Thank you all

vinny3 · November 2006

I want to thank you all for your support and kind suggestions. I am stopping the chemo after 9 Folfox/Avastin cycles. I will be watching my diet and also try to get more sleep. I have cancelled my chemo appt for Monday but will be seeing my oncologist to go over it with her. I have done a review of most of the latest recommendations for Stage II colon cancer and there is not a definite answer. There is a clear benefit, it appears, for Stage III and IV. Thus the oncologists use that as indirect evidence that it will help for Stage II. There appears to be a benefit for disease-free survival for Stage II but there is not a clear difference in overall survival between surgery and surgery plus chemo for Stage II. There may be some in the higher risk category (invasion of veins/lymphatics, perforation or extension through the bowel wall for whom there would be more benefit.I will make a list of the articles if anyone is interested.

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shmurciakova · November 2006

You are very welcome. I am glad you finally came to a decision that you feel comfortable with. You can clear up any last questions when you go in to talk with your doctor. Try to be straight forward with her and hopefully she will do the same. I am still curious as to when they began putting Stage II patients on chemo, esp. Oxy. and Avastin (which I thought was only for Stage IV) and more importantly, why? knowing how potent it is and the risk of permanent side effects. If you could clear that up, that would be great.
In any case, I am sure you will be feeling much better very quickly!
I hope you will now be able to put this chapter of your life behind you and look forward to a very bright future.
Good luck to you and your family,
Susan H.

mwomack · November 2006

I don't know if this is of any interest at all, but wanted to make you aware of it. I really hesitate to post this because it seems you have thoroughly researched this though. But maybe there is a Stage III Senior that might need a little extra push to finish.

http://www.cancer-innovations.com/focus_article.asp?b=cancerinnovations&f=colon_cancer&c=colon_stopping-chemo-risk&spg=FI

I can understand your decision and wish you the best of luck. There's no guarantees in this business anyway. My husband has done everything "by the book" and is starting round 3 (originally Stage IIIc 10/04). He did Folfox without a hitch. Then had presacral recurrence with surgery and finished 7 weeks/1 day of pelvic radition treatments in May, and now ready to start FOLFIRI w/Avastin for 3 new pelvic mets. Hopefully, this will be the one that can conquer his monster.

Good luck,

MA

DK2006 · November 2006

Hi,
Congratulations on being done with chemo!
Let the healing begin!
Donna

vinny3 · November 2006

shmurciakova said:
You are very welcome. I am glad you finally came to a decision that you feel comfortable with. You can clear up any last questions when you go in to talk with your doctor. Try to be straight forward with her and hopefully she will do the same. I am still curious as to when they began putting Stage II patients on chemo, esp. Oxy. and Avastin (which I thought was only for Stage IV) and more importantly, why? knowing how potent it is and the risk of permanent side effects. If you could clear that up, that would be great.
In any case, I am sure you will be feeling much better very quickly!
I hope you will now be able to put this chapter of your life behind you and look forward to a very bright future.
Good luck to you and your family,
Susan H.

Hi Susan,

It would appear that they may be giving the Stage II patients chemo due to the improvement noted for Stage III and IV and the fact that the studies leave the question open abit so the oncs tend to do what they are familiar with = give chemo. One of the reasons given for the ambiguity is that most of the studies don't have enough Stage II patients to give more reliable results. I am going to try to find time here, and will get it done, to type out the salient findings from the studies and the articles in case anyone wants to read them.

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HowardJ · November 2006

****,

I'm sure it was a difficult decision. I found the same information as you when initially deciding whether or not to do chemo (I'm stage 2a colon ca). I decided not, after much research and discussion with a few oncologists I know. Everyone needs to make their own decision and it's not "one size fits all", even for the same stage. Personally, if I were 2b or had lymphatic or neuro invasion I would have done the chemo.

Howard

vinny3 · November 2006

HowardJ said:
****,

I'm sure it was a difficult decision. I found the same information as you when initially deciding whether or not to do chemo (I'm stage 2a colon ca). I decided not, after much research and discussion with a few oncologists I know. Everyone needs to make their own decision and it's not "one size fits all", even for the same stage. Personally, if I were 2b or had lymphatic or neuro invasion I would have done the chemo.

Howard

Thanks Howard,
The reason I did what chemo I did is because I had rectal cancer which has a higher recurrance rate than colon cancer and it was within 5 cm of the anal opening and that has a higher recurrance rate.

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Moesimo · November 2006

Vinny,

I support your decison. I know that you have thought it out alot.

When I was diagnosed in 3/03, they were only giving chemo for stage 3 and 4. My endoscopic ultrasound showed that I was probably a 3. There was an enlarged node on my initial cat scan, but they weren't sure if it was inflammation from the cancer. My cancer was very low, it was less than 5 cm. Because I was a healthy 46 y/o I was given 5 weeks of 5fu and radiation. They weren't giving oxy then for stage 3. I had surgery with a temp. ileostomy that was reversed 8 weeks later. I had 2 positive nodes. I was then supposed to get 12 more treatments of 5 fu and leukovorin. I recieved only 4 and had diarrhea so bad I was hospitalized and put on TPN for 4 weeks. I had lost 40 pounds and was down to 108 pounds. I wanted more chemo, but my docs had me stop because I had been so sick. My onc. told me if it was an agresssive cancer it would probably come back even with the whole course of chemo. I wondered about the what if...and still do.

It has now been over 3 years and I still remain NED. I will be having a routine cat scan on Sat. I am praying for good news again.

Sorry for the long post, I guess my point is that so far I have done OK and I didn't get all my chemo.

Keep us posted.

Maureen

CAMaura · November 2006

It really seems as if your have done your homework - in your head as well as your heart - and your decision seems logical and safe.You will enjoy the rest and the time to plan your nutritional
work...All the best to you and feel free to ask for some resources with the diet stuff. Gradual changes are great...One thing
seemingly leads to another. Personally, I think you will enjoy the next phase very much! Take care - Maura

PGLGreg · November 2006

vinny3 said:
Thanks Howard,
The reason I did what chemo I did is because I had rectal cancer which has a higher recurrance rate than colon cancer and it was within 5 cm of the anal opening and that has a higher recurrance rate.

****

Stage 2 rectal cancer 5cm above anus. Sounds just like mine. I'll be very interested in what you find out about currect adjuvant treatment for us stage 2 folks. What was prescribed for me was 33 pelvic radiation treatments, 5 per week, and 10 injections of 5FU/leucovorin with 5 at the beginning of the radiation treatments and 5 at the end. And I did that Jan-Feb of this year.

vinny3 · November 2006

Moesimo said:
Vinny,

I support your decison. I know that you have thought it out alot.

When I was diagnosed in 3/03, they were only giving chemo for stage 3 and 4. My endoscopic ultrasound showed that I was probably a 3. There was an enlarged node on my initial cat scan, but they weren't sure if it was inflammation from the cancer. My cancer was very low, it was less than 5 cm. Because I was a healthy 46 y/o I was given 5 weeks of 5fu and radiation. They weren't giving oxy then for stage 3. I had surgery with a temp. ileostomy that was reversed 8 weeks later. I had 2 positive nodes. I was then supposed to get 12 more treatments of 5 fu and leukovorin. I recieved only 4 and had diarrhea so bad I was hospitalized and put on TPN for 4 weeks. I had lost 40 pounds and was down to 108 pounds. I wanted more chemo, but my docs had me stop because I had been so sick. My onc. told me if it was an agresssive cancer it would probably come back even with the whole course of chemo. I wondered about the what if...and still do.

It has now been over 3 years and I still remain NED. I will be having a routine cat scan on Sat. I am praying for good news again.

Sorry for the long post, I guess my point is that so far I have done OK and I didn't get all my chemo.

Keep us posted.

Maureen

I am glad that you are feeling well and NED. It helps to give me more comfort in my decision. I don't feel as sick as I have been. I think part of it was the dread of going to chemo on the following Monday.
Here's hoping that your scan continues to show that you are NED.

****

vinny3 · November 2006

PGLGreg said:
Stage 2 rectal cancer 5cm above anus. Sounds just like mine. I'll be very interested in what you find out about currect adjuvant treatment for us stage 2 folks. What was prescribed for me was 33 pelvic radiation treatments, 5 per week, and 10 injections of 5FU/leucovorin with 5 at the beginning of the radiation treatments and 5 at the end. And I did that Jan-Feb of this year.

I will post a further note about the studies and hopefully be able to scan them into my computer, when I get the scanner working. I had chemo/radiation prior to my first surgery in 2005. The first surgery, however then was just a local excision and then the cancer came back 8 months later. I believe the surgeon didn't take out the whole scar from the radiation and that there was microscopic cells there.

****

Thank you all

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