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Who has had chemo FIRST then surgery?

Phil64's picture
Posts: 838
Joined: Apr 2012

Recently found liver mets via MRI.  Per surgeon, not a candidate for surgery at this time (five liver mets in various locations). The recommendation is to use chemo (FOLFIRI and Erbitux) to shrink/stop the tumor growth and then consider surgery at a future time.

Anyone been down this road before?  Is surgery a consideration after using chemo? Has anyone had liver resections after using chemo to shrink/stop tumor growth?

Thanks in advance for the info.


Blog: http://PScamihorn.me




bigman4christ's picture
Posts: 87
Joined: Oct 2012

Hi Phil, the Onc said that i wasnt a candidate for surgery either because there were to many spots on my liver so we just jumped into Chemo hoping to shrink everything first.  i dont know if that helps you out at all but you are not the only one that they started chemo first with.  hope that helped


barbebarb's picture
Posts: 464
Joined: Oct 2011

Phil - sorry to hear this. my reoccurence is to liver-same place. They did thorecotomy, wedged to get tumor right lower lung and had to go thru diaphram to get first tumor (they missed in 08!) Ugh. Had 4 Xelox chemos before this surgery and four treatments after. Sorry, first surgery was left lung lobectomy...2/4/12 and 2nd 4/9/12 was the other, no chemo in between. Have small - 5mm left module that has not grown and did. NED 8/27 and liver reoccurence in December. Liver surgeon suggested Rfa but new local oncologist working with N. Western said focus on lung module and liver mets reoccurence-same place on left snd one on right-bothe small. Will I be a candidate for surgery on the liver, guess I wont know. Mets are small on left and right but reoccurence is on vena cava on left same place. Of course, they are watching everything with me since brain tumor surgery (recent mri-no evidence of cancer) and lesions on trachea confirmed colon cancer. Have read good results with Rfa and surgery. Craiger will probably give insight. I am on folfori - 4 cycles -KRAS mutant -hoping this works on all my needs. Wishing the best for you. Your posts and Craigs were more of my first inspirations and gave me strength. I know it was best going to N. Western for surgeries but good to be 10 minutes away for chemo., whatever my next outcome is.

Hope this helps... get those surgeons opinions for "options ". Barb

Coloncancerblows's picture
Posts: 296
Joined: Feb 2013

Hi Phil,

Before I had my surgery to remove the tumor, the surgeon did another colonscopy to see exactly how much room he had to cut.  If he didn't have enough room to cut and would have to cut into my rectum, then I was going to have to do chemo first to shrink the tumor and then he would do the surgery.  It ended up he did have room to cut so I had my surgery last month and will be starting chemo next week.  Probably not the answer you were looking for but hope it helps a little.

barbebarb's picture
Posts: 464
Joined: Oct 2011

There is a lot of discussion about chemo before and after...

tachilders's picture
Posts: 313
Joined: Jun 2012

Pretty standard practice to do chemo before surgery these days.  Actually, you'll most likely do chemo before and after surgery....


herdizziness's picture
Posts: 3642
Joined: Apr 2010

I had too many spots in my liver, lungs, ovary, colon, ureter and they told me I would never have surgery.

Did chemo from Feb to end of October, had my surgery on colon/ureter/liver resections in same day.  The other tumors had calicified.

Again, I am waiting to shrink tumors to have liver resection.

Winter Marie

Posts: 1170
Joined: Sep 2012

Hi Phil,

My husband, Steve, is in the same situation. He has maybe 7 mets throughout his liver. Largest is 4 cm. Mets are not in one area, but spread throughout both lobes. Has done 8 Folfiri. The surgeon wants to plan toward a resection. Hopefully, it works out. I am not getting my hopes up. Would be happy with RFA. I think chemo before surgery is normal.

Good luck

Several weeks ago I asked if anyone had ever heard of sandwich chemotherapy. The surgeon we met specializes in sandwich chemo with folks with colorectal liver mets. Learned that this simply means chemo - surgery -chemo.

Phil64's picture
Posts: 838
Joined: Apr 2012

I found other posts about Hermain Cain and one referencing this article.


He too has had chemo then liver resection surgery and he is NED for 5+ years now.  His case sounds very similar to mine, but of course the devil is in the details.

Happy Friday to everyone!!!


Posts: 1282
Joined: Apr 2012

I had chemo concurrently with radiation for 5 weeks with a six week rest before my resection.

BusterBrown's picture
Posts: 221
Joined: Mar 2005


I was dx's with Stage IV, with mets to liver (3 spots). My once decided to do chemo first (folfox) and I had excellent results, Primary tumor decreased in size and the 3 spots on my liver were gone (for about a year).  In the 9th week, I had a colon resection adn 6 weeks later I started on the Folfox again along with 5 weeks of radiaton.


Helen321's picture
Posts: 1428
Joined: May 2012

Hey Phil, I haven't had a liver resection but my doctor at Sloan said that studies in Australia found that chemo and rad before surgery are more successful than after. It seems to be the latest trend.  That's how they treated me.

Posts: 20
Joined: Jan 2013

Hi Helen,


Who is your doctor at sloan?

dmj101's picture
Posts: 527
Joined: Nov 2011

neo adjuvant treatment is very common in many cancers.. especially when there are mets pressent.

this treatment is meant to controll the growth and possibly shrink it to make it more operable.

Good luck our friend. I know it seems like a long road ahead.. but keep us posted as to it goes.



PhillieG's picture
Posts: 4912
Joined: May 2005

When I was DX, I had a large tumor in my liver (along with many other tumors) that prevented surgery at the time. I went on FOLFOX and Avastin and it shrunk the tumor so it became operable. So surgery is definitely an option after chemo.

Good luck!

impactzone's picture
Posts: 542
Joined: Aug 2006


I had chemo done for 4 months with a liver met at Stanford. they wanted to see CEA reaction and tumor response. I had liver resection and then continuded chemo. That was 6 years ago, so go for it!


KathiM's picture
Posts: 8077
Joined: Aug 2005

Then a rest, then surgery (J-Pouch). 

There was time to do this, because I was not completely obstructed...and the tumor was large, so there was hope to shrink it first... 

I was just grateful to do ANYTHING to stop the pain!!  (Tumor was pressing on my tailbone).


Hugs, Kathi

Posts: 1
Joined: Feb 2015

Hi Kathy,

i was curious to know the outcome of chemo first??



annalexandria's picture
Posts: 2573
Joined: Oct 2011

You might want to send a PM directly to Kathy, as this is an old thread.  I am happy to be able to say that she is doing very well per her most recent posts here!

You could also start a new post all together...say hello and ask any questions you might have.  We're a pretty friendly bunch!

sdp's picture
Posts: 181
Joined: Jan 2012

Pl see subject.

Had chemo first 8 cycles ' folfox plus erbitux .

Then LAR ( primary in sigmoid ) and then liver resection followed by RFA .

Balance 4 cycles folfox and maintenance chemo of erbitux for 3 months after. 

Several recurrences- 

Several ablations , tace and most recent SIRT


Helen321's picture
Posts: 1428
Joined: May 2012

I did this for my rectal tumor.  My doctor based it on a study out of Australia.  The only thing I wish I had done differently was to use that medication everyone says you should take to prevent spreading.  Otherwise so far so good.  My tumor was gone when we did the surgery and two years out I'm still going.

Posts: 17
Joined: Nov 2013

I went to the same hospital for two small liver mets.  They said they'd found it very powerful to have chemo in advance of surgery as well as after.  I had not yet had any chemo when they told me this so my liver had no chemo damage.

I had four treatments of FOLFOX6, middle two of those with Avastin.  They did liver rx surgery about six weeks later.  They said the two tumors were largely necrotic.  

I've read it makes a difference as to the chemo drugs you've had before liver rx.  Some are more damaging to the liver than others. 


Trubrit's picture
Posts: 5512
Joined: Jan 2013

It is always with mixed emotions when I see these older posts brought back. Remembering those who have passed who posted in this thread brings a tear to my eye. 

Sue - Trubrit

Helen321's picture
Posts: 1428
Joined: May 2012

I know when I realized this was old and saw Barb, my heart just sank.  Then I looked at the others and it sank further.  Chris who went so young.  You just wish you could go back to this moment in time and have a do over.

Trubrit's picture
Posts: 5512
Joined: Jan 2013

all gone. 

Haven't heard from Buster for a while. Hope he's hanging in there. 


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