see aproach and at my six month follow-up was found to have a recurrence at the exact same spot as original tumor so I went in for the sugery. After surgery (laproscopic with temp. illeostomy) surgeon said I was stage 1 and all cancer was removed with no signs anywhere else (lymph nodes clear). There was no mention of any post-op chemo but I will decline if asked. Remember chemo is not intended to be used as a preventitive treatment. It cannot stop cancer from starting only slow or halt it's growth once it is active. By taking it before anything is there it may (?) lessen it's effectivness down the road. Specific chemos sometimes stop working on a person after awhile so they have to change them up. With cancer they say you have to play the hand you are dealt. Well, personally, I don't want to show my hand before it's called.
Just my opinion.
Take care, CJ