post-chemo questions

[FindTheBestHelp]

Hi All,

Have some post-chemo questions and hope for some valued, experienced input:

1. Just got done with chemo and had first post-chemo CT scan today. Only abdominal and rectal scans since nurse said chest scan was taken last July (before chemo started) and was said to be clean, so nurse said they didn't want to have another given due to the added radiation. is that risky or deemed ok to not have a chest scan today, and relying on the 6 months old result, taking next chest scan in 6 months, at about the 1 year point?

2. noticed in on-going conditions list on medical record that cachexia was added. concerned about that since what's been read about it indicate it's not reversible and a serious condition. asked onc if she was sure about the cachexia. Nurse replied by email saying she's not sure who put cachexia on the record but they usually use the term when there has been a weight loss measured, but also said it's reversible.. so not sure what to make of it.. how to tell if you have cachexia or not?

3. during last 3 months of chemo, fell down twice in middle of night while getting up from bed.. 1st time, fell flat on back and don't remember the incident at all, and no injury. 2nd time, fell back and back of head hit bottom of bedroom door (enough to put a dent in the cheap door 5" in diameter or so, and leaving a 2" abrasion on back of head on scalp), again with no recollection of the incident. Visited ER the 2nd time and EKG and CT scan of head came back clear. Not sure if it's the blood pressure meds, chemo effects, or something else. Doc just said to get up out of bed slowly to avoid swift changes in blood pressure.
Anyone else experienced anything like this before?

4. medical record showed that likely the colon cancer wasn't hereditary even though mother had it too. some indication of gene mutation. what does this mean to someone post-chemo who wants to do whatever is possible to avoid recurrence by taking the best care possible of body and mind? does it mean it's out of one's hands and in the hands of fate and the nature of the gene mutation? or are there things one can do the avoid recurrence by lifestyle changes, nutrition, exercise, etc?

5. is Coq10 safe to take post-chemo? if there's no conclusive data on its effectiveness to prevent cancer/recurrence, does it hurt to take it just in case it helps? how about baby aspirin? was told by onc she's reluctant to give okay to take since she's concerned about bleeding given aforementioned history of falls during chemo.

6. what are the best foods and ways of preparing one can have to give optimal health and most reduced risk of recurrence? what are the best lifestyle changes one can make (i.e exercise, etc)? in other words, what are the best things post-chemo folks can do to avoid recurrence? especially for those who have had total colectomy and absorbing sufficient nutrients back into the body is a concern... what foods should be stayed away from entirely? what foods should be eaten plentifully? have been reading that mushrooms are good, fruits, veggies.. have recently read eggs may promote cancer.. for examples.

7. onc approved travel 2 weeks after last chemo treatment. anyone have concerns about traveling (vacation by cruise or going overseas) shortly after chemo?

Thanks in advance.

[NZJay]

Regarding your lifestyle question, I like this article, and I follow its recommendations as they're pretty easy haha.

http://consumer.healthday.com/cancer-in ... 88450.html

TUESDAY, June 3, 2014 (HealthDay News) -- Regular exercise and a diet that includes fish may help colon cancer patients improve their odds of avoiding a relapse, a new study suggests.

The likelihood that patients will suffer a return of colon cancer more than doubles if they eat fish less than twice a week, or if they get less than 60 minutes of moderate exercise a week, researchers reported Monday at the American Society of Clinical Oncology meeting in Chicago.

Lead author Dr. Mohammed Shaik hopes these preliminary findings will motivate cancer patients to keep healthy habits even though they are sick.

"Once somebody is diagnosed with colon cancer, they may think there is nothing they can do to maintain a healthy lifestyle," said Shaik, a fellow at Michigan State University's Breslin Cancer Center. "We show they can help prevent a recurrence."

About 135,000 new cases of colorectal cancer occur every year in the United States, according to the American Cancer Society. It's estimated that 50,000 Americans will die of colorectal cancer this year.

The multinational study involved 1,515 colon cancer patients from the United States, Poland, Vietnam and Western Europe, including 188 people who suffered a recurrence of their cancer following treatment.

Researchers surveyed the patients, asking about their diet, exercise habits, and whether they smoked or consumed alcohol. "We wanted to know what factors could affect their progression," Shaik said.

People who eat fish less than twice a week or exercise for less than an hour each week are about 2.5 times more likely to have a recurrence of their colon cancer, the researchers found.

No other dietary factors appeared to affect the risk of colon cancer recurrence, including intake of red meat or alcohol consumption. Smoking also did not affect a person's recurrence risk, the study authors noted.

The findings regarding fish and exercise are consistent with earlier studies that investigated what might increase someone's risk of developing colon cancer in the first place, Shaik said.

However, until the results are published in a peer-reviewed medical journal, they should be considered preliminary. And the association between colon cancer risk, and fish consumption and exercise seen in the study does not prove a cause-and-effect relationship.

Researchers have hypothesized that the omega-3 fatty acids in fish might somehow reduce colon cancer risk, Shaik said.

It also might be that people who eat more fish end up eating less red meat and processed foods, which other studies have linked to increased colon cancer risk, said Dr. Smitha Krishnamurthi, an ASCO spokeswoman and an associate professor at Case Western Reserve University School of Medicine in Cleveland.

"In the United States, there are people who include fish as part of their diet intentionally to be healthier. It's not a standard part of our diet, like it is in other parts of the world," Krishnamurthi said.

Previous studies have established various benefits of exercise for colon cancer, Shaik and Krishnamurthi said.

"There's a growing body of epidemiologic evidence that exercise is associated with a reduced risk of recurrent colon cancer," Krishnamurthi said. "It makes sense. For example, we know that exercise reduces insulin levels in the body, and insulin is a growth factor for both normal cells and malignant cells."

Exercise also reduces inflammation in the body and helps thwart obesity, which are two other risk factors for colon cancer.

Weekly moderate exercise can include activities like a brisk walk or a bicycle ride. You can split up the needed hour of exercise, and do 20 minutes three times a week rather than do it all at once, Shaik said.

Krishnamurthi said she is not surprised that smoking or drinking did not seem to affect colon cancer risk. Previous studies have found no link between smoking and colon cancer, and only weak evidence linking colon cancer and alcohol.

However, she was surprised that no link was found between red meat consumption and colon cancer recurrence. She said she often warns her patients to avoid red meat and processed foods.


For more about colon cancer, visit the U.S. National Cancer Institute.

SOURCES: Mohammed Shaik, M.D., fellow, Michigan State University's Breslin Cancer Center; Smitha Krishnamurthi, M.D., ASCO spokeswoman, oncologist and associate professor, Case Western Reserve University School of Medicine, Cleveland, Ohio; presentation, American Society of Clinical Oncology meeting, Chicago, May 14, 2014

Last Updated: Jun 3, 2014

[Mastan]

Regarding CTs they are normally given every 3 mos the first yr. post resection. Then the interval goes to 6mos the second year. However, the standard is ito measure the CEA every 3 mos. for a number of years. If one is not having CEAs every 3 mos. and is getting CTs at 6 mos intervals I would personally consider that to be risky. I was NED for 2 yrs and in a 2 mo span of time my CEA spiked from below 4.0 to 8.0, after which a CT showed a bunch of lung mets.

Regarding your question about travel, i travel ( short duration - 1 to 2 weeks) often while on chemo. I just plan to go the week following chemo. In fact i am doing chemo this week and doing air travel next Monday. I will admit that I am not fully recovered but still functional.

[peanut_8]

Your issue with falling sounds similar to one I had while on Xeloda. Have you checked your blood pressure at home? BP monitors are affordable and might help pinpoint your problem. While on treatment, mine would go as low as 95/40. Discussed it with my onc and came up with a plan. Now that treatment is over, the problem resolved.

I think traveling after treatment depends a lot on how you feel. My DH and I had scheduled an overseas trip about a month after I finished treatment. I decided I was to fatigued to travel that far, and we decided to do something closer to home. I would think a cruise would be a good idea. Low stress and pleasant. Sorry I can't help with your other issues.
cheers, peanut

[Don.in.Dallas]

1. My first post-chemo scan, scheduled for Monday, covers head, neck and abdomen - probably because of my previous cancer.
2. N/A
3. I fall down from time to time and have learned to always grab rails, chair backs, etc. when walking. Nighttime is especially bad. Hopefully this will go away at some point.
4. Cancer happens to people of all types. Living healthy is good for many reasons but it will not likely affect future occurrence of colon cancer.
5. Same as #4.
6. Same as #4.
7. I traveled to Antarctica (airplanes, taxis, buses, ships, small boats, hiking, climbing) a few weeks ago in the late stages of chemo - between FOLFOX cycles 11 and 12. Symptoms remained the same (neuropathy, cold sensitivity, weakness, fatigue, diarrhea) but the journey was enjoyable. My greatest concern was finding a toilet when (frequently) needed.

Time to get back into life!

Don

[AbsumZero]

Cachexia is a complex syndrome associated with the end-stages of terrible diseases. I can't imagine why they'd use that term rather than 'malnutrition'. If you had cachexia you'd be wasting away no matter what you ate and your muscle tissue would be breaking down.

As for avoiding recurrence, yes, studies find a marked difference in recurrence rates among people who exercise and eat a healthy, balanced diet. Getting cancer in the first place is mostly a matter of chance; there are factors that can make it more likely but eventually something like 40% of U.S. Citizens get some form of cancer in their lives; it's a numbers game and the longer we live, the more cell divisions, the more likely there is to be an error that develops into full-blown cancer. Recurrence is a different matter though, because those cancer cells are already there inside of us, and the healthier we keep ourselves the harder it is to set-up shop. It doesn't mean that someone who takes great care of themselves won't have a recurrence, sometimes fate just craps on people, but there's no reason not to try stacking the odds in your favor.