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To chemo or not to chemo that is the question

Easyflip's picture
Easyflip
Posts: 588
Joined: May 2013

Hey all,

So I'm 3 weeks out from a successful resection of my liver met and I'm seeing the docs Wednesday. The main topic will be to start adjuvant chemo or not. The idea is to 'mop up' anything that might be left but some studies suggest it's of no benefit. Any thoughts? I'd love to skip any chemo but I'll do everything I can to improve my chances. I plan on staying on cimetadine, exploring CBD oil, exercising and of course eating well. Plus supplements and medicinal Chinese tea, meditation etc. which I'm already in the habit of now. I will of course listen to what the docs have to say but they might give me the option. Thanks ahead of time for any advice and know I'm pulling for each one of you as well.

warmly,

Easyflip/Richard 

 

 

 

tanstaafl's picture
tanstaafl
Posts: 1292
Joined: Oct 2010

Xeloda tx alone papers are not the same as xeloda+cimetidine tx or xeloda+cimetidine+PSK++++ etc tx by a long shot.  I don't think you will find clinical trials that exactly match your combined treatment choices. 

In terms of OS for curatively resected patients, starting from ca stage III, Japanese patients doing daily low dose oral chemo (with UFT) clearly did better with 2 years chemo than one year or 6 months chemo.  

Other Japanese papers suggest that recurrence odds, overall survival, and oral chemo+cimetidine success are likely strongly controlled by a combination of biological factors identified with the CSLEX1 and CA19-9 tissue biomarkers. This identified group is the majority of advanced CRC patients and a highly dominant percentage of those who would recur and die without chemo+cimetidine treatment. A number of Japanese researchers consider these markers a quantitative marker pair.  The closest we could do easily and soonest was to try to estimate this group's identificaton based on peak CEA and CA19-9 serum markers where their result agreed for my wife, after some time and effort to get both tissue markers done.  After that (++), chemo+cimetidine decisions were a no brainer for her although her situation is different.   

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

That's been my question for the past while but I chose to go back on it. In the future I might not, though, if I needed it again. This is my first follow up so I figured I'd better give myself the best chance I can even though my doctor wasn't optimistic about doing it four months after surgery. I really hate the idea of the poison in my system, though.

Trubrit's picture
Trubrit
Posts: 4851
Joined: Jan 2013

i was faced with the same decision After my Liver Ablation back in April. I too would have done the Chemo if my Oncologist had suggested it, but after consulting with his colleagues at UCSF he decided to wait and see if my CEA - a good indicator for me - dropped, which it did, so no Chemo for me.

I know our Oncs don't want to overload us with poison, and if you have a good working relationship with your Onc, then I wovule do what he suggests. 

I am so glad that you are recovering so well from your resection. 

Good luck!

sue - Trubrit

Helen321's picture
Helen321
Posts: 1388
Joined: May 2012

I'm not schooled in any of this but I just wanted to say congrats to your successful resection, healing and meditation, all good things=)  Helen

annalexandria's picture
annalexandria
Posts: 2573
Joined: Oct 2011

that "mop up" chemo is beginning to be viewed as less helpful by many docs.  Of course, he's the cut it out guy, so maybe have to take it with a grain of salt!  I hope your doctors will be able to give you a better sense of what path to take...it's a hard choice.

janderson1964
Posts: 2215
Joined: Oct 2011

That is a very tough question. Anna is right. In the 9 years that i have been in and out of treatment i have seen a shift from doing mop up after surgery to wait and see. I did mop up after the first two liver resections. My onc and sugeon were on the fence about doing mop up after the third liver resection but we decided to do it.

In hindsight i probobly wouldnt have done mop up chemo after the last 2 surgeries. The thinking is if mop up doesnt really help that much you are better off saving it for if you really need it like in my case at the moment where I am inoperable and now how less options then if I hadnt done mop up chemo. It is so hard to say what is right and wrong.

I told my wife recently that now i feel any decisions made about ALL treatment options is a gamble since we are all differnt and most of the time the options are a big gray area. There is no black and white.

YoVita's picture
YoVita
Posts: 590
Joined: Mar 2010

.. so it's hard to give advice to others.  I will say that after my one lung met two years after my initial stageIIIC rectal diagnosis with surgery/chemo/radiation/chemo, my oncologist and I both agreed not to do mop up chemo for the lung met.  I reviewed NCCN guidelines, this seems to be the trend for this situation (one met following initial diagnosis/treatment).  I'm still here :)

Annabelle41415's picture
Annabelle41415
Posts: 6212
Joined: Feb 2009

If it gave me one ounce of prevention from future disease I'd take it and I'd do it all over again because they said that is what my adjuvent chem would be "mop up."  I'd be thinking the "what if" but you have to think about "what if" for another reason.  Its up to you and your tolerance for treatment and what you feel you can handle and what you feel you can live by with diet and exercise.  For me, I'd always been a healthy eater and always exercised so when they told me it wasn't anything that I'd done wrong it was something I'd felt was correct but many on this board feel differently about diet so I'm not saying they are right or I'm right it has to be what is right for you. Be sure of your decision and never look back.  You may want to question it but you will say to yourself "this is what is right for me".

Kim 

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

I wish I inew in 2008, what I know now. I would have tried the vegan diet. 3 years of chemo with no change to my outcome. I would have fought while my immune system was intact, then if it didn't work, I would have done chemo. But that's me.  

Shelleyb70's picture
Shelleyb70
Posts: 2
Joined: Oct 2014

More than likely, they'll put you on Xeloda or some other pill form (perhaps an infusion every 3 weeks).  I did it and the side effects weren't bad at all (as compared to).  

I did 6 months of the Folfox cocktail, got a month's rest, had my resection, then did Xeloda as a precaution.  My liver stayed tumor free for about 8 months.  I was really glad to have that 8 months.  

 

tootsie1's picture
tootsie1
Posts: 5056
Joined: Feb 2008

I would eliminate the "what ifs" and take the chemo.

 

*hugs*

Gail

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

I've had two mop up chemo treatments now and the side effects are much worse after just the second treatment. I don't want to continue. Am I right in thinking that doing chemo now makes it less effective if I need it later? Or am I reading things wrong?

My oncologist thinks I 'might as well' do it but doesn't know if it'll help at all or if i even need it. I had three lymph nodes involved and a tear in my colon and am stage three.

Steve444
Posts: 105
Joined: Sep 2014

I've read conflicting info (like most info on the web).  I'm tired of feeling like crap and am taking a break from chemo through the holidays.  My onc wanted to discuss it with me today after emailing him.  He said he'd prefer to stay in front of it while numbers look good.  He indicated his experience is that when stopping chemo, it comes back and is more resistant to chemo (at least with my case of not having surgery).  I had read that keeping on chemo it typically comes back as well resistant, so who really knows...  We're all different and respond differently.  It seems it can come back resistant to the first line treatment either way.  I personally am choosing to drop the 5FU pump, but am, going to still go in and get Avastin every 3 weeks to see how that works alone For the rest of the year.

i hope you feel better soon.

PhillieG's picture
PhillieG
Posts: 4888
Joined: May 2005

That's a damn good question too. I wish I had the answer. Rule of thumb, if you like and trust your team then give their advice some weight. At the end of the day it's your decision and you have to be comfortable with it.

For the record, I did/do it but then again I've never been all clear

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