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Radiation Post Chemo and Surgery for Colon Cancer

Posted: Wed Sep 05, 2012 2:47 pm
by sandrichelle
Has anyone here had to have radiation to their entire pelvic region for Colon Cancer POST surgery?

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Wed Sep 05, 2012 9:45 pm
by NWgirl
I wouldn't say my "entire pelvic region", but I did have radiation post surgery.

When I was first diagnosed (via a scope), I was staged as late stage 1, early stage 2. I had tons of diagnostic tests to determine whether I had any lymph node involvement and they all came back showing no lymph nodes were involved. So I went straight to surgery. Unfortunately for me, the pathology revealed 27 of 38 nodes affected with cancer. Bad day for me. So I had 4 rounds of FOLFOX, then radiation/chemo, then 8 more rounds of chemo.

Because the surgery had obviously removed the tumor, the radiation was directed at the field where the tumor had been removed.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Wed Sep 05, 2012 10:36 pm
by WorriedWife
You know..I wonder what makes an oncologist decide/prescribe chemo or radiation? My hubby is stage 2, no lymph node involvement, had surgery, everything is fine now....they want him to do mop up chemo..i wonder why not radiation? Or I wonder if radiation is to shrink tumors only?

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 12:00 am
by Redtexa5
Normally you don't get radiation for COLON Cancer as the colon is not a stable target, your intestines move so, as it was explained to me, they can't get a stable point to aim their beam at. Also, as long as the cancer is confined to the colon, stage 2 and below, resection of the effected bowel is simple as the colon is basically floating in your abdominal cavity. The rectum, while it is still the colon, is held in place as it passes through the pelvis and the muscles that allow us to control our bowel movements so you have a stable target, and there are many muscles etcetera that need to be cut to remove the affected bowel so typically they want the tumor as small as possible with nice clean margins before they cut to keep the collateral damage to a minimum, so the order is reversed from typical colon cancer treatment with chemo and radiation before surgery and then chemo if needed after. At least that is how the radiation oncologist explained it to me. As far as irradiating the whole pelvis, I have never heard about that, sounds very strange as there is lots of soft tissue there that they usually don't want to irradiate. So speaks the Colon cancer survivor who had radiation and chemo BEFORE they removed the tumor, but I was a very odd case. Take it from me it is not the type of fame you want.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 12:14 am
by weisssoccermom
worried wife
It's very simple. The colon isn't fixed - it moves and radiating a 'moving target' is difficult. The rectal area, which is what you are probably referring to, is fixed -it isn't constantly moving so yes, it can be radiated. Also, the pelvic region is rich in lymph nodes and to help stop local spread, radiation for rectal cancer is usually rxd for stage II and above. In addition, radiating the colon is rough. Some portions of the colon for the rectal cancer patient get radiated and the collateral damage can be brutal. Radiation is not solely used to shrink a tumor. It is also used, in circumstances where clean margins were not able to be obtained to provide that 'extra' measure of safety - i.e. kill any stray cancer cells. Trust me, if the rad onc doesn't feel your husband needs radiation - be happy.

Redtexa5 - yes entire pelvic radiation is not uncommon. Rectal cancer patients who receive traditional radiation, contrary to popular belief, generally do not have radiation solely aimed at the tumor. The lymph nodes are also radiated and, because of radiation 'scatter', a large portion of the pelvis is also radiated. It's actually quite common for damage to the vaginal area, the bladder as well as portions of the large intestine (and sometimes the small intestine as well). Also want to clarify that no, the rectum is NOT considered part of the colon. It has a definite beginning and end and is classified as such. It is entirely different from the colon. While yes, one reason radiation is used is to shrink the tumor it is by far not the only reason. Studies have concluded that for the rectal cancer patient, radiation significantly improves local recurrences - actually a more important reason that merely shrinking the tumor. In addition, most rectal cancer patients do end up losing most, if not all of their rectum, even when the tumor is higher up so while shrinkage may be of more significance to the low lying rectal cancer patient, it just isn't as important to those patients whose tumor lies higher up. Even in cases where the tumor is nothing more than a scar - generally speaking the entire rectum is removed.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 12:26 am
by WorriedWife
Redtex and Jaynee,

I am amazed at how much you know! Thank you for the answers!! :D

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 4:18 am
by Amy14760
I also had radiation/Xeloda after surgery. The tumor was very small and all tests only showed only one possible lymph node involved. The surgeon was confident that he could remove the tumor with clean margins and spare me the radiation. As it turned out, pathology report came back with 15 out of 19 lymph nodes involved. At that point the tumor board recommended that radiation be done. I personally had a tough time with radiation because I was not able to stay hydrated. The last 2.5 weeks I got a daily 1 liter drip to get me through to the end. Best of luck to you. Amy

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 4:49 am
by prtza
sandrichelle wrote:Has anyone here had to have radiation to their entire pelvic region for Colon Cancer POST surgery?


Yes, I had, for tumour invasion. The lower edge of the treatment field passed through my bladder.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 1:34 pm
by sandrichelle
Thank you all..for those of you that did have it, would you say it was worse or easier than chemo (FOlFox) that is?

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 2:37 pm
by weisssoccermom
I only had one infusion of oxi - really terrible - so I'm not a good judge. Radiation can be VERY difficult - particularly for the female patient.
The main thing is you MUST KNOW WHAT TO EXPECT AND YOU MUST TAKE PRECAUTIONS FROM DAY ONE!!!
It isn't good enough to do something after side effects/symptoms begin. Then it's really too late.
While chemoradiation isn't a walk in the park, it is doable with the knowledge ahead of time to take precautions. Unfortunately too many rad oncs just gloss over the issues or better yet (being sarcastic) avoid them all together. This is an area that I am PASSIONATE about and have worked with the area radiation centers to 'try' and educate them with simple, common sense advice.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 7:25 pm
by NWgirl
For me, radiation was pure hell. A lot of my pain was inside. FOLFOX was no picnic, but radiation (for me) was worse. Just my experience.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Thu Sep 06, 2012 7:53 pm
by SugarBubbie
radiation was really hard.......please do as weissermom says and get prepared. I thin you can search for all the tips on here. No lotions before radiation, use glyverine soap only, and drink lots of water.

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Fri Sep 07, 2012 12:12 am
by prtza
sandrichelle wrote:Thank you all..for those of you that did have it, would you say it was worse or easier than chemo (FOlFox) that is?


For me, radiation was far easier than chemo (XELOX)

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Sat Sep 08, 2012 4:32 pm
by Merlin
I have stage iv colon cancer. Had tumor removed, sigmoid, and since tumor broke through colon wall, radiation to pelvic area was recommended. I laid on a table as radiation was applied at five different angles. Took about 10 minutes. Had it for five weeks, m-f. Also had the 5 fu pump, m-f. The last two weeks I had pretty bad abdominal discomfort. I found kiefer, a liquid yogurt very helpful. I drove myself to all treatments. After that, I had an attempted liver resection in jan '12 to remove the one liver met that showed on scans. Unfortunately, many small ones were found, so none removed.

Had chemo, FOLFIRI, for 6 months, and SIRT spheres to liver during that time. The one tumor that shows up has shrunk 50%. I am having a liver resection this Monday.

Good luck to you.

Lisa

Re: Radiation Post Chemo and Surgery for Colon Cancer

Posted: Tue Dec 11, 2012 1:06 pm
by mich
my husband finished pelvic radiation 2 months ago.... he had pelvic radiation because of a margin that couldn't be reached after a retroperi lymph node resection. His recent scan was clean and his cea normal at last check! it will be 6 years this January since initial diagnosis:)
He has already beat those internet odds!