Today is my last day of Chemo!

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Beckster
Posts: 157
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: Today is my last day of Chemo!

Postby Beckster » Mon Jun 12, 2017 10:50 am

Jacques wrote:
Beckster wrote:... Thanks for the info....No, he did not say anything about the Survivorship Care Team. All I know right now is that he said CT every 6 months for 2-3 years and bloodwork every 3 months.
Maybe he is waiting for my appt the end of June. I have a CT and bloodwork scheduled next week. If he doesn't say anything, I am going to ask.

The bloodwork next week is important because it represents the baseline for your 5:year surveillance program. For this reason, it makes sense to have a comprehensive blood test, including all of the major blood panels, plus certain key additional tests, even if you have to pay for some of these tests yourself.

Member rp1954 has written about this many times. Here are some examples of his posts on the value of having good, comprehensive baseline data to work with:
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55285&p=438646#p438646

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52840&p=416346#p416346

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=50038&p=380871#p380871


My gastroenterologist sent me for presurgical bloodwork which included:
Alkaline Phosphatase, S, GGT, CEA, aPTT, ALT & AST, Basic Metabolic Panel (7), CBC/Diff Ambiguous Default, Chest Xray and CT with contrast (chest to pelvis.) This was all done before I saw the surgeon. All came back in normal range...

My oncologist orders CBC W/ DIFFERENTIAL and COMPREHENSIVE METABOLIC PANEL every cycle during chemo. Now that chemo is finished, he ordered:

CBC W/ DIFFERENTIAL [LAB3498 Custom]
CEA [LAB57 Custom]
COMPREHENSIVE METABOLIC PANEL
CT ABDOMEN AND PELVIS W IV AND PO CONTRAST
CT CHEST W CONTRAST

What is he missing? Is there anything I should additionally request? I have excellent coverage and it pays for everything.

Beckster
57/Female
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Tumor type: Adenocarcinoma
Tumor size: 3.5 cm x 2.5 x 0.7 cm
Tumor grade: G3 (surgical) G2 (biopsy from colonoscopy)
TNM: T3N0M0/IIA
Positive lymph nodes: 0 out of 24
Lymphovascular invasion
Surgical margins: clear
Lynch- Negative
12/27/2016 - Capeox, anaphylactic reaction to oxaliplatin on first infusion-discontinued
1/2/17 to 6/9/17- Xeloda monotherapy
6/26/17- CT scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Re: Today is my last day of Chemo!

Postby Jacques » Mon Jun 12, 2017 11:29 am

Beckster wrote:...What is he missing? Is there anything I should additionally request? I have excellent coverage and it pays for everything.

Beckster

I'm not an expert on this, but off-hand I would say that what's missing are the tests for systemic inflammation, since they can serve as early warning that a metastasis might be brewing.

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=57488&p=454046#p454046

Here are some examples of other tumor markers to monitor, and also some systemic inflammation markers: CA19-9, AFP, CA72-4, CA125, LDH, hsCRP, ESR

I routinely monitor CA19-9, LDH, and hsCRP in addition to CEA.
Last edited by Jacques on Mon Jun 12, 2017 2:11 pm, edited 4 times in total.
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
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How to Select a Surgeon
List of Forum Features
Colorectal Cancer Stages (TNM)

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kellywin
Posts: 473
Joined: Wed Jan 23, 2013 4:46 pm
Location: Northern CA

Re: Today is my last day of Chemo!

Postby kellywin » Mon Jun 12, 2017 12:10 pm

Congrats Beckster! Time to get on with the rest of your life!
Kelly, mom 12 yo girl
Dx 11/15/12 Rectal Cancer @ age 40
Stage IIIC
5.5 weeks Xeloda & Radiation - complete 2/5/13
Colectomy 3/12/13, 7 of 14 nodes positive - no ileo
4/24/13-8/20/13 - 5 rounds Xelox, 1 Xeloda only
7/2015 Clear colonoscopy!
4/2017 Clear CT!

justin case
Posts: 4184
Joined: Sun Sep 04, 2011 8:26 am
Location: Katy, Texas

Re: Today is my last day of Chemo!

Postby justin case » Tue Jun 13, 2017 1:41 am

kellywin wrote:Congrats Beckster! Time to get on with the rest of your life!

I agree 8) 8) 8) 8) 8) 8)
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

User avatar
peanut_8
Posts: 2132
Joined: Sun May 25, 2014 1:31 pm
Location: Capital of Texas

Re: Today is my last day of Chemo!

Postby peanut_8 » Tue Jun 13, 2017 8:33 am

Beckster wrote:
Jacques wrote:
Beckster wrote:... Thanks for the info....No, he did not say anything about the Survivorship Care Team. All I know right now is that he said CT every 6 months for 2-3 years and bloodwork every 3 months.
Maybe he is waiting for my appt the end of June. I have a CT and bloodwork scheduled next week. If he doesn't say anything, I am going to ask.

The bloodwork next week is important because it represents the baseline for your 5:year surveillance program. For this reason, it makes sense to have a comprehensive blood test, including all of the major blood panels, plus certain key additional tests, even if you have to pay for some of these tests yourself.

Member rp1954 has written about this many times. Here are some examples of his posts on the value of having good, comprehensive baseline data to work with:
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55285&p=438646#p438646

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52840&p=416346#p416346

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=50038&p=380871#p380871


My gastroenterologist sent me for presurgical bloodwork which included:
Alkaline Phosphatase, S, GGT, CEA, aPTT, ALT & AST, Basic Metabolic Panel (7), CBC/Diff Ambiguous Default, Chest Xray and CT with contrast (chest to pelvis.) This was all done before I saw the surgeon. All came back in normal range...

My oncologist orders CBC W/ DIFFERENTIAL and COMPREHENSIVE METABOLIC PANEL every cycle during chemo. Now that chemo is finished, he ordered:

CBC W/ DIFFERENTIAL [LAB3498 Custom]
CEA [LAB57 Custom]
COMPREHENSIVE METABOLIC PANEL
CT ABDOMEN AND PELVIS W IV AND PO CONTRAST
CT CHEST W CONTRAST

What is he missing? Is there anything I should additionally request? I have excellent coverage and it pays for everything.

Beckster


I get my vitamin D levels checked every 3 months, and have to supplement with D3 to keep the levels in the suggested range. As radnyc pointed out in a previous thread, it seems like a good idea. http://www.medscape.com/viewarticle/881250

Best wishes with all your follow-ups Beckster.
peanut
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

User avatar
peanut_8
Posts: 2132
Joined: Sun May 25, 2014 1:31 pm
Location: Capital of Texas

Re: Today is my last day of Chemo!

Postby peanut_8 » Tue Jun 13, 2017 8:33 am

Beckster wrote:
Jacques wrote:
Beckster wrote:... Thanks for the info....No, he did not say anything about the Survivorship Care Team. All I know right now is that he said CT every 6 months for 2-3 years and bloodwork every 3 months.
Maybe he is waiting for my appt the end of June. I have a CT and bloodwork scheduled next week. If he doesn't say anything, I am going to ask.

The bloodwork next week is important because it represents the baseline for your 5:year surveillance program. For this reason, it makes sense to have a comprehensive blood test, including all of the major blood panels, plus certain key additional tests, even if you have to pay for some of these tests yourself.

Member rp1954 has written about this many times. Here are some examples of his posts on the value of having good, comprehensive baseline data to work with:
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55285&p=438646#p438646

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52840&p=416346#p416346

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=50038&p=380871#p380871


My gastroenterologist sent me for presurgical bloodwork which included:
Alkaline Phosphatase, S, GGT, CEA, aPTT, ALT & AST, Basic Metabolic Panel (7), CBC/Diff Ambiguous Default, Chest Xray and CT with contrast (chest to pelvis.) This was all done before I saw the surgeon. All came back in normal range...

My oncologist orders CBC W/ DIFFERENTIAL and COMPREHENSIVE METABOLIC PANEL every cycle during chemo. Now that chemo is finished, he ordered:

CBC W/ DIFFERENTIAL [LAB3498 Custom]
CEA [LAB57 Custom]
COMPREHENSIVE METABOLIC PANEL
CT ABDOMEN AND PELVIS W IV AND PO CONTRAST
CT CHEST W CONTRAST

What is he missing? Is there anything I should additionally request? I have excellent coverage and it pays for everything.

Beckster


I get my vitamin D levels checked every 3 months, and have to supplement with D3 to keep the levels in the suggested range. As radnyc pointed out in a previous thread, it seems like a good idea. http://www.medscape.com/viewarticle/881250

Best wishes with all your follow-ups Beckster.
peanut
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Re: Today is my last day of Chemo!

Postby Jacques » Tue Jun 13, 2017 11:13 pm

Since you have been under the care of MD Anderson, I would imagine that you would be setting up your five-year surveillance program when you meet with the Survivorship Care Team. I think that it would probably be better to set up a comprehensive followup program.rather than a program that just looks at CEA values and CT scans every 3 or 6 months. That's just my personal opinion.

The main MD Anderson site in Texas has a survivorship course designed specifically for colorectal cancer:

https://www.mdanderson.org/education-training/professional-education/professional-oncology-education/survivorship/colorectal.html

You might find it interesting to look at the outlines of some of the relevant lectures:

https://cms.mdanderson.org/access/content/group/Colorectal%20Cancer%20Survivorship/content/courselist.html
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
Create Your Signature
How to Select a Surgeon
List of Forum Features
Colorectal Cancer Stages (TNM)

DarknessEmbraced
Posts: 2785
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Today is my last day of Chemo!

Postby DarknessEmbraced » Wed Jun 14, 2017 10:41 am

Congratulations!
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

User avatar
WriterGirl1969
Posts: 450
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Today is my last day of Chemo!

Postby WriterGirl1969 » Wed Jun 14, 2017 9:28 pm

Beckster wrote:It has been a long six months, but in 2 hours I will take my last dose of Xeloda. :D :D :D
I am now thinking about all the CT scans and bloodwork, especially CEA numbers. Scanxiety is now setting in.....but this forum will help me through it! Ct scans every 6 months and bloodwork every 3 months. My oncologist said I have an excellent prognosis, but I reminded him that if something were to happen, it would happen to me! :shock: :o


Congrats, Beckster! :)
I took my last dose of Xeloda back on October of last year (2016), and still remember how great - and SCARY - it felt to know my treatment was done. How I had looked forward to that day! And then how suddenly frightening it felt to no longer be actively doing something. <:- ) We all still get scanxiety. I doubt it will ever go away. Try to enjoy and let your body and mind have some rest and time to regenerate. No matter what the doctors tell you, your body will definitely still feel the effects of chemo for a bit. Take time for you. Do all those things you wanted to do but might not have been able to. Kick up them heels. :)

Hugs and Prayers,
Tracy
DX 3/4/2016 Colon Cancer; age 46 Mom of 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Left Hemi
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
3/6/17 CT clear
NED at 1 year
“If I can help somebody as I walk along, then my living shall not be in vain.”

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LeonW
Posts: 306
Joined: Sun May 03, 2015 4:59 pm
Location: Amsterdam, Netherlands

Re: Today is my last day of Chemo!

Postby LeonW » Thu Jun 15, 2017 5:38 am

WriterGirl1969 wrote:. . . took my last dose of Xeloda back on October of last year (2016) and . . . how suddenly frightening it felt to no longer be actively doing something. <:-) We all still get scanxiety

How true. But you may get used to that one too. Believe me, it get's easier after a while
Best wishes, L
Dec 2012 - Dx CC; MM @ 65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen (IVa T3N1bM1a) 2/26 nodes, MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, mets shrink from #3
Sept - nuclear liver scan, 2x failed Portal Vein embolization
Oct 2013 - R liver resect 28 hosp days (liver failure, bad delirium, emboli, encephalopathy) all cancer gone, pCR
2014/15 - recovery; benign polyp Apr '15
Apr 2016 - new house/town/life
clean CTs and 1.3/1.4 CEAs: 4x2014, 4x2015/16, May2017, next Nov 2017


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