CRC later recurrence - is it ever curable?

[greens]

Dear Clubbers


I have read there are many factors that affect the chance of either local recurrence or metastatic recurrence suffice to say anyone for stage 1 to 3 is at risk and probably for ever.

I have read that recurrent local CRC is hard to treat so presumably not curable but is it worse than metz to lung/liver/ elsewhere?

Clubbers any experience/knowledge gratefully received - is local or metz recurrence "better" ?

I have seen some liver /lung metz appears operable / treatable but not sure whether this is true or not?


Best wishes

Charlie
T3 N2 M0

[BrownBagger]

I don't think anybody is "incurable" but your odds of beating it go down dramatically if you get a recurrence. Not sure about local vs. distant. Local recurrences don't seem to be all that common, at least not around here.

[SkiFletch]

Local recurrance in colon cancer in the colon itself is actually highly curable since you can just go ahead and chop out another batch of colon. Local recurrance in colon cancer is also very rare. In rectal cancer, pelvic recurrance is considered local and more difficult to treat/cure. Local recurrance in rectal cancer is more likely, especially the more advanced stage the patient is. In all cases though, distant metastatic recurrance represents a greater danger to the patient's health/prognosis/curability/whatever you want to call it.

[sadysue]

I sure hope it's curable....I am counting on it! I was staged T3N1M0 but was told that there was no cancer in the lymph glands that were removed. One was enlarged, hence the N1. It was a big tumor and had grown to about 4 inches right where my rectum and colon join. I am doing Folfox now and hope to never see this miserable disease again. I hate it.
Mary Ann

[greens]

Thanks

Local recurrence appears to be circa 5 to 6% but does anyone know if its treatable?

As Ski Fletch says distant Metz is a greater risk, probably anywhere from 15% to 40% depending upon many factors but including nodal status of specimen.

Is there a "good" place to get metz to or is any distant metz untreatable?

Best wishes


Charlie
T3 N2 M0

[Bob_Weiss]

Recurring rectal tumors are most often found in the liver, and my gastrointestinal oncologist insists that liver metastases are potentially curable depending upon characteristics of the tumor and other factors. This conforms to articles I have found on the subject. Of course, the survival statistics decline when there is metastatic spread, although the survival percentages are difficult to pin down, since they vary according to when the study was done, etc.

[BrownBagger]

All mets are treatable. Whether or not the treatment is effective over the short and long terms, on the other hand, is the big question. I have two lung mets that we're treating with Xeloda. And they're shrinking. So it's working, at least for the moment. Even "inoperable" tumors can be treated in a variety of ways--sometimes very effectively.

Surgery is always your best bet with a tumor, but it's not uncommon to treat them with chemo or radiation or more exotic procedures like radio frequency ablation (RFA) before attempting surgery. I expect I'll have some form of surgery on the tissue that hosted these two mets once they are gone.

Where's the "best" place to get distant mets? My only experience is with lung mets, and I wouldn't know they were there if they didn't show up on a CT scan. I had major lung surgery last fall (wedge resection/thoracotomy) and I haven't noticed any reduction in my lung capacity, despite the fact that I use them pretty hard bicycling thousands of miles annually, etc. So from my point of view, lung mets are pretty tolerable, as long as we can keep them under control. I can't comment on liver involvement, other than to say that I'd rather have lung surgery than liver surgery.

[BrownBagger]

survival percentages are difficult to pin down, since they vary according to when the study was done, etc.

I've never figured out exactly what those "survival statistics" are measuring. I think all they report is the percentage of Stage 4 patients who are still alive 5 years post dx. That doesn't mean you're cured at 5 years or in remission. Just that you're alive. So, with effective treatments keeping the disease under control, the 30% "survival" number doesn't tell you much. And it tells you even less with rectal cancer, which can recurr up to 10 years after diagnosis and remission/apparent cure.

[Bob_Weiss]

/quote]

I've never figured out exactly what those "survival statistics" are measuring. I think all they report is the percentage of Stage 4 patients who are still alive 5 years post dx. That doesn't mean you're cured at 5 years or in remission. Just that you're alive. So, with effective treatments keeping the disease under control, the 30% "survival" number doesn't tell you much. And it tells you even less with rectal cancer, which can recurr up to 10 years after diagnosis and remission/apparent cure.

I think you are basically right. The survival period used is most often 5 years; sometimes shorter and only rarely longer. "Survival" is usually defined as alive at end-of-period; or alive with no recurrances. Sometimes the data excludes patients whose death is not related to cancer (ex: hit by a bus), and sometimes it is not clear to me how the non-cancer related deaths are treated.

[Lee]

I was diagnosed almost 8 years ago, during these past 7+ years I've met a 2 people who were given a cancer diagnoses and chose to do nothing about it beyond surgery. In other words, they chose not to do chemo. They did not survive beyond a few years. I'm sure there are other people out there like these 2 people. I realized people who DO take an active interest in there cancer and try to fight it actually have better odds than someone who chose NOT to do anything.

I've also come to understand, as new treatments/procedures come along, a person's survive rate tends to go upward. When I was first diagnosed and especially following my surgery when it was determined 6 out of 13 nodes were positive for cancer. I was told my 5 year survive rate was anywhere from 30% to 60% depending on who you talk to. I was one of the few people to get on board for oxyplatin before it had been approved for stage III cancer (at that time, FDA only approved it for stage IV). Today, because of treatment/surgical options, survival rates are in the 70% for stage IIIC cancer.

When I was diagnosed, if a person had multiple mets (ie one met verses several met in the liver) there was not a whole lot they could do for that person, today they can and do treat multiple mets successfully. Even it the mets are in different parts of the body.

Many many years ago a friend's dad was diagnosed with colon cancer. Because he had a met, he was only given 6 months to live and that was pretty accurate simply because there was not much they could do for him then. I'm sure if he had been diagnosed today, he would have many years ahead of him if not NED.

Lee

[BrownBagger]

I was diagnosed almost 8 years ago, during these past 7+ years I've met a 2 people who were given a cancer diagnoses and chose to do nothing about it beyond surgery. In other words, they chose not to do chemo. They did not survive beyond a few years. I'm sure there are other people out there like these 2 people. I realized people who DO take an active interest in there cancer and try to fight it actually have better odds than someone who chose NOT to do anything.

I've also come to understand, as new treatments/procedures come along, a person's survive rate tends to go upward. When I was first diagnosed and especially following my surgery when it was determined 6 out of 13 nodes were positive for cancer. I was told my 5 year survive rate was anywhere from 30% to 60% depending on who you talk to. I was one of the few people to get on board for oxyplatin before it had been approved for stage III cancer (at that time, FDA only approved it for stage IV). Today, because of treatment/surgical options, survival rates are in the 70% for stage IIIC cancer.

When I was diagnosed, if a person had multiple mets (ie one met verses several met in the liver) there was not a whole lot they could do for that person, today they can and do treat multiple mets successfully. Even it the mets are in different parts of the body.

Many many years ago a friend's dad was diagnosed with colon cancer. Because he had a met, he was only given 6 months to live and that was pretty accurate simply because there was not much they could do for him then. I'm sure if he had been diagnosed today, he would have many years ahead of him if not NED.

Lee

Well said, Lee. I think that's the trajectory we're on. Hopefully the government/economy won't do anything to slow or reverse this positive trend.

[greens]

Yes its a very good point....that in every 5 year cycle there are new developments which can benefit those who may not have been treatable to "cure " but only to "manage" but now can be treated to "cure". Its a great hope for all CRC sufferers and is another reason NEVER to give up hope.

What do Clubbers feel is the greatest recent development for treating CRC mets and any treatments that they are aware of in the pipeleine that may be availabe in 3 to 5 years time for those CRC sufferes who were previous NED and now have a distant recurring mets?


best wishes


Charlie

[Lee]

What do Clubbers feel is the greatest recent development for treating CRC mets

Charlie

Surgical options and advancements!

Today there are lots more options for treating CRC mets. When I was diagnosed, there were only a few places in the U.S. that could/would treat multiple mets (MD Anderson, Sloan K, etc). Today many people are receiving that same excellent care in their local hospital. What once was considered inoperable, is now operable.

When I was diagnosed, laproscoptic surgery was only an option is you were a stage I or II. Today I believe it is much more common, even for those people who are stage III like me. This was not an option for me 7 1/2 yrs ago.

There have been many advancements made for people dealing with rectal cancer and not having to live with a permanent colostomy bag. While some rectal cancer patients do struggle with bathroom issues, there are a lot more many people out there today that don't have an colostomy and few if any bathroom issue. 7 1/2 yrs ago, getting a permanent colostomy was the best solution, if I were being diagnosed today, I believe I would have options.

When I had my surgery, hospital stay was 7-10 days following surgery. I believe the time is much shorter today, like around 5 days being the norm.

Lee

Now if they could just perfect fixing hernias, I could get my rather large hernia fixed.

[wrs]

I was diagnosed almost 8 years ago, during these past 7+ years I've met a 2 people who were given a cancer diagnoses and chose to do nothing about it beyond surgery. In other words, they chose not to do chemo. They did not survive beyond a few years. I'm sure there are other people out there like these 2 people. I realized people who DO take an active interest in there cancer and try to fight it actually have better odds than someone who chose NOT to do anything.

You can see in my signature what I chose, it's not nothing. My experience with chemo was that it's more like death than life and therefore I chose to find a different way to manage my post operative recovery. At five years out I am healthier than before I was diagnosed because I am now cancer free and plan to remain that way. I believe that your state of mind makes a huge difference in your recovery. To me, chemo was not conducive to feeling that I was recovering and so I chose not to do it. What I did do has worked for me.

[lauragb]

wrs, I am interested to hear if you had any positive lymph nodes in your surgical pathology report. I had a very clear report and am considering
the no chemo route that was recommended by my surgeon. Looks like it has been a successful path for you.