OK, here's the chemo deal...

True to my word, my husband and I sat down and talked with two very nice oncologists at the University of Michignn Comprehensive Cancer Center today. As you all know, all the research so far says chemo is not recommended for Stage II colon cancer, especially like mine with no lymph nodes involved (out of 14 tested).

The oncs told us that people with my path report usually reach the 5-year mark 89% of the time with surgery only. However, they pointed out, there are those 11% who relapse.

U-M is taking part in a study of Stage II colon cancer folks with no lymph node involvement to see if they can predict whose tumors indicate a likely relapse. It is part of a nationwide study of more than 3,600 survivors, only 36 of us from U-M. They follow us like puppy dogs for 10 years.

Here's the deal: They take a piece of your tumor and send it to a special lab where they'll evaluate two tumor markers: 18q LOH and microsatellite instability (MSI), whatever the heck that all is.

Supposedly these marker evaluations will place you in a group, either low-risk for tumor reoccurrence or high-risk for tumor reoccurence. If you are deemed low-risk you will have no chemo but participate in all of the follow-up office visits and tests they would normally do anyway, except they follow you for 10 years.

If you are deemed high-risk for reocurrence they you will be put in one of two "arms". Arm A is a standard two-day regimen of Folfox given on days 1 and 2, every two weeks for a total of (12) two-week cycles.

If you are placed in Arm B you'll get the same Folfox regimen followed up with Avastin on day 1 every two weeks.

I was intrigued by the idea of having my tumor tested to see if they can truly predict who is low-risk and who is high-risk. I signed up. I am of the general feeling that I will be deemed low-risk (ever the optimist) and placed in the control group. However, should they deem me high risk I am ready to undertake the chemo (while rebuilding my immune system with the vitamins and minerals I have already started taking). While they made it clear that I shouldn't sign on the dotted line unless I clearly would be willing to do the chemo (and you're randomly assigned into one of the two regimens), they also said you can opt out anytime. I figured I have nothing to lose... except maybe some hair if I get in Arm A or B. Like I said, I hope I am in the control group.

I'm also having part of my tumor sent off for genetic testing. Get this: they said my crummy primary insurance insists I get authorization for this testing. My secondary will cover it; I just need to get a referral from my secondary provider.

The oncs assurede me that all the records for the study and the genetic testing are strictly confidential and would not be released to my insurer unless I signed a release (which I did not and won't). I am not in fear of any problems arising with my job because of this as I feel pretty secure where I am. However, I want to know if there is a genetic component that my kids, siblings and cousins should know about.

So that's it for now. My tumor goes off Monday in two different directions. I'll talk to the oncologists on Aug 14 to find out what group they would place me in and then meet with them on Aug 18 for the first blood tests, etc...

Another piece goes out for testing for the genetics and I am told that takes at least six weeks. That's fine, cuz the first appointment for a new patient of the geneticist is late October anyway!

Oh, and did I tell you? My CEA, even before the surgery, was only 1.5! Perhaps CEA isn't going to be a reliable marker for me, eh?

So what do you guys think? Can you give me the lowdown on these two treatments? For either Arm A or Arm B the Folfox regimen is Oxaliplatin 85 mg/m2 IV Day 1; Leucovorin 400 mg/m2 IV Day 1; 5-FU 400 mg/m2 IV bolus Day 1; 5-FU 2.4 gm/m2 continuous IV infusion over 46 hours (Day 1 and Day 2). If you are in Arm B you also receive 5 mg/kg Avastin (bevacizumab) via IV on Day 1 as well.

So what do you guys think? I know, it's long. Thanks for reading this whole thing. Any input is appreciated!