Question

ricco · December 2011

John23 said:
Wow.

Nice data Blake!

Re:
Stage II Colorectal Cancer: To Treat or not to Treat

Continuing down that link you provided, is the following:

"Conclusion

In conclusion, randomized controlled trials and meta-analyses
have uniformly failed to definitively detect a survival benefit
for adjuvant chemotherapy in stage II CRC.

These trials have included insufficient numbers of patients with
stage II disease to ultimately determine whether adjuvant
chemotherapy in this population is truly beneficial.

Nonetheless, there remains no clinical or biological reason
to believe that the clinical behavior of stage II tumors
should be different from that of stage III tumors.

Therefore, clinical trials in stage II CRC must incorporate
better risk stratification using molecular markers and an
adequate number of patients to define the relative disease-free
and overall survival benefits from chemotherapy. "

As a cancer victim, and as a stage four since 2006, I am tired
of doing the research only to find the same data repeated time
and time again.

Chemo can help stall or slow the progression, but at a cost....

The cost can be in second cancers or permanent neurological
problems, and the patient should not be afraid to ask before
submitting to the treatments.

Yes, I believe the good must be weighed against the bad; I had
to do that, you had to do that, and every one of us here should
have had to do that.

The decision should not be made out of haste or fear, but only after
weighing all the options.

The point is, that not too many of us knew all the options, we
only heard about the "conventional" options, and we're made to
believe that they are the only options available.

Emily, Scouty, I, and others have tried options that most individuals
did not know existed; we are still here to talk about it. Perhaps
I won't be here tomorrow, but it will not mean that it was a failure,
it will only mean that my time had come.

There are no guarantees with chemo, radiation, TCM, or any
other practice; cancer kills. And when it isn't the cancer itself
that kills, it's the after-effects of treatment (or in my case) surgery
that manages to snuff the life out of us.

There are choices available to provide life and strength to battle
cancer and other ills in life; TCM and herbal remedies are only
a small part of it.

We're here to help provide some insight and hope; to allow
others to know that if the "conventional medicine" fails to work,
or is doing more harm than good, that there is indeed other
ways to do battle without the side effects and hazards.

Best of health to you,

John

Thanks John
Wise words.

I am new here. I have had stage 2b colon cancer treated with surgery.

After 1 cycle of chemo I am putting a stop to it. I wasn't worried about the treatment until 2 days in I spent 3 days in hospital after what they called a "heart episode". A rare side effect but a side effect nevertheless. The doctors want to change my regime and give me cardiovascular drugs to offset the problems. Apparently the arteries go into spasm. I have no underlying heart disease but could end up with a heart problem or worse.

I feel a weight has been lifted after this decision.

Ricco

Buckwirth · December 2011

John23 said:
Wow.

Nice data Blake!

Re:
Stage II Colorectal Cancer: To Treat or not to Treat

Continuing down that link you provided, is the following:

"Conclusion

In conclusion, randomized controlled trials and meta-analyses
have uniformly failed to definitively detect a survival benefit
for adjuvant chemotherapy in stage II CRC.

These trials have included insufficient numbers of patients with
stage II disease to ultimately determine whether adjuvant
chemotherapy in this population is truly beneficial.

Nonetheless, there remains no clinical or biological reason
to believe that the clinical behavior of stage II tumors
should be different from that of stage III tumors.

Therefore, clinical trials in stage II CRC must incorporate
better risk stratification using molecular markers and an
adequate number of patients to define the relative disease-free
and overall survival benefits from chemotherapy. "

As a cancer victim, and as a stage four since 2006, I am tired
of doing the research only to find the same data repeated time
and time again.

Chemo can help stall or slow the progression, but at a cost....

The cost can be in second cancers or permanent neurological
problems, and the patient should not be afraid to ask before
submitting to the treatments.

Yes, I believe the good must be weighed against the bad; I had
to do that, you had to do that, and every one of us here should
have had to do that.

The decision should not be made out of haste or fear, but only after
weighing all the options.

The point is, that not too many of us knew all the options, we
only heard about the "conventional" options, and we're made to
believe that they are the only options available.

Emily, Scouty, I, and others have tried options that most individuals
did not know existed; we are still here to talk about it. Perhaps
I won't be here tomorrow, but it will not mean that it was a failure,
it will only mean that my time had come.

There are no guarantees with chemo, radiation, TCM, or any
other practice; cancer kills. And when it isn't the cancer itself
that kills, it's the after-effects of treatment (or in my case) surgery
that manages to snuff the life out of us.

There are choices available to provide life and strength to battle
cancer and other ills in life; TCM and herbal remedies are only
a small part of it.

We're here to help provide some insight and hope; to allow
others to know that if the "conventional medicine" fails to work,
or is doing more harm than good, that there is indeed other
ways to do battle without the side effects and hazards.

Best of health to you,

John

WOW!
you mean I got it right the first time when I posted this:

Your 2% number might hold true for at least one class of CRC patients:

In contrast, the International Multi-centre Pooled Analysis of Colon Cancer Trials (IMPACT) B2 study, which combined data from patients in five separate trials, did not show any statistically significant benefit of 5-FU/leucovorin combinations over surgery alone in stage II patients [7]. Those studies enrolled 1,025 patients who had stage II node-negative colon cancer into four Canadian/European and several North Central Cancer Center Treatment Group (NCCCTG) trials. The overall survival rates at 5 years were 80% for the control group and 82% for the treatment group, suggesting that for every 100 individuals with node-negative disease, adjuvant 5-FU therapy only benefited two of them.

My opinions on chemo are more nuanced than you often make them out to be, but you always seem to assume and never actually ask.

Buckwirth · December 2011

ricco said:
Thanks John
Wise words.

I am new here. I have had stage 2b colon cancer treated with surgery.

After 1 cycle of chemo I am putting a stop to it. I wasn't worried about the treatment until 2 days in I spent 3 days in hospital after what they called a "heart episode". A rare side effect but a side effect nevertheless. The doctors want to change my regime and give me cardiovascular drugs to offset the problems. Apparently the arteries go into spasm. I have no underlying heart disease but could end up with a heart problem or worse.

I feel a weight has been lifted after this decision.

Ricco

Ricco,
As the poster of the actual data, your welcome.

I do recommend that you have a frank discussion with your oncologist, and go over the current stats (these are six years old). I know from other readings that at least one form of stage 2 has survival stats that mimic stage 3. The odds are this is not what you have, and not doing chemo is probably a good decision (I know I would not do it for a 2% change in outcome).

tanstaafl · December 2011

Buckwirth said:
WOW!
you mean I got it right the first time when I posted this:

Your 2% number might hold true for at least one class of CRC patients:

In contrast, the International Multi-centre Pooled Analysis of Colon Cancer Trials (IMPACT) B2 study, which combined data from patients in five separate trials, did not show any statistically significant benefit of 5-FU/leucovorin combinations over surgery alone in stage II patients [7]. Those studies enrolled 1,025 patients who had stage II node-negative colon cancer into four Canadian/European and several North Central Cancer Center Treatment Group (NCCCTG) trials. The overall survival rates at 5 years were 80% for the control group and 82% for the treatment group, suggesting that for every 100 individuals with node-negative disease, adjuvant 5-FU therapy only benefited two of them.

My opinions on chemo are more nuanced than you often make them out to be, but you always seem to assume and never actually ask.

high risk stage IIs
Most of the stage II patients who are at great risk are those whose tumors stain high for CA19-9 and CSLEX1 on fixed slides. They might as well be early stage IV if they don't take cimetidine.

This is the subject of about two dozen Japanese papers as well as some from Denmark, Australia, China, Korea, Taiwan. The most successful treatments have been metronomic dosed 5FU (oral! ca 1990 Japan) and UFT for 1-2 years with cimetidine and PSK. Hard to say Xeloda would do as well in a minimum residual disease case (without tumor masses).

The best that the average person can do is get a serum (blood) CA19-9 before surgery, or whenever if necessary. Although papers indicate a significant (p<0.05) cimetidine benefit for values over 33-37, other papers imply that cimetidine survival benefit might be mined from CA19-9 blood tests down to about 3 to 10 with additional testing.

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