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

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

What are the chemo options?

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