jmn wrote:...Does anyone have suggestions for me as I prepare for my appointment with Dr. Saltz? Are there any Stage IIA folks on this forum who received low-dose metronomic chemotherapy after surgical resection? What treatment, if any, did you receive or are you receiving?
Thanks for posting an update well in advance of your appointment. This will give time for some Stage IIA folks to see your post and to reply if they have any comments to offer.
My main comment would be for you to address the issue of your MSI-status (if you know what it is). If you are Stage IIA and possibly considering chemo, then it is important to know whether you are MSI-H or MSS. About 16% of all CRC patients are MSI-H, and for patients in this category research has shown that first-line chemotherapy involving 5FU is not so useful, and may even be damaging. So this issue might come up in your meeting.
The MSI-H vs MSS distinction for Stage IIA patients is discussed in the NCCN guidelines below:NCCN Guidelines on Colon Cancer - (see p. 42 for Stage IIA recommendations)https://www.nccn.org/patients/guidelines/colon/files/assets/common/downloads/files/colon.pdf
There is also the Oncotype-DX test that Stage IIA patients sometimes use to get an idea of their risk of recurrence. This topic, too, might come up in your meeting.Oncotype-DX test for colon cancerhttp://www.genomichealth.com/en-US/oncotype_iq_products/oncotype_dx/oncotype_dx_colon_cancer
If you are going to consider any kind of chemotherapy, then you should understand that chemo has both short- and long-term effects. The diagram in the article below gives an idea of some of the side effects to expect.The Effects of Chemotherapy on Your Bodyhttps://www.healthline.com/health/cancer/effects-on-body#1
There is also the issue of left-side tumors vs. right-side colon tumors, and since you had a right-side tumor the doctor might have some comments to say about this.
There are a number of members of this board who were diagnosed as Stage IIA. Some of them opted for "no chemo" and haven't been heard from since. Others had one or more high risk factors and opted, instead, to go for adjuvant chemo. One in the latter category is member, Beckster
, who was diagnosed Stage IIA about two years ago, and whose signature tells the story.
There are others in the same category. Basically, you have to go through and assess all of your risk factors and then make your own decision after discussing the available options with your doctor.