We've used a different playbook for para-aortic nodes, one where fundamentals, prior successes, logic and economics have more sway. .F
irst, we kept as much chemistry on the nodes as possible, continually for years; to a degree even through surgery - not this 2-3-4-6 week standoff stuff, before and after surgery. Of course, there were adjustments
in the run up to major surgery.S
econd, we shopped until we found people who could advance issues like (potentially involved) lymph node dissection, however irregular to the old ASCO or NCCN algorithms or guidelines. Dr No should never get the last word.T
hird, therapeutic nutrition has many answers but it remains a highly fragmented art with greatly different levels of performance possible. I've become an art collector. "Side benefits" instead of "side effects" are a goal.F
ourth, a better multimodal treatment strategy and its implementation are largely driven by self advocacy and homework.
Even the largest, "most advanced" cancer centers have limited menus of what is available or offered globally.
I largely gave up hope of (micro)met clearance 3 years after the last surgery, to remove a conglomerated para aortic node cluster, with no escape from "chemo forever". However my wife didn't. My wife has taken a chemo vacation for at least these last 2 months, and her markers are holding down pretty well.
Brearmstrong wrote:I am told that there is a very high rate of recurrence once in distant lymph nodes and while my surgeon did a great clean up and had clean margins, I am also not a candidate for immunotherapy because of my MSS status. I will stay on xeloda for at least a year and indefinitely if I can continue to tolerate it. If it comes back a third time, I'm out of chemo options ;-(
We live in a different world where there are many immunotherapies, and immunochemo combinations, just not institutionally sponsored ones.