Would you get chemo for stage IIA?

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Nate
Posts: 5
Joined: Thu Jul 23, 2015 3:48 pm

Would you get chemo for stage IIA?

Postby Nate » Thu Jul 23, 2015 3:59 pm

I just had a stage II A tumor and 7 inches of my colon removed. Tumor did protrude outside of the colon wall, but there was no cancer in the lymph nodes. All other markers are clear too. I've seen two oncologists. One says no chemo necessary, just vigilance. The other says, no chemo necessary, but he advises for it because he wouldn't want me to look back 10 years from now should it reoccur and regret not doing everything I could for it now - especially since it would not be a severe chemo treatment (every two weeks for 6 months).

Has anyone been in this place? I'm not looking to get chemo if I don't have to, but I certainly want it if it will improve the odds of this not recurring or worse, some hidden cells in my gut that will make their way to my liver or lungs.

Which way would you go - chemo or no?

Lydia666
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Joined: Sat Jun 06, 2015 6:50 pm
Location: Montreal, Canada

Re: Would you get chemo for stage IIA?

Postby Lydia666 » Thu Jul 23, 2015 4:28 pm

I think i would do it. I could be in a similar situation and i thought about it. My doc said there are no benefits to chemo if no nodes are involved, but i think i would ask 2-3 oncologists and decide- but i would go for it just to be able to say i did all i could.
Oct 2012- thyroid cancer
June 19, 2015 Dx@39 yrs- CRC-T3N1M0
No vascular, no perineural invasion
Aug-Sept 2015- 28 rad/5FU
Oct 28, 2015- LAR- temp ileo, neg. nodes- 0/11
March 2016- 6 rounds Xeloda/positive CHEK2 mutation
August 2016- DCIS and decided post prophylactic double mastectomy
May 2018 - clean CT
Sept 2018-clean scope
Devastation, total shock- oct 2018, invasion of peri mets
Dec 20 - 2 round of folfox
Mom to 4 & 7 yrs kids - at least i brought them to this level of independence.

alphagam
Posts: 203
Joined: Tue Jun 14, 2011 10:48 am
Facebook Username: Kathy Maine Ruess

Re: Would you get chemo for stage IIA?

Postby alphagam » Thu Jul 23, 2015 4:38 pm

I did not have to make that choice as my tumor had not gone past the lining of the rectum. However, I did do research, talked with people, and continue to do so. My passion in life us sewing and embroidery. That means picking up a teeny tiny needle which is threaded making teeny tiny stitches, never taking up more than one minuscule thread of the fabric. If I couldn't sew I honestly don't know what I would do. So my decision, which has not changed, would have been to do the 5fu, but not the oxipalatin. Quality of life was first and foremost in my mind. Just my opinion.

Kathy
Dx Feb 2010 4 cm tumor, just inside rectum
EUS stated T3 tumor
2nd opinion, need better path
Mar 2010 transanal surgery. Surgery by board certified CRS found tumor only in lining
6 exams of surg site, 3 PET, 3 scopes laterNED.
Scope in Mar2015, clean colon
Next scope/test in 3 years

Lydia666
Posts: 676
Joined: Sat Jun 06, 2015 6:50 pm
Location: Montreal, Canada

Re: Would you get chemo for stage IIA?

Postby Lydia666 » Thu Jul 23, 2015 4:53 pm

I was also thinking- how many nodes did they take out? If it s a large number like 20, and none were involved, then it's very good, but if they took out half of that, then who knows? It only takes one freaking ugly nasty cell.
Oct 2012- thyroid cancer
June 19, 2015 Dx@39 yrs- CRC-T3N1M0
No vascular, no perineural invasion
Aug-Sept 2015- 28 rad/5FU
Oct 28, 2015- LAR- temp ileo, neg. nodes- 0/11
March 2016- 6 rounds Xeloda/positive CHEK2 mutation
August 2016- DCIS and decided post prophylactic double mastectomy
May 2018 - clean CT
Sept 2018-clean scope
Devastation, total shock- oct 2018, invasion of peri mets
Dec 20 - 2 round of folfox
Mom to 4 & 7 yrs kids - at least i brought them to this level of independence.

tif2112
Posts: 114
Joined: Wed Jul 04, 2012 4:23 pm
Facebook Username: tif2112
Location: Henderson, NV

Re: Would you get chemo for stage IIA?

Postby tif2112 » Thu Jul 23, 2015 5:18 pm

I had 5 weeks of Xeloda and radiation but my tumor was classified as Rectal. I would do it again to better my odds of a reoccurrence.
51 year old female
Henderson, Nv

T3N0M0
2012 DX - Rectosigmoid Mass, Colon Resection, rx - radiation and chemo
07-24-2014 NED
2014 englarge lymph nodes, biopsy of 1 negative
07-07-2015 even bigger enlarged lymph nodes, shown on MRI & CT
2015 biopsy of bone marrow, lymph nodes-negative
3-6-2018 still enlarged lymph nodes, no diagnosis

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Kick'nAssCancer'sAss
Posts: 248
Joined: Tue Feb 25, 2014 4:38 pm

Re: Would you get chemo for stage IIA?

Postby Kick'nAssCancer'sAss » Thu Jul 23, 2015 5:28 pm

Tough decision but I had the same one to make. I had a pCR and no node involvement but I had a T3 when clinically staged and my onc suggested that was good enough reason to do the mop up FOLFOX. It was brutal and the worst part of my journey (every 2 weeks for 16 weeks) and I still have neuropathy in my feet although not severe it is a problem. If the cancer does return then at least I can say I did everything possible after round 1 and if you skip the chemo you really can't say that you did everything possible, Do the chemo.
53M Dx RC Halloween 2013
CT & BONE scan
MRI/T3N0M0 1 suspicious LN
5 wks chemo/rad
LAR open TME Feb 26/14
temp bag
0/24 nodes pCR/pathological
Folfox (8) Mar 28-Jul 4 /14
Aug/14 clear CT scan
Aug 27/14 reversal
Feb/15 clear scope
July/15 Feb/16 Feb/17 Feb/18 clear CT scans
Feb/18 clear scope
Sept 19 clear CT scan & DISCHARGED :P
Mar/23 clear scope
CEA 1.6 @ dx
1.6,1.4,1.7,2.4,2.9, 2.7 2.3 2.5 2.2 2.1 2.5 2.6 2.7
2.7 Sept 19
0-4 normal
https://kickingasscancersass.blogspot.com/

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NZJay
Posts: 640
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Location: NZ

Re: Would you get chemo for stage IIA?

Postby NZJay » Thu Jul 23, 2015 5:44 pm

Are you comfortable gambling with the knowledge you hold a very strong hand?

Personally I recommend taking the chemo. If it proves intolerable, you can always reduce dosage or stop treatment early. This is a one-time opportunity to fight an invisible enemy who may or may not be stalking you. My recommendation is not to miss it.

But of course, I was diagnosed with extremely advanced stage 3 cancer... of course I'd hold this opinion haha.

Best of luck with your decision :)
11-13 Dx CC
SPS T4b(touched stomach organ),N1(3/23),M0(Stage 3B)
11-13: resect + partial gastrect
2-14: 1 Tx Cape + Oxy; renal failure, colitis
4-14: 7 Tx Capecitabine
1-15: clear CT
7-15: clear scope
1-16: clear CT
3-17: clear CT
10-17: clear scope (5 year gap now!)
CEA@dx: 8.4 / 6-15: 4.0 / 10-15: 4.2 / 2-16: 4.9 / 7-16: 4.9 / 11-16: 5.0 / 6-17: 4.5
NED since resection

SoConfused
Posts: 1027
Joined: Mon Jan 30, 2012 2:40 pm

Re: Would you get chemo for stage IIA?

Postby SoConfused » Thu Jul 23, 2015 5:59 pm

I am not a medic and my situation was different than yours at diagnosis; however, I wanted to share my friends disease trajectory with you as it was similar to yours. She was diagnosed with stage IIa 1.5 years ago. No chemo was recommended and she opted not to seek further treatment beyond the resection. Fasttrak to a month ago when she went in for an annual CT and was found to have lung nodules. She now regrets not having pushed for that follow-up chemo. She is undergoing Folfox right now as a mop up for the lung resection she just had. She was lucky to have been a surgical candidate and might still be cured.
Stage IV CC

weisssoccermom
Posts: 5988
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Would you get chemo for stage IIA?

Postby weisssoccermom » Thu Jul 23, 2015 6:12 pm

This is a decision that only you can make. However, there are some things to consider.

1. Look at your pathology report and see if you have any negative prognostic factors? If you don't have a copy of your path report....GET ONE. Also, get a three ring binder, complete with dividers to keep all the test results that you will be undergoing. You should have, at the very least, a copy of your original path report (from the scope), your operative path report and a copy of your CT scan report.

2. If the doc is recommending FOLFOX (or XELOX) it isn't an all or nothing proposition. You do have the option of just taking the 5FU (or Xeloda) and garnering most of the benefit that chemo has to offer....particularly for the stage IIA (with no negative prognostic factors) patient. Don't let any onc tell you it's FOLFOX or nothing....be proactive.

3. You have a few weeks to make a decision what you think will work best for you. Get to know the side effects, the risks and the benefits of all the chemo agents and make a sound, educated decision based on ALL the information.

I was diagnosed as a IIA a little over 9 years ago. At the time, oxi was 'relatively' new...was touted (at least IMO) as the 'wonder' drug and I insisted that I needed to have it even though my onc thought (and still believes) that it is overkill for most stage II patients. Even knowing the risks of making my neuropathy worse (I have neuropathy due to foot surgeries) I insisted that I have it. One dose and an awful reaction....and I was done with that drug. I remember feeling really upset...as though someone had pulled the rug out from under me. My onc was 100% behind me finishing up all the cycles with Xeloda only....which is what I did.

Just remember that this is YOUR life....and you need to take everything into consideration....side effects (both short and long term), benefits v risks and your quality of life. If I had to do it again, knowing what I know now....I would do exactly the same thing that I did eight years ago. No oxi...but I would, without a doubt do the 5-6 months of Xeloda only. Side effects are minimal, no port and you get the majority of the benefit of the 'standard of care' chemo. Good luck with whatever YOU decide.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

SugarBubbie
Posts: 239
Joined: Sun Jun 12, 2011 3:55 pm
Facebook Username: Rhonda Pinkston
Location: Texas

Re: Would you get chemo for stage IIA?

Postby SugarBubbie » Thu Jul 23, 2015 6:32 pm

I would (and did). As you can see by my cancer recap below, I've used at least 5 different chemos and both cancers were stage II. I'm not taking any chances. Read up as much as you can on how to mitigate the side effects (wish I'd found this forum during my first diagnosis) as long as your doc is ok with that. I have some hand/foot neuropathy which is probably permanent. But hey, I'M STILL HERE.
DX Stage II anal cancer 2007 age 57
Radiation 6 weeks, Xeloda/oxilaplatin
DX Breast cancer Jun 2011 Stage3 one lymph nodes
Taxol 12 weeks FAC 4 tx, 31 radiations
5 year survivor certificate from MDA 2012 for anal cancer
DX triple neg bc oct 2015 4 rounds adriamyicyn, 20 radiations
"Positivity has no downside"

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Voxx66
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Facebook Username: Michael Void Ward

Re: Would you get chemo for stage IIA?

Postby Voxx66 » Thu Jul 23, 2015 6:33 pm

I was IIa and chose not to do chemo. The cancer recurred. However - given the same information I had available then, I would still make the same decision. There are possible consequences no matter what you choose. Keep gathering info so you can make an informed decision.
DX and resect 10/2012 age 46
Stage IIa CRC
liver mets both lobes 8/2013
CEA 28
FOLFOX + Avastin 8/26/13 3 rounds
Folfox only 3 rds + rd 8
platelets low round 7,9,10 5FU only
1/14 CEA 1.0 y90
5fu
10/14 mets lung and peri
1/15 Folfiri

lpas
Posts: 1010
Joined: Wed Nov 19, 2014 11:11 pm

Re: Would you get chemo for stage IIA?

Postby lpas » Thu Jul 23, 2015 6:57 pm

Ask your doctor about doing OncotypeDx to determine how high-risk you are for a recurrence. I'd use that as a basis for my decision.
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing cimetidine & other targeted supplements
Mom to a 6 & 8yo

justin case
Posts: 4269
Joined: Sun Sep 04, 2011 8:26 am
Location: Katy, Texas

Re: Would you get chemo for stage IIA?

Postby justin case » Thu Jul 23, 2015 7:07 pm

Nate, how old are you. If your 60, and the doctor told you, after 10 years, he didn't want you to be remorseful, that's one thing. If your 40, you may want to think about chemo, although it is a pain in the ass :roll:
Michael
7/11 diagnosed Stage 2 colon and rectal cancer
chemo/rad
lar/temp ilio
Reversal & port removal
21 round of chemo Folfox 9tx, 5fu 12 tx
Last treatment July 2012

cathy123
Posts: 665
Joined: Sat Nov 08, 2014 3:36 pm

Re: Would you get chemo for stage IIA?

Postby cathy123 » Thu Jul 23, 2015 7:18 pm

I had stage 1 with some negative prognostic markets and opted for chemo. The xeloda itself isn't bad at all, so I would think about at least doing that. In my case I have young kids so decided to do xelox just to be safe. I agree that you should think about your age and other health issues as well. It is a tough decision.
Cathy

Diagnosed 10/14 low rectal cancer age 43
Clinical T2NXMX
Radiation/xeloda 12/14-1/15
LAR with temp Ileo 3/15
pT2N0M0, lymphatic invasion 0/37 nodes
4 xelox, 1 xeloda only
Reversal 9/15
Mom to 9&11 year olds

Nate
Posts: 5
Joined: Thu Jul 23, 2015 3:48 pm

Re: Would you get chemo for stage IIA?

Postby Nate » Thu Jul 23, 2015 8:07 pm

Thank you all for the thoughtful responses. I am 48 with 3 kids ages 13, 11, 10. It sounds like most of you would opt for chemo...at least some form of it. How does an oncotype help?


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