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Post Extended Right Hemicolectomy Treatment Options

camicom
Posts: 20
Joined: Jun 2019

Hello all, its been a while since I posted. I had an extended right hemicolectomy on 7/19 to remove a 5cm mass from my TC. It was originally supposed to be done by robot, but they had to convert because of its locations. They took 2/3 of my colon. The surgery lasted approx 2 hours and everything went well. The mass was only 2.6cm and all margins were clear. My hospital stay was 3 days, and just had my first firm bm. Got the path report back as follows

PT3PN1A

Stage 3a with only one the primary lymph node involved

They took a total of 48 LN.

The surgeon recommended a 3 month chemo. He told me my 5 year DF would go from 40-80% with chemo. Those statistics are incorrect.

 

Here are my thoughts after much research. I have put some much time researching this over the last couple months and in the last 7 days I have found many studies that say, Stage 3a with only the primary LN involved is different that regualr Stage 3a's. I found found at least 2 studies that show curative surgery is just as succesful in 5 year DF as 2 chemo options. Not only that but I have used the different cancer survival calculators by the CLeveland Clinic, Sloan, and MD ANderson that show 5 y rates with or with chemo and it shocked me with the below results. The calculators are very specific age, location CEA level, pos LN, total taken lymph nodes etc

https://www.mskcc.org/nomograms/colorectal/disease_free_probability

5 year disease free after surgery with no chemo 79%

5 year disease free after surgery with chemo 78%

 

Cleveland Clinic Calc confirms Sloans numbers

http://riskcalc.org/ColorectalCancer5and10YrRecurrenceFreeSurvival/ 

No Chemo 81%

Chemo 80%

 

I think the total amount of nodes taken play into these numbers. 

At this point I am leaning against doing chemo, and staying with a anti inflammatory diet that I have successfully for the last 2 months. I would very much like you thoughts and suggestions, and your experience with short similar chemo cycles.

 

Dave

 

SandiaBuddy's picture
SandiaBuddy
Posts: 892
Joined: Apr 2017

Everyone has a different outlook on this.  I was 3b and did four months of capecitabine as a monotherapy that caused heart problems that almost killed me, as well as a host of other side effects.  As for me, I wish I had not done the chemo.  Cancer might kill me in a couple of years, but I need my heart beating every minute of every day.

camicom
Posts: 20
Joined: Jun 2019

Thank you for the reply. How is your fight going?

SandiaBuddy's picture
SandiaBuddy
Posts: 892
Joined: Apr 2017

2.5 years NED.

camicom
Posts: 20
Joined: Jun 2019

Awesome

myAZmountain
Posts: 269
Joined: Apr 2018

may you be forever NED!  Cami I am a Stage 4 (cecum) with mets to 2 different areas, surgically removed except lung met,  then 9 rounds FOlfox and I can tell you If I was in your place I would not do the chemo. Quality of life matters.

flutemon's picture
flutemon
Posts: 15
Joined: Jan 2019

I was a stage 3 with one of 21 lymph nodes positive - right hemicolectomy.  I chose to do the xeloda pills only. 4 months later CT scans found 5 liver mets where I was clear right after surgery.  I don't think the xeloda did much good.  I then did folfiri + avastin (6) before liver resection and sbrt.  Followed that with Folfox (6).  Last CT was clear but going for another this week.  

I don't really look at stats because we are all different.  I didn't have severe side effects with any of the chemo, so I don't know if I would have done something different if I had.  We worried about the neuropathy with folfox, but it didn't cause me problems.

Have you looked at mutations, MSS/MSI, etc.?  I can't remember if that's only for stage 4s, but it might inform your decision. 

camicom
Posts: 20
Joined: Jun 2019

those should be in shortly

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

I’m Stage 4 with one liver met. I did chemo to shrink the met and have to agree with Azmountain... if I were in your shoes I would not do chemo. For me quality-of-life is everything and I didn’t have much quality of life on chemo.  As Flutemon says though each & every one of us react differently.  The decisions we make have to come after some soul searching.  I am waiting for my next scan at the end of August which will determine if I have surgery or not on the liver met. I will do surgery but personally I won’t do you any more chemo no matter what.

Elaine

myAZmountain
Posts: 269
Joined: Apr 2018

Gosh am in the same boat Elaine, get scanned end of August as well! Thinking of reprising that old Dolly Parton song into "Living Scan to Scan" not working 9 to five lol.

 

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