Rectal cancer- Staging question? Follow Mop up Chemo??

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dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Tue Apr 26, 2016 1:01 pm

My fiance (42yrs old) was diagnosed July 2015 with rectal cancer... After the flex colonoscopy the results show T3 N0 lesion . He was given 4 session of 5FU, 28 chemo/radiation treatment and he had his surgery on March 17,2016. Not only did the surgeon removed the area where the tumor was but he also found that there was a piece of the lower colon that received radiation somehow (SO MAD WHEN I HEARD THIS!!!))))) so he also removed this!!! Overall the surgeon told us that everything went great!!! He does have a temporary Ileostomy! The recovery has been tough..on the 4 day he developed a slight fever and the next day a pain in his tailbone... the surgeon right away sent him to the a ct scan done and they found a leak. They put him a drainage thru his right butt cheek and that relief the pain. He was given pain medication and antibiotics... he was discharge from the hospital April 1st... he still has the drainage, no more antibiotics...just pain killer here and there due to momentary pain in his butt cheek, sometimes he feels a discomfort in the area where they put the drainage (pelvic area).... he feels a discomfort when he pees but once he is done he feels a relief.

We went to see the oncologist and my fiance responded good to his treatment... Pathology reports says he is T2N1 , clear margins... the tumor was no longer there only minimal microscopic residue!!!! So he responded to more than 50% of his treatment!!! we also follow up with the surgeon on 4/13 and he told him that he is going in the right path. On Mondy 4/25 the moved the drainage a little bit out of the area where is collecting the fluid....

His oncologist mentioned to us about a Mop up chemo.... i am guessing he wants to complete the 11/12 rounds of the Folfox..!!! Did anyone else had to do this??? Does it have to be Folflox or can it be with the Xeloda pills??? Is his case consider stage 3 or 2?? Please help!! Thanks :)
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

User avatar
Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby Nik Colon » Tue Apr 26, 2016 1:27 pm

Original dx stage 2A (T3NO) Surgery dx stage 3A (T2N1), so its stage 3A.

http://www.cancer.net/cancer-types/colo ... cer/stages

Postoperative oxaliplatin-containing regimens

On the basis of results of several studies, oxaliplatin as a radiation sensitizer does not appear to add any benefit in terms of primary tumor response, and it has been associated with increased acute treatment-related toxicity. The question of whether oxaliplatin should be added to adjuvant 5-FU/LV for postoperative management of stages II and III rectal cancer is an ongoing debate. There are no randomized phase III studies to support the use of oxaliplatin for the adjuvant treatment of rectal cancer. However, the addition of oxaliplatin to 5-FU/LV for the adjuvant treatment of colon cancer is now considered standard care.

http://www.cancer.gov/types/colorectal/ ... k/_712_toc
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

esscape
Posts: 16
Joined: Fri Jan 22, 2016 5:13 am
Facebook Username: Damla Sahin
Location: Turkey/Istanbul

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby esscape » Tue Apr 26, 2016 2:32 pm

My sister will be starting mop up chemo after her surgery tomorow. That is the common treatment for stage 2 and 3. She is on xelox. Xeloda pills and oxy through IV every two weeks.
My Sister dx @ age 36 Ultra Low Rectal Cancer(signet ring cell) November 2015
Finished 5 weeks rad/5FU January 2016
History of Ulcerative Colitis 1998-2008
History of Crohn's Disease 2008
APR surgery April 2016
Permanent colostomy April 2016
Path report: T3N2M0 stage 3c
Started adjuvant chemo Xelox

OrchardWriting
Posts: 53
Joined: Wed Nov 18, 2015 9:10 am

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby OrchardWriting » Wed Apr 27, 2016 6:11 am

I did the mop up chemo too. It was hard, but I made it through. As you go along there are a lot of people here who can help with dealing with side effects.
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Ooops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13.

ticktock10
Posts: 49
Joined: Fri Mar 07, 2014 3:49 am

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby ticktock10 » Fri Apr 29, 2016 5:34 am

My experience is slightly different in that I didn't have the surgery, but I had the mop-up chemo anyway.

Your fiancé sounds like he is doing it tough at the moment, but it would definitely be advisable to follow through with the mop-up chemo and try and complete the course.
Oct 2013 - Dx Stage 2/3 low rectal cancer
Dec 2013- 6 weeks neo-adjuvant chemo-rad
Apr 2014 - PET and MRI show 'complete response'
May 2014 - Chose 'watch and wait' instead of APR surgery
Jun-Sep 2014 - 'adjuvant' chemo - 5FU
Sep 2014 - PET and MRI clear

dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Fri Apr 29, 2016 1:17 pm

Thank you for the responses!!! :)

Yes he is having a little rough time but I have Faith in God that little by little things will get better.

Yeah we will definitely follow with the Mop - up chemo... i just want to know which is more effective the Folflox or the Xeloda....
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

ab123
Posts: 120
Joined: Tue May 21, 2013 12:25 pm
Location: Boston

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby ab123 » Fri Apr 29, 2016 1:49 pm

I had a similar diagnosis. It's normal to take out a good deal of the lower colon along with the rectum. The way my surgeon described it, there's kind of a minimum take - once you cut the nerves and blood vessels to the rectum, the lower 10-inches of colon have to come out too regardless of whether they were irradiated. But not to worry - there's plenty of colon above that. 3 1/2 years now post surgery and I'm basically back to normal. Adjuvant chemo is a bit rough - I did FOLFOX - but not too bad most of the time. Even so I went to work and lived pretty normally through it. There will be adjustments, of course. I still have a little neuropathy in my feet, for example, but it doesn't impair function at all and I hardly notice it anymore. Today I take Metamucil daily and probably have 3 BMs a day, so that's a little inconvenient, but you get used to it and they aren't emergencies or anything.

Good luck.
Aug 2012: RC DX Stage IIIC, T3N2M0 by MRI - 38M
Fall 2012: Chemorad
Nov 2012: LAR - Path report: 0/13 LNs, tumor reduced to "microscopic foci"
Jan-Apr 2013: 8 rounds FOLFOX
May 2013: Ileostomy takedown, port removal
July 2013 (and since): NED!

peanut_8
Posts: 2334
Joined: Sun May 25, 2014 1:31 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby peanut_8 » Fri Apr 29, 2016 2:01 pm

dmondgirl wrote:My fiance (42yrs old) was diagnosed July 2015 with rectal cancer... After the flex colonoscopy the results show T3 N0 lesion . He was given 4 session of 5FU, 28 chemo/radiation treatment and he had his surgery on March 17,2016. Not only did the surgeon removed the area where the tumor was but he also found that there was a piece of the lower colon that received radiation somehow (SO MAD WHEN I HEARD THIS!!!))))) so he also removed this!!! Overall the surgeon told us that everything went great!!! He does have a temporary Ileostomy! The recovery has been tough..on the 4 day he developed a slight fever and the next day a pain in his tailbone... the surgeon right away sent him to the a ct scan done and they found a leak. They put him a drainage thru his right butt cheek and that relief the pain. He was given pain medication and antibiotics... he was discharge from the hospital April 1st... he still has the drainage, no more antibiotics...just pain killer here and there due to momentary pain in his butt cheek, sometimes he feels a discomfort in the area where they put the drainage (pelvic area).... he feels a discomfort when he pees but once he is done he feels a relief.

We went to see the oncologist and my fiance responded good to his treatment... Pathology reports says he is T2N1 , clear margins... the tumor was no longer there only minimal microscopic residue!!!! So he responded to more than 50% of his treatment!!! we also follow up with the surgeon on 4/13 and he told him that he is going in the right path. On Mondy 4/25 the moved the drainage a little bit out of the area where is collecting the fluid....

His oncologist mentioned to us about a Mop up chemo.... i am guessing he wants to complete the 11/12 rounds of the Folfox..!!! Did anyone else had to do this??? Does it have to be Folflox or can it be with the Xeloda pills??? Is his case consider stage 3 or 2?? Please help!! Thanks :)



Hi dmondgirl.
Your fiancé may want to consider 6 rounds of adjuvant chemo instead of 12. There are studies that show the 2 regimes have equitable outcomes.
Best Wishes, peanut
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Fri Apr 29, 2016 2:14 pm

Hello Peanut :)

he took 4 rounds of chemo prior to his surgery ...but now his doctor wants to complete the cycle meaning 7/8 more to go.... He told us that it was the standard protocol.... So based on the article you are referring if lets say he goes for 2 more that will have the same effect as having 7/8 more as recommended?
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

User avatar
Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby Nik Colon » Fri Apr 29, 2016 2:20 pm

dmondgirl wrote:Thank you for the responses!!! :)

Yes he is having a little rough time but I have Faith in God that little by little things will get better.

Yeah we will definitely follow with the Mop - up chemo... i just want to know which is more effective the Folflox or the Xeloda....

Can you clarify. Do you want to know about just doing the pills without the oxi? Xeloda is just 5fu in pill form. Xelox is with oxi. Folfox is with oxi also, the 5fu in the pump you take home for 2 days.
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Fri Apr 29, 2016 2:30 pm

Hi Nik,

Yes just the pill itself .... i think i may be confused ....maybe overwhelmed with everything.
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

peanut_8
Posts: 2334
Joined: Sun May 25, 2014 1:31 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby peanut_8 » Fri Apr 29, 2016 3:16 pm

dmondgirl wrote:Hello Peanut :)

he took 4 rounds of chemo prior to his surgery ...but now his doctor wants to complete the cycle meaning 7/8 more to go.... He told us that it was the standard protocol.... So based on the article you are referring if lets say he goes for 2 more that will have the same effect as having 7/8 more as recommended?


Sorry I was unclear, I meant 6 rounds after surgery.
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Fri Apr 29, 2016 3:53 pm

Got it thanks :)
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

dmondgirl
Posts: 104
Joined: Thu Apr 14, 2016 1:54 pm

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby dmondgirl » Fri Apr 29, 2016 4:02 pm

Nik Colon wrote:
dmondgirl wrote:Thank you for the responses!!! :)

Yes he is having a little rough time but I have Faith in God that little by little things will get better.

Yeah we will definitely follow with the Mop - up chemo... i just want to know which is more effective the Folflox or the Xeloda....

Can you clarify. Do you want to know about just doing the pills without the oxi? Xeloda is just 5fu in pill form. Xelox is with oxi. Folfox is with oxi also, the 5fu in the pump you take home for 2 days.



Okay so I just checked the folder where I have all his information and he was receiving the Folfox in the hospital and the 5FU home infusion and he got 4 sessions of that, then a break and then radiation with Xeloda.
Fiance – Diagnosed 7/ 2015 @ 41yrs old- rectal cancer
Initial staging - T3N0M0
4 tx of Folfox/5FU
28 radiation with Xeloda
LAR surgery 3/17/16 final stating T2N1M0.

Rough Recovery
9/16-Recurrence @ resected area
Biopsy - Poorly differentiated adenocarcinoma, with signet ring cell features & neuroendocrine differentiation.

8 tx of Folfiri! No shrinkage everything stable .. lymph nodes behind his abdominal area grew a little bit
4 tx of Erbitux + Irinotecan- No shrinkage everything stable

User avatar
Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: Rectal cancer- Staging question? Follow Mop up Chemo??

Postby Nik Colon » Fri Apr 29, 2016 4:23 pm

dmondgirl wrote:
Nik Colon wrote:
dmondgirl wrote:Thank you for the responses!!! :)

Yes he is having a little rough time but I have Faith in God that little by little things will get better.

Yeah we will definitely follow with the Mop - up chemo... i just want to know which is more effective the Folflox or the Xeloda....

Can you clarify. Do you want to know about just doing the pills without the oxi? Xeloda is just 5fu in pill form. Xelox is with oxi. Folfox is with oxi also, the 5fu in the pump you take home for 2 days.



Okay so I just checked the folder where I have all his information and he was receiving the Folfox in the hospital and the 5FU home infusion and he got 4 sessions of that, then a break and then radiation with Xeloda.

For me (I had stage 4 colon cancer) I did 4 tx prior to surgery, first 3 full dose folfox, 4th without oxi. After surgery I did 8 more tx to equal 12 total, but they switched me to folfiri because of bad side effects from the oxi. I did my remaining 8 ... first with full folfiri, 2nd without iri cuz se's, 3rd-6th with 80% iri, last 2 just 5fu pump.
As for your question. How was the oxi? Where the side effects bad? Do they want to do only 6 more or 8 to make 12 total. I have not had the pills myself. If you are just doing the 5fu, some would rather do that than going in to have the pump hooked up. I have heard more hand/foot symptoms with the pills. I would discuss all this with the doc and also how the previous tx was tolerated. I also posted above viewtopic.php?f=1&t=54464&p=432130#p431894 about adjuvent chemo with oxi for rectal cancer. I would say I would personally have to weigh the benefits/problems before making the decision about doing either with oxi, then discuss the pill vs pump (there are good and bad to both depending on personal choice, convenience, and side effects). Best wishes.
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc


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