Wife detected with earlier stage 4 rectum cancer

[Jon9569]

My beloved wife is detected with earlier stage 4 rectum cancer. From CT scan, it did not spread to Liver and Lungs etc....

Had surgery to remove the tumor 2 weeks ago and the operation went well (He removed the tumor and the suspected lymph nodes. However, from the final pathology, 7/12 lymph nodes was tested positive.

Was told that she need to do chemo. Just went to see the oncologist and most probably will be in another 2 week times.

[Delinda]

Jon, wecome to our CC family, but very sorry you need us. You have come to the best possible place for information & support. I'm pretty new so don't have any advice myself,but can tell you that our more experienced members are wonderful about responding to newbie questions. Also, search past threads first because many issues have already been addressed. Read the "Tems & Abbreviations" pinned near the top - very helpful. And finally, do not be frightened by Dr Google. Statistics are outdated due to recent advances in treatments, etc. It will drive you crazy & your wife is not a statistic. BREATH, repeat as needed - you can do this. Take care & come here often; we also have lots of wacky folks to make you laugh daily. XXOXO, Delinda

[chemo sabe]

I am sorry if this sounds harsh, that is certainly not my intent. Following the surgery, there should be a report from a pathologist. This report should provide the "staging" of your wife's cancer. There really is no clinical definition of "earlier stage 4". The pathology report should also tell you if the margins are clear, if the tumor is moderately or highly differentiated, etc. You are owed a copy of that pathology report.

Your surgeon and oncologist should tell you if you are on the Curative Path or not.

Standard of care dictates having post surgery adjuvant chemo. Front line therapies include Oxaliplatin. You really should have a Port installed prior to starting the chemo. I did 6 months of a thing called Xelox. Infusion of Oxaliplatin followed the 2 weeks of xeloda (oral), one week off and then back for another infusion.

I wish you and your wife the very best. Stay strong for her.

[Jon9569]

My wife is 41 years old.

Her final pathology report stated stage 4 rectum cancer. But her colon doctor told us that it is advanced stage 3. Anyway, she will need to do chemo.

Already consulted the oncologist recommended by her colon doctor and will most probably starting the adjuvant treatment in 2 week via PICC method.

Just wondering what is the expected side effect although her oncologist mentioned that there will be nausea, dizziness, numbness in both hand and leg etc......

How to manage this side effects?

Not sure is she ok to work during chemo but just a question, Is it better to do the treatment on which day like Monday or Wednesday?

[justin case]

I am sorry if this sounds harsh, that is certainly not my intent. Following the surgery, there should be a report from a pathologist. This report should provide the "staging" of your wife's cancer. There really is no clinical definition of "earlier stage 4". The pathology report should also tell you if the margins are clear, if the tumor is moderately or highly differentiated, etc. You are owed a copy of that pathology report.

Your surgeon and oncologist should tell you if you are on the Curative Path or not.

Standard of care dictates having post surgery adjuvant chemo. Front line therapies include Oxaliplatin. You really should have a Port installed prior to starting the chemo. I did 6 months of a thing called Xelox. Infusion of Oxaliplatin followed the 2 weeks of xeloda (oral), one week off and then back for another infusion.

I wish you and your wife the very best. Stay strong for her.

On this I have to agree. Just because some nodes were tested positive, that does not make a staging of 4. Sabe has it right all around, and I would heed this advise.
Michael

[JDinNC]

I might not be understanding your full situation correctly...but to be a stage 4, the cancer needs to spread to a distant organ..like the liver or lung. I would think she's a stage 3

Chemo will affect everyone different....Oxaliplatin ...will cause neuropathy so watch for a early numbness in hands and feet.

[basedballguy]

The surgeon should be able to confirm the pathology report then give an accurate staging. I was administered 6 months of fol fox chemo (once every two weeks for a total of 12 treatments) I also had a picc line. It's a godsend but you have to keep it real clean. They showed me how to flush it. They stopped administering the oxy in my cocktail after the 10th dose because I developed neuropathy which I have never fully recovered from, but you just learn to live with it. I wish your wife good luck and tell her to keep positive thoughts as it sure helped me with my battle. I'm 4 years NED now.

[chemo sabe]

Jon9569,
In the United States, there are 2 front line adjuvant chemo treatments for Colorectal cancer. Folfox and Xelox. They are essentially equivalent. Both include infusions of Oxaliplatin. You can read about the toxicity of both treatments. There are many possible side effects and everyone gets some and thankfully nobody gets them all.

Although generally well tolerated, both of these treatments have some real side effects and you are counting on your Oncologist to manage the toxicity so the treatment does not lead you into the emergency room. However, the patient has to be completely honest with the Onc for this to work.

I chose Xelox because I got an infusion every three weeks, you take an oral form of 5FU for 2 weeks and then a week off. Folfox gets the infusion every 2 weeks and then gets a slow dose of 5FU over 2 days and you go back to the Onc to get that disconnected. I did not like the idea of a tether that short. On the other hand, the oral treatment is well known for causing hand foot syndrome.

As far as work goes, I worked throughout those 6 months but the fatigue was a real drag. The only days I took off were infusion days. I had anti-nausea meds administered with the infusion of Oxy, also steroids to manage symptoms. I had a prescription for anti nausea meds but did not use it. From time to time I did feel ill, but eating some bread would calm it down.

[dianetavegia]

Agree with Chemo Sabe.... Stage IV indicates spread which could be to lymph nodes outside the area. As far as early stage Stage IV, there is Stage IVa (new terminology), but that is when only a small met is found in one distant organ.

You do need the path report and to ask more questions.

[Jon9569]

Hi

My wife started Folfox today which mean she will gets the infusion every 2 weeks and then gets a slow dose of 5FU over 2 days and you go back to the Onc to get that disconnected. At night, she start to feel tired as well as some numbness on her hand.

Her doc told us that for her 2nd treatment, he will continue with Folfox plus Avastin...... Twice more expensive that what I am paying today for the Folfox alone.

1 down ..... 11 to go. GOD BLESSES HER

Any advise for me to take better care of her while she is on the treatment for the next 6 month to go?????

[mstults]

I had Avastin with most of my folfox treatments. She will be prone to bleeding so that should be monitored closely. The folfox along with Avastin ran my platelets very low. The only place I ever bled was the nose. I was lucky. Avastin isn't technically a chemo so the side effects aren't really that bad. Watch for hand and foot problems. The dosage of Oxaliplatin may have to be adjusted. I got good results with folfox. Hair usually thins but doesn't come out - a plus for women. If she eats well she should be able to continue her daily activities.