Chemo or no chemo????

nana98 · August 2006

Back in 3/06 I was diagnosed with Stage III rectal cancer. I immediately began radiation and Xeloda. On 7/06 I had surgery to remove the tumor(approximately 3"). According to my surgeon and path report the tumor shrunk to the size of an ulcer(no evidence of disease) and no lymph nodes were affected. My oncologist told me I hit the lottery. Now the question is whether or not to have chemo. My oncologist wants to go back and check every scan, x-ray, ultra-sound, blood work and what ever else was done before he makes a recommendation. I am so torn right now because I don't want to say a year or five years from now "I should have had the chemo". Any suggestions??? Thank you...
Karen

KathiM · August 2006

Karen...why was it stage III? Usually that is reserved for us that have local mets. That means the beast is on the move....chemo time. Was it just because of the size it was III? (Chemo brain is preventing me from remembering all the stuff). I had one node involved, so the decision was made for me....BUT I know it's a tough thing...reverse for me....pre-surgical chemo/rads completely eliminated my tumor....scar tissue left...my resection became my comfort level choice. I chose to do the surgery (changed my life for the rest of my life with no rectum or sig colon), and have no regrets...I'm a worrier...I KNEW I would forever be concerned about the beast being back!!!! I had no post-surgical chemo.
Whatever decision you make, it's the right decision....don't go second guessing years from now. Some paths are ones that are a lasting choice.
If you choose 'no chemo' (if you are given the choice), no regrets should you have down the line if you face the beast again.
If the beast should come your way again, like it did for me 3 months after NED (breast cancer-unrelated), well, you'll fight it again!!!!

Hugs for a very hard decision...it is, in the end, your to make.

Hugs, Kathi

lfondots63 · August 2006

Hi Karen,

Like Kathi said it is a hard choice. I'm stage 3 1 node involved. I had chemo because the one node and the tumor was in the wall of the colon but not through. I wanted to make sure there were no beasties left in my blood. I got through 9/12 treatments of folfox. I'm diabetic and it started messing with my body so I decided to stop. My onc was comfortable with this since it is "just in case" chemo. I also changed my diet with a little help from 2bhealed and Scouty. A good book to read for this is "Beating Cancer with Nutrition" by Patrick Quinlan (darn we should all get paid to tout his book!!! LOL) It is a very good one though with recipies too. Please tell us what you decide and come back for any other questions. HUGS too!!!

Lisa F

staceyp · August 2006

Hey Karen,

My husband was dx'd with colorectal cancer a couple of years ago. He had a colon resection and there was no lymph involvement. They said he was cured and very lucky that they caught it so early. He was not given chemotherapy.

2 years later the cancer returned in the liver. They suspect that it had been there all along - just too small to be seen on a scan. Hence, he should have had chemo the first go around.

A liver resection and 6 months of chemo later, he is NED. And, yes, we second guess ourselves everyday. We always think, "if only he'd had the chemo from the start". If we had it to do over, he would have definitely had chemo. It may have prevented him from enduring another painful surgery. It also may have killed any cells floating around in his body.

Hope this helps. It is your body and only you know what is best for you - chemo or no chemo. I wish you well.

Stacey

kerry · August 2006

Karen,

This decision is a tough one. I was diagnosed Stage 3 and decided to take chemo. You will have some folks who will tell you NOT to and others who will try to convince you to do it. Most important is that you have a good line of communication with your doctor, that you trust your doctor and his advice and then you make your decision. Cancer is a tricky sneaky disease. You will be in my thoughts.

Let us know how you are doing, and whether or not you decide to take treatments. You'll find lots of help and support either way here at this site.

Kerry

4law · August 2006

I always vote in favor of chemo -- why take chances? I'm not sure what "stage" I was when I was diagnosed in 9/04 (TxNxM0 -- whatever this means -- and then diagnosed T2N0M0 after surgery -- I think it means stage 2) also with no involvement of lymph nodes. Anyway, after 6 1/2 weeks of radiation and 5-FU thru 24 hr pump, my surgery for rectal cancer also only showed an ulcer and all cancer gone. I had temporary ileostomy and then 6 months of 5-FU and Leucovorin -- why take any chances! My follow up CT scan and colonostomy this past April showed NED. I wouldn't have been able to live with myself if the cancer came back and I didn't choose chemo. If it does come back, I know that at least I gave it a hard fight. Chemo can be real hell, but with good results with your pre-surgery chemo, I believe adjuvant chemo will be the icing on the cake and you will have peace of mind, especially if things get rough during chemo, that you are doing everything possible to kill this lousy disease and keep shooting it over and over so it will never raise its ugly head in your body ever again.

4law · August 2006

I forgot to mention that my oncologist told me that rectal cancer is a very "aggressive" cancer and we both felt we didn't want to take any chances. If the cancer is aggressive, I beleive we should be aggressive in fighting it.

Betsydoglover · August 2006

Hi Karen -

This a difficult and very personal decision. Still with a Stage III diagnosis, I would lean heavily toward trying chemo. (I am Stage IV so there was really no choice.)

How do they know you are Stage III? I thought you could only detect that during surgery - after lymph node biopsy. On the other hand, it is possible that the chemo-radiation you have received resulted in a NED diagnosis, but you may have still been Stage III prior to that.

Chemo is no fun, but chemo for CRC is better than chemo for some other forms of cancer. In general fewer side effects although it is certainly not without side effects.

Talk to your doctor about the proposed chemo regimen, come back to us and talk, and consider your own psychological makeup - if you really worry about regretting a no-chemo decision (I can understand that), then consider getting the chemo.

Take care and I wish you good luck with your decision.
Betsy

scouty · August 2006

Hi Karen,

You are asking a very good but difficult question. My first recommendation is to wait and see what your onc recommends.

Whatever decision you make (and it needs to be your decision), you must feel very confident in it or your may regret it down the road. We all have that cross to bear.

I did chemo for 8 months and it worked at first but then stopped and then I completely changed my diet and followed an alternative route with some success thus far. I know it could all change tomorrow but I will never regret my decision. I did way too many drugs for way too long.

I suggest you get your onc's recommendation and then come back to let us know his reasonings behind it.

I too had/have rectal cancer but mine was not aggressive and that really makes the stats and the guessing that generates tougher.

FYI, whether you chose to do chemo or not, cancer found a nice home within your body and if you do not change that comfort level internally, it will come back whether you do chemo or not!!!!!!!

Lisa P.

shmurciakova · August 2006

Hi Karen,
That is great news. Personally I would not have chemo with no lymph nodes involved. I was diagnosed Stage III with lymph nodes involved and I had chemo, then just like Staceyp's husband, a liver met showed up which they believe had been there all along. The chemo did not get rid of the liver met. I then had a resection, like he did followed by more chemo and then a couple of mets were seen in my right lung that also had been there all along, not a recurrence per se. So, that time I had the surgery and no chemo. It is not that I don't think that chemo helps people, because I am sure that in advanced cases it can and does, but in your case, w/ no lymph nodes involved I would forego any additional chemo and just get on with your life.
You already had chemo, before your surgery.
Take care,
Susan.

vinny3 · August 2006

Hi Karen,
What kind of surgery did you have and did they tell you why they judged you to be Stage lll? It usually is if it has broken through the wall of the rectum or spread to lymph node(s).
I was diagnosed with Stage ll rectal cancer 5/05. I had an excellent response to 5-Fu and radiation. I had just a local excision and no cancer cells were seen. However 7 months later the cancer recurred and I had the rectum removed and now am doing chemo. There has been no evidence of node involvement or spread but one of the oncologists I consulted says because I had preop chemoradiation he thinks I could not accurately be staged and could have been Stage lll. He would have recommended chemo after my first surgery. It is true that rectal cancer has a higher rate of recurrance.

It is a difficult decision but make sure you get more than one opinion. Good luck and God bless.
****

pink05 · August 2006

Karen,

Well, you certainly have heard everyone's advice and different opinions. I guess it just depends on how you feel about it. If it was me, I would probably have the chemo because I am a HUGE "whatifer" I would always worry and say "what if" for the rest of my life. On the other hand, I know someone who had stage III and decided not to go with the chemo despite her oncologist's recommendation to do it. Two years later, she is still cancer free. You just have to weigh your options and think to yourself, how will I feel a couple of years from now? Chemo for colorectal cancer doesn't seem as bad as chemo for some of the other cancers. My dad is 77 years old and has handled the chemo fairly well. You would only have to go through it for a few months (maybe not even that long) and then you'll be done. As others have said, I would also read the book "Beating Cancer With Nutrition." It is a great book and will help to keep those cancer cells away.

If, you decide not to do chemo, I would push your doctor to order CAT scans frequently. I think with any cancer diagnosis (early or late) it is very important to be followed so that in the event a recurrence does occur, it will be caught early.

Hope this didn't confuse you more!!!

God bless you with the right decision for you,

-Lee-

steelerfan · August 2006

Hi Karen, I had Stage II rectal cancer diagnosed in 9/04, had chemo and radiation also prior to surgery and my tumor also shrunk to almost nothing. My surgery was in 1/05 and all lymph nodes were negative also. My oncologist suggested chemo and I didn't hesitate. I want to know that I did everything possible so this horrible beast doesn't come back. I had chemo once a week for 6 weeks and then 2 weeks off in between rounds. I had three rounds of this. It really wasn't too bad. Hope this helps you. Good luck with your decision. Mary

Chemo or no chemo????

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