Newly Diagnosed

[fucancer]

Hello, I am a first time poster, although I've been reading this board since I learned I have colon cancer, and it's helped me already.

My drama started in December 2013 with sharp abdominal pains. I thought it might be appendicitis. A CT scan revealed a colon perforation, so I was admitted to the hospital for 4 days and given IV antibiotics. I was given a diagnosis of diverticulitis. They wanted me to wait about 6 weeks for the inflammation to subside, then do a colonoscopy. This was done on Feb. 25th, when the tumor was discovered in my sigmoid colon. Surgery was March 6th, they removed about a foot of colon and a tumor the size of a tennis ball. The pathology came back T3 N0 MX. 24 lymph nodes were taken, there were clean margins, the tumor was moderately differentiated, but lymphovascular involvement was noted. Because of this, the oncologist considers me a high risk Stage IIA. He is pushing for chemo as if I were a Stage III. Oxi, 5FU, LV. He didn't want to order the Oncotype DX assay, said "it wasn't very useful". He did order immunohistochemistry, and all markers came back positive (MLH1, MSH2, MSH6 & PMS2).

I don't know what to think. This has all happened very fast and it's been a lot to take in, research, etc. I am a 54 yo female, and a Type 2 diabetic. I really don't want to go through chemo, but afraid of what might happen if I don't. I am looking to get a second opinion next week or so at UCSF.

Feeling a bit overwhelmed...

[stpio]

I am so sorry to hear about your diagnosis. So normal to feel overwhelmed, confused, scared and concerned about chemotherapy. I was diagnosed Stage 3 in 2007 and had the same chemotherapy you mentioned below for 6 months. Although it wasn't easy I made it through as did many of us on this board. I am not a diabetic and tested negative for MLH1, MSH2, MSH6 & PMS2 so unfortunately I cannot offer any information on that topic. You found a great forum here that has helped me and others tremendously. Good luck at your second opinion and I hope you have a lot of support from family and friends.

[Rob in PA]

Welcome, yet sorry you have to be here. Stage II can be a tricky diagnosis because even though there is a tiny bit of relief that you are not stage III or IV, you are still vulnerable to advancing to stage IV if you are not aggressive with your treatment. If your onc is concerned, you should be too. Nobody likes having to "choose" to put your body through chemo but the payoff and peace of mind could be substantial. So if you haven't been able to tell from my words yet...yes, i think you should do chemo.

Best to you,
Rob

[Oneeyeddog]

Yes, do the chemo -- especially if you onc is pushing for it. While chemo is no breeze, it is entirely do-able. Speaking bluntly, if you did have a recurrence further down the road you might always be kicking yourself for not using everything in your arsenal to prevent that from happening. With lymphovascular involvement, there is a chance there are microscopic cancer cells floating around your body and the chemo is there to take care of that (if that is indeed the case). So, yes, I would do it certainly. I wish you all the best, whatever you decide.

[Lee]

Welcome, sorry for the reason you are here.

As others have said, do the chemo. Stage II is really a grey area. Too many people with stage II have moved to stage IV. You want to fight this cancer NOW with everything you can so that you don't look back and say "maybe I should of".

Lee

[justin case]

If vascular involvement was noted, I would think this a no brainer. please do the chemo.
Michael

[fucancer]

Thank you, everyone, for your thoughts. I think I'm resigned to doing the chemo now. I'm still going to get a second opinion, but I will need to pay for it out of my pocket, since I want to go outside my HMO for it. They may give the same advice, but I will feel a little better about it.

[PainInTheAss]

Standard care is becoming no chemo for stage IIa if there are no risk Factors. Since you have risk factors....

I agree... It's a no brainer.

When I struggled with the risk/side affects dilemma even as a stage III, I found peace in something Bev said in one post something like, "I finally realized that if I was going to survive, I needed to trust my doctors."

Go ahead and get a second or third opinion, but stop when you are just trying to find someone who will tell you what you want to hear. Better to do preventive now while you still can.

[katsheba]

Just wanted to say good luck. I did chemo last year. It is was no walk in the park to say the least, but as bad as those months were, they did end and now I feel great. I'm sure you know that people's experiences with chemo can be very different depending on a multitude of factors. Even each round of chemo can be different for the same person. I had a complication from surgery that made the first half of my chemo worse than it would have been otherwise. Even so, I got through it. When you are in the middle of it, sometimes it is hard to see that it will be over. But it is finite. It's not an easy decision even when there is "no choice." My onc always said, "Right now is our big shot to do this right." As many on this thread have said, you can't go back in time and decide to do it if you don't do it now. I was stage IIIC, so chemo was a no brainer for me. Nevertheless, it helped me to actively make the decision to do it. In other words, I felt emotionally better when I looked at it as the best decision I could make under the circumstances I was in vs. just going along and feeling like it was being forced on me by the doctors and I had no choice. That's my point of view. I wish you all the best as you continue dealing with this difficult situation. Take care.

[orcasres]

I am stage IIA and I had risk factors. My onc strongly urged chemo and I did 12 rounds of FOLFOX (the last 4 without OXI). I just decided I could not live with my choice if I did not do chemo and if I had a recurrence and while chemo was no walk in the park, it was doable. I have a little residual neuropathy in my feet and a lot of aches and pains that I did not have before chemo, but I will never regret doing it.

Good luck with your decision, Lois

[radnyc]

Nobody wants to do chemo. Lymphovascular involvement is a sign that some cancer cells might have move into the lymphatic system. I would not take any chances, do the chemotherapy. Folks here will help you along with any questions you might have. Hang in there.

[lorrainem]

Also stage II here, and also one who was strongly urged to opt in for chemo. Same location sigmoid junction so treated for both rectal and colon as tumor was on the low side … only difference being chemo/radiation prior to surgery then started the Oxy routine six weeks post op.
Treatment isn't a picnic, it actually sort of sucks, but it's 2014 and I am still disease free, in September it will be seven years since diagnosis.
If it comes back, I know I did what was necessary.
I hope you have good results both on your second opinion and your journey.

[Kick'nAssCancer'sAss]

Stage IIA here also and I got a CPR but still doing the chemo. I just have gone through so much to date that if I blew off the chemo and what if?????
My ONC suggested I do the chemo since my original T3 tumour would be considered aggressive and you never know if clusters of micro cancer cells are lurking waiting to attack even though I have to lymph node involvement and no more tumour.
I have 8 treatments and not looking forward to it but if I am alive 10 years from now I will be glad I went through it.
Do the chemo.

[rp1954]

I think a fair summary of past chemo options discussed here on the board for stage II-III is:

Xeloda (an oral chemo AKA capecitabine) or 5FU-LV only, 6-12 months
Folfox for 6 months (or Folfiri if 'fox problems)
Folfox for 2-4 months + 5FU-LV or xeloda for 2-4 months (remainder of 6 mo)
(chemo 1-2 rnds +) long term off label adjuvants like cimetidine, PSK, metformin, celebrex and/or anticancer supplements
Xeloda 6-12months, plus off label adjuvants like cimetidine, PSK, metformin, celebrex and/or anticancer supplements

The precise length of time on oxaliplatin is a major consideration that you might follow previous posters' experience and comments about side effects and net value. Also any CEA and CA19-9 data, pre-op and post op, can shift the odds and potential choices.