Stage IIA (T3,N0, M0) Sigmoid Resection - Should I do adjuvant chemotherapy?

bigsmile1k

I guess I have 2 risk factors for recurrence: 1) MMR Proficient. It may mean the tumor is more aggressive 2 ) Obstruction - Controversial on the definition: Two oncologists considered obstruction since regular size probe cannot go through in colonoscopy or sigmoidoscopy. But another two oncologists did not think so since I don't have a complete bowel obstruction and there is no need for hospital care on any obstructions.

Go or no go on Chemo.?

After surgery in 12/2021, the stool is narrow but medium soft/firm. Do you know why it keeps narrow? Do you have similar symptoms? Sometimes the thought of still having some issues somewhere in the system appears in my mind.

One oncologist ordered CT scan. Another one ordered PET-CT from skull to mid-thigh for checking if there are any cancer issues left. Do you do both PET-CT AND CT? Do you use more than one oncologist?

SandiaBuddy

The chemotherapy issue is a tough one--you might want your oncologist(s) to get very specific about how much of a gain in survival s/he thinks you will get by doing the chemo. Chemo can have serious consequences. As for me, it caused permanent heart damage and I wish I had not done it, but everyone's experience is different.

This soon after surgery, your body is likely still adjusting to the altered anatomy. I have certainly had narrowing of stool since surgery, but have no real concerns. As long as the system is working, that seems to satisfy the doctors, and me as well. There are always some adjustments to "the new normal." There are always worries about function and recurrence. I guess you just get used to them after a while.

I have never had a PET scan, so I cannot comment on it, but if you are seeking information, maybe the more information you get the better.

Good luck with these issues.

SnapDragon2

I swap up between between CT's and PET/CTs for surveillance.

What are the chemo options?

StonedCamaro

I'm same stage as you completely. But my team doesn't want to do surgery. Diagnosed on 11/19/21. Started chemo on 1/7/22, Capeox which is Oxiplatin infusions and Xeloda pills. I'm HATING the Ox infusions! Pills aren't as bad but I worry about long term effects. They want me to do chemo for 4 and half months and then chemo/radiation for 6 weeks after that.

I'm still learning the language but I had no genetic markers and no known reason that I got it. Wondering what other factors separate us?!

airborne72

I'll share my experience as it parallels some of what both of you are encountering. But remember that I am not a medical practitioner.

Diagnosed with stage 2 rectal cancer in May 2017 after a colonoscopy that I requested. Had been experiencing the common symptoms of CRC (constipation, bloody stool and fatigue) for several months. I had to assemble a team of surgeon, chemical oncologist and rad oncologist. The chemical oncologist was the best team player. The others were somewhat on their own tangent.

I underwent the 25 daily treatments of radiation while consuming the Xeloda pills. The goal was to shrink the tumor so the surgical extraction would be less problematic. The downside to this neo adjuvant treatment was the cumulative effect of the radiation (fatigue and finally uncontrollable diarrhea). That resolved itself and two months later I had my resection surgery.

An unpredicted outcome of the surgery was a temporary ileostomy. That was necessary because the surgeon had difficulty getting his medical tools in/out of my colon after the resection and he feared that the staples/stitches would not properly hold my gut together while it mended. I quickly learned to live with an ileostomy.

After two months of recovery I agreed to begin the follow-up (mop-up) chemo therapy treatment via a port that was inserted in my chest during the resection surgery. My chemical was FOLFOX. At that time (late 2017) the commonly accepted best practice for that regimen was 12 infusions (one every other week). I had spent much of my recovery time researching the efficacy of mop-up chemo versus the risks (impact on my physical, emotional and mental health plus the high incidence rate for neuropathy). I was not convinced that I needed that much treatment considering that my tumor had a 100% clinical response to the neo adjuvant treatment AND the resection surgery. The oncologist kept saying that it only took one cell and I kept looking at myself in the mirror. We agreed upon a shortened version of treatment of only six infusions, but I reserved the right to call it quits if/when I determined that the neuropathy was problematic.

After three infusions I called it quits. My weight was dropping rapidly, my mental health was shaky and my "non cancerous" gut told me that I did not need anymore infusions. After another three months of recovery I was strong enough to endure the ileostomy reversal surgery.

It's been over four years since I was last infused and I have yet to have any indications of recurrence. During my last six month visit with my oncologist he mentioned that the best practice today for a tumor like mine in 2017 would not include the adjuvant chemotherapy.

At the end of the day it's all an individual decision - the patient's decision. Gather information, review the facts and make a decision. Understand that you are operating from an emotional perspective while the medical practitioners are operating from a clinical perspective.

Jim

beaumontdave

Hi, and welcome. I was 111b with the mass in the sigmoid section, but not obstructed, as it was shedding some weird-looking tissue, along with light blood, the sign that this was not normal stuff. After surgery I did the 12 of Folfox, with minimal, but annoying and persistent side effects. I guess that puts me on the least affected list, though my hands, feet, and some things affected seemed to last over a year and a half. My CEA never got down all the way to normal, so the onc decided it was in my liver when the colectomy was done, though only two nearby nodes lit up on the PET scan. Two surgical trips to remove liver masses resulted. I never did chemo again because, as the onc, stated, ''We took our strongest shot already''. I had nearly as many PET scans as CT scans for quite a while, the CT followed by an order for a PET scan, annoying and scaring me at the same time. Why not just do both at once? They just kept seeing uncertain things in me. Things in a sewn together colon stay in flux for awhile, thin stools sounds like normal healing to me. Best of luck with your choices and outcomes here..........................Dave