Should I have chemo

[gman3]

I had surgery a week ago doing well right now but I have been told that I will need Chemo. I had Tumor removed from my colon and 28 lymph nodes 1 was positive for cancer . I stayed in the hospital 3 days and came home. My bowel movement is good I drove my car yesterday and my appetite is good. I have read that chemo sometimes can make cancer return I don't know what to do.

[PGLGreg]

Yes, you should have chemo. Could chemo cause another cancer later? I never heard that, but if it's possible at all, it's surely very unlikely. You have to balance out the good effects and bad effects of chemo, and since there is evidence you still have active cancer in your body, you really don't have a choice.

[gman3]

Thank you for your response I have not really talk to an oncologist yet but I thought if they removed the lymph the cancer was gone they said that it had not spread anywhere.

[PGLGreg]

Thank you for your response I have not really talk to an oncologist yet but I thought if they removed the lymph the cancer was gone they said that it had not spread anywhere.

Of course you'll understand that my advice is comparatively worthless -- just some guy you met on the net. Trust your doctors.

A big problem with treating cancer is telling whether you have it. You can perfectly well have cancer cells in your body that cannot be detected directly, but can grow and spread until they become life threatening. It's important to treat cancer early, so sometimes doctors have to go by the odds. Even if it's possible you have no cancer, if there is a significant chance you do, your best bet may be to have chemotherapy. If you wait for therapy until you are sure that you do have it, it may be too late to keep it from killing you.

The importance of finding cancer in one of the lymph nodes they took out of you is that it is evidence there are cancer cells in your lymphatic system, and from there the cancer can spread to other parts of your body. So it's not the cancer in that one lymph node that you have to worry about, but the cancer cells in your lymphatic system which have not been detected directly, but whose presence is inferred.

If you want to quantify your risk, your oncologist can probably supply you some figures about how likely it is you will survive the next 5 years cancer free if you do not have chemotherapy versus the likelihood of surviving if you do have chemotherapy. Then you can decide if you want to roll the dice. My intuition is that you will find that your chances are poor without chemotherapy.

[weisssoccermom]

Look at it this way. Once the cancer has gotten into your lymphatic system, it could have and possibly has traveled somewhere else. Your lymphatic system is much like the interstate freeway system.....it connects all parts of your body and has entrance/exit 'ramps' everywhere in your body. The fact that one node was found to be cancerous simply means that cancer found it's way into your lymphatic system. Just because they removed that one node doesn't mean that the cancer has/hasn't traveled so some other part of your body. You just don't know that right now so why take the chance by not taking the chemo? Statistically, the fact that the cancer has been detected in your lymphatic system means that you are at a greater risk for having spread....why not minimize that risk NOW before cancer has a chance to set up shop somewhere else in your body? Isn't it better to crush any potential cancer cells that 'may' be in your body when they are tiny and not allow them to grow and become a bigger adversary?

I have never heard of chemo allowing cancer to return...frankly that doesn't make sense. IF that were the case, then WHY would oncologists recommend that you take it? Where did you read this? Look at the source and make sure it isn't from someplace that is totally against traditional medicine. You don't have to take chemo but then be aware that you are taking some very serious risks. I'm not saying that chemo is a walk in the park but think of the consequences if you don't take it. Sure, you may be fine....then again, you may not. Right now, it appears (based solely on what you posted) that it doesn't appear that cancer is anywhere else in your body....BUT....those tests can not tell you with 100% accuracy that one or more microscopic cancer cells aren't somewhere in your body, travelling around ready to wreak havoc in the future. The docs said it hadn't spread anywhere based solely on those tests and possibly a quick look during surgery....but please, remember that those tests can't detect one or two cells that may somewhere in your body and a simple look during surgery can't necessarily detect spread everywhere. Those tests can only show a small tumor (not a cell or two) that has already set up it's new home somewhere in your body.

It's your life and you are the only one who can make the determination about what to do. Frankly, this isn't some 'gray' area where the risk/benefit of chemo is questioned. You are a stage III and the fact that the cancer has entered your lymph system puts you at a higher risk of recurrence than if it hadn't....those are statistics. You do, however, have something in your arsenal that you can use to help minimize those risks...CHEMO. Why not take advantage of it? Listen to the doctors....they are giving you the best advice that is out there based on years of experience and statistics.

[O Stoma Mia]

Would you be able to get a printed copy of the surgery pathology report that mentions the 28 nodes and other details? This report will give information on other various risk factors such as tumor type, lympho-vascular invasion, etc., that are present in your case. Then you need to study your pathology report and look at the big picture, which includes all of the known risk factors present at this time.

While it may be true that you are NED (No Evidence of Disease) right now after surgery, this doesn't take into account the fact that there are possibly many Circulating Tumor Cells (CTC) that are far too small to show up on any scan at the present time. These are the threats that you want to minimize with chemo while they are still small and vulnerable.

[PGLGreg]

While it may be true that you are NED (No Evidence of Disease) right now after surgery, ...

Well, it's not true. Cancer found in a lymph node is evidence of disease.

[gman3]

Thank you Guys for all the information I think that you are right I will need to do the Chemo . I want to live to see my 1st grandchild 5mths old grow up. I am 58 years old I have never been sick a day in my life and I had never been in the hospital before. This is all new to me and kind of hard to understand everything. I do have a lot of faith in God and that what has gotten me to this point I appreciate everything that each of you have said.

[jhocno197]

Yes, chemo can cause other cancer later. It is possible, but it doesn't happen to everyone. Whereas, you know you have this cancer right now. Chemo can make it less likely to come back. I would do the chemo.

http://ctep.cancer.gov/protocolDevelopm ... FOLFOX.doc

[horizon]

I had a similar situation and I have no regrets about doing chemo. Each person is different but I couldn't have lived with the regret if it came back and I hadn't done everything that was available to prevent that when I could have.

[chrisca]

Were I in your position, I would have the chemo. I am very glad I did mine even though I didn't have any lymph node involvement. The only caveat is I don't know the details of your surgery and diagnosis. As with any decision you need to talk with your doctor and discuss the details of your particular situation. Then, ask what chemo is recommended (there are many kinds, each with their own pluses and minuses) and do some homework, including a second opinion, to be sure this recommendation is the best for you. As others have noted, any time a lymph node is positive for cancer it could mean it has "escaped" and is trying to set up shop somewhere else in the body.

A second consideration is whether or not to do radiation. Radiation often has more negative effects than chemo but it can be a necessary tool. Your oncologists will also discuss this if it's recommended. Radiation is only useful for killing cancer at a localized site, while chemo works throughout the body. That's why it's a good idea in most situations.

[Cj51]

PGL Greg said

Well, it's not true. Cancer found in a lymph node is evidence of disease.

X2.

[NZJay]

Do chemo. That is 100% the best decision.

[JudeD59]

It's highly unlikely that I'll have the option to do mop-up chemo because I had problems tolerating the first infusion, but if I was allowed to do it, I would. Anything you can do to kill every last stray cancer cell floating around in your body is worth it, IMO.

Good luck and be sure to stop back here for information on managing chemo side effects and to keep us updated on your progress.

Judy

[Nik Colon]

PGL Greg said

Well, it's not true. Cancer found in a lymph node is evidence of disease.

X2.

BUTT....if it has been removed it is NED, no EVIDENCE of CURRENT cancer. Yes, it WAS there, but being removed = NED. That does not mean there IS NONE, just what was seen has been removed, again NO EVIDENCE OF DISEASE after surgery (seen cacer was removed). Big difference. Again, NED does not mean NO CANCER, just no EVIDENCE of it still in the body. The lymph that was removed showed cancer, yes, but again, it was removed, hence currently NED. Which is what the reply was about. She said "may be NED right now"