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removing colon tumor before chemo or after

Badger3
Posts: 4
Joined: Apr 2019

My husband was diagnosed with colorectal cancer and liver mets in October last year. He  received

Folfox for 6 rounds and then folfox, oxi and avastin for 6 rounds. At first his pain was severe but he had a pain

block done and was great for 3 months. Last week he had a ct scan and the liver is doing well but the

colon tumor has started growing again. The oncologist changed his chemo to Folfiri and irinotecan.

 Even though he is on morphine he is in extreme pain all the time and does not feel like eating.

I have read on here so many times that the Colon is removed fairly quickly after the tumor is discovered.

Just wondering why they may take the tumor out on some but have other people wait? This is all

very new to us and we are loosing hope.

SandiaBuddy's picture
SandiaBuddy
Posts: 914
Joined: Apr 2017

I have no direct experience with your specific situation, but I can say that if you are not getting satisfactory answers from your doctor, you should pin him or her down and get those answers, or you should consider a different doctor.  I have found that to get good health care it is essential to be your own advocate.  Hopefully members with "neoadjuvant" experience can comment more on your specific question.

8colon8's picture
8colon8
Posts: 41
Joined: Jan 2019

My wife's tumor in the colon was removed as soon as the colonoscopy came back as possible cancerous.  It was to prevent further spreading. Chemo followed.  You should pin down your oncologist on this.  I have learned that you need to push for answer and don't feel like an inconvenient to the medical staff. You are paying them to give you answers. Good luck. 

Woodytele
Posts: 163
Joined: Apr 2017

They sometimes choose to shrink the tumor with chemo before doing surgery.  My surgery was done first then chemo, but you can do chemo to shrink as much as possible. Definitely ask the dr. why he is choosing to go this route. 

myAZmountain
Posts: 281
Joined: Apr 2018

When I was diagnosed in the ER with a mass in my colon the first thought was to do chemo first--m however it had grown into the neck of appendix and cause acute appendicitis, and it was excruciaitng, that convinced the surgeon to take it out first. I  am so thankful that I was able to have the tumor removed from the get go, as well a met to omental wall.  I honestly believe it saved my life. Now just dealing with one pesky lung met. But I do know if I had not had so much pain from the appendix they woud have wanted to do chemo first. I don't get it at all.

Msboop15's picture
Msboop15
Posts: 81
Joined: Apr 2019

So sorry he’s in so much pain.

As soon as the Gastro saw my tumor he called to get me into a surgeon as soon as possible.   Chemo wasn’t even mentioned until after surgery. Interesting the different approaches. I assume there is some rationale behind all of them but I’d sure want to know why they aren’t doing surgery, considering the amount of pain he is in.

 

  I totally agree with Sandia that we have to be our own advocates.  I just went through an ordeal with oxalyplatin... I had to keep asking questions and pushing back Because of some fairly extreme side effects.  I think we’ve come up with a solution or at the very least aN alternative. 

 

 

 

Annabelle41415's picture
Annabelle41415
Posts: 6249
Joined: Feb 2009

Every treatment is different.  For me it was radiation/chemo, six weeks healing from that then surgery and more chemo.  If you are happy with your doctor, you should possibly get a second opinion.  Sorry you have to be here and hope that your husband's treatment goes well.

Kim

NewHere's picture
NewHere
Posts: 1117
Joined: Feb 2015

I was in surgery within 12 days of the colonoscopy pathology report.  Started looking for surgeons immediately coming out of colonscopy based just on the visual and that it clearly was cancer. ( I got into Memorial Sloan Kettering and I am convinced I am alive today as compared to going to some other local places recommended by the doctor my colonoscopy doctor recommended.  I shudder thinking about what I was told fby the first surgeon I met with.  And almost went with them just to take some action.  Booked and then cancelled when I realized some answers I got sounded just wrong/inexperienced based I what I knew. and from the three scans I had leading up to the colonoscopy.)

But as others pointed out there are other plans.  The one thing I recall seeing here regarding the chemo before surgery was to make the surgery easier (for lack of better term).  

Get solid answers to this question.  And if you are not satisfied with the answer (talking past you without really focusing on concerns) get another opinion. And then get a second even if you like the answer if you feel unease.  

OnTheRoad
Posts: 14
Joined: Jul 2018

Hello, Badger3,

 

When my cancer was identified, the first thing doctors tried to do was to stage it, so the correct treatment could be done. According with them, anthing that is not metastatic theoretically could have surgery and the sooner the better. If I had distant mets, then they would propose chemo first.

 

I like a lot the document below. It was very good for me to start understanding this beast on the first days. 

https://www.nccn.org/patients/guidelines/colon/47/index.html#zoom=z

If you open the link above you should go directly to the page with treatments of metastatic colon cancer. Your doctor is probably using "option 2"... but you really need to ask why he is taking so long for the surgery. I had a partial blockage in my colon and I can tell you that after surgery, even feeling some pain and fear to have something wrong, the relief to not have a blockage was enormous.

My best wishes foy you and your husband

Badger3
Posts: 4
Joined: Apr 2019

thank you so much! So much to think about!

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