Did you have chemo again after surgery just as a precaution - yes or no. Thanks!

Carey-Ann
Carey-Ann Member Posts: 5
in Esophageal Cancer #1

Thanks to all for your help on my last post. A question for you as I prepare for Jeff's post-surgery oncologist appointment this week. Jeff's pathology at time of surgery showed 1 lymph node tested positive for cancer. We have no idea if that was all the cancer and we are all good - which would be great, or if there is another lymph node floating around somewhere with cancer that wasn't taken out. We are hearing from doctors at Princess Margaret that chemo hasn't been shown to be effective in treatment post-surgery if done before surgery with radiation like Jeff had.

For those of you who had surgery, did you have chemo within 6-8 weeks after as cleanup chemo just in case of spread even though you didn't have other tumours showing that would need it. I would like to hear the yes and no's.

For those who are yes, what kind of chemo did you have after surgery. For how many days at a time, for how long? And what were the symptoms and life like for you post-surgery going through this? Thanks greatly!

Comments

  • Deathorglory
    Deathorglory Member Posts: 364 Member
    edited February 2018 #2
    Hello Carey-Ann

    Hello Caey-Ann,

    I had post surgery chemo.  First I had chemo/radiation, then I had surgery.  Even though the surgical pathology showed a "complete response" to the chemo/radiation, I still had bonus chemo.  The chemo was the same as with the radiation, but was at a much higher dose.  With the radiation, I was given an "activating" dose which was supposed to make the radiation more effective.  After surgery, I was given the full strength dose of chemo.  I had pneumonia after surgery, so it took me a couple/few months to strengthen up for more chemo. 

    It lasted about six months.  It was one day every two weeks of infusion and then (I think) five days of 5-fu fanny pack.  I was back at work by the time of the bonus chemo and worked straight through (desk job, not actually working for a living).  We did this because I was young (40 at diagnosis, 41 at surgery) and we wanted to be as aggressive as possible.  Bayonetting the cancer corpses seemed like the best thing to do to ensure long term survival (decades, not years).  Turns out it didn't work, as I had a recurrence (stage IV in a lung) when I was 44.  I'd still do it the same way, though.  It gave me the best chance to beat this SOB, and that's really all you can do for yourself.  I'm now 50 and testing clean from my recurrence.  That's not supposed to happen, but I'll take it.

    There's another guy here, Paul, who had additional chemo after surgery because he had lymph nodes light up.  He's been successful in fighting off more cancer.  He'll probably post to you and give you another point of view.

    Best Wishes,

    Ed

  • paul61
    paul61 Member Posts: 1,392 Member
    #3
    As Ed said, I had post surgery chemo

    I had post-surgery chemotherapy because I had one of the lymph nodes removed in surgery showed positive for cancer cells.

    So about six weeks after my surgery I started an 18-week chemotherapy program. There is some disagreement in the medical community about the value of post-surgical chemotherapy. Some oncologists believe an aggressive monitoring program after surgery is a better approach because chemotherapy while recovering from surgery is difficult.

    However, my oncologist was of the opinion that once cancer gets into the blood stream it can go anywhere in the body. So, his opinion was do as aggressive of a chemo program as the patient can tolerate. So that is what I did, and I am glad I did it because I am blessed to say I have had NED results since.

    Best Regards,

    Paul Adams

    McCormick, South Carolina

    DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
    Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
    Eight Year Survivor

    Life may not be the party we hoped for, but while we are here we might as well dance!

  • Carey-Ann
    Carey-Ann Member Posts: 5
    edited February 2018 #4
    paul61 said:

    As Ed said, I had post surgery chemo

    I had post-surgery chemotherapy because I had one of the lymph nodes removed in surgery showed positive for cancer cells.

    So about six weeks after my surgery I started an 18-week chemotherapy program. There is some disagreement in the medical community about the value of post-surgical chemotherapy. Some oncologists believe an aggressive monitoring program after surgery is a better approach because chemotherapy while recovering from surgery is difficult.

    However, my oncologist was of the opinion that once cancer gets into the blood stream it can go anywhere in the body. So, his opinion was do as aggressive of a chemo program as the patient can tolerate. So that is what I did, and I am glad I did it because I am blessed to say I have had NED results since.

    Best Regards,

    Paul Adams

    McCormick, South Carolina

    DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
    Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
    Eight Year Survivor

    Life may not be the party we hoped for, but while we are here we might as well dance!

    thanks

    Was it every week for 18 weeks? How many days a week?  What were the symptoms like to be on this kind of chemo?  Thanks. Carey-Ann

  • paul61
    paul61 Member Posts: 1,392 Member
    #5
    It was six rounds in a three week cycle

    The chemotherapy protocol I was on was six rounds. Each round was a three-week cycle.

     

    So, each round went as follows:

     

    Week 1 – Monday – Labs with Blood Work and Physical Exam with oncologist - Receive IV fluids with Dexamethasone and Emend for nausea prevention, Receive IV of Cisplatin, Receive IV of Epirubicin, Receive saline IV to flush kidneys. Fill personal IV pump with one-week supply of Fluorouracil (5-FU)

     

    Week 2 – Monday- Labs with Blood Work - Refill personal IV pump with 5 FU

     

    Week 3 - Monday- Labs with Blood Work - Refill personal IV pump with 5 FU

     

    The three-week cycle described above was repeated six times

     

    Side effects included:

     

    Mouth and lip sores from 5 FU – reducing the dosage and gargling with (Magic Mouthwash) resolved this. (your chemo nurse will have the recipe for Magic Mouthwash)

     

    Dehydration from Cisplatin and 5 FU – I found if I went in for IV hydration on Wednesday of the week of my Cisplatin and Epirubicin this helped. I also kept a bottle of water with me and sipped all the time.

     

    Diarrhea from 5 FU and Epiribicin – my oncologist gave me a prescription for Lomotil that I took three times a day that solved this issue (But I tended to stay around the house on week one of each chemo cycle and I made sure I knew where the nearest bathroom was if I went out).

      

    I have to say I think chemo is more difficult after surgery because you are in a weakened state from surgery and your digestive system has been modified, but I found that working with my oncologist and chemo nurse, there were approaches to addressing the major side effects.

     

    Of course, I had a lot of fatigue during the period of chemotherapy but I am not sure how much of this was from chemo and how much was from surgery.

     

     

    Paul

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