Adjuvant Chemo

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Joined: Thu Dec 13, 2018 10:46 am

Adjuvant Chemo

Postby SusanD » Thu Dec 13, 2018 11:05 am

I'm new to this forum and was hoping for some insight on adjuvant chemo. I had LAR surgery 11/19/2018 with temp ilestomy
Pathology showed no lymph node involvement 0/59, but showed Lymphovascular invasion was present.

Surgeron wants me to talk to the onologist about possible adjuvant theraphy. Assuming its Chemo.
I'm terrifed of both chemo & radiation and am leaning not to do any adjuvant theraphy.

pT3 N1c, at least Stage IIIB
Tumor located below peritoneal reflection

Posts: 131
Joined: Mon Apr 30, 2018 2:36 pm

Re: Adjuvant Chemo

Postby Koreysue » Thu Dec 13, 2018 1:06 pm

I would get another dr. to weigh in. Then you need to ask yourself- will I wish I had done more? I know it’s scary, and hard to know what to do.
Diagnosed: June 2017 stage 3 colon cancer
Sigmoid colon, 2 nodes affected
CEA at diagnosis: 6
Sigmoid Colectomy and folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 clear (cea rise a mystery for now, doc said maybe all the smoke in my town from forest fires)
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT clear 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2

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Joined: Mon Oct 01, 2018 4:29 pm

Re: Adjuvant Chemo

Postby Punky44 » Thu Dec 13, 2018 4:15 pm

If you are Stage 3, I believe mop up chemo is strongly recommended. You want to make sure you beat this. I know it is scary but chemo for colorectal cancer is generally more tolerable than chemos for other cancers (like breast cancer.) Everyone reacts differently obviously but many seem to be able to get through it and even maintain normal life activities (work, exercise) etc during it.
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
CEA 2.1; 1.9; 2.6; 2.8
6/28/19 Reversal and port out
10/22/19: CT showed new nodules
1/28/20: CT showed nodules shrinking

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

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Posts: 225
Joined: Tue Feb 25, 2014 4:38 pm

Re: Adjuvant Chemo

Postby muskokamike » Thu Dec 13, 2018 6:01 pm

You are new. If you were here for a few years like myself and read the stories of those who skipped the chemo and now wished they didn't, you would do the chemo. This is a no brainer Stage III's do the adj chemo.

You need to put every nail in the cancer coffin.
53M Dx rc10/31/13
CT scan, BONE scan
MRI/T3N0M0 1 suspicious node
5 wks chemo/rad
LAR open TME 2/26/14
temp ileo
0/24 nodes pCR/pathological
Mop up Folfox (8) Mar/28-Jul/4
Aug/14 clear CT scan
8/27/14 reversal
Feb/15 clear scope
July/15 clear CT scan
Feb/16 clear CT scan
Feb/17 clear CT scan
Feb/18 clear scope
Feb/18 clear CT scan
Sep/19 clear CT scan DISCHARGED!
CEA levels 1.6 dx
1.6,1.4,1.7,2.4,2.9, 2.7 2.3 2.5 2.2 2.1 2.5 2.6 2.7
2.7 Sept 19
0-4 normal

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Joined: Sat Nov 04, 2017 11:08 am

Re: Adjuvant Chemo

Postby heiders33 » Thu Dec 13, 2018 6:13 pm

Don’t be scared of the adjuvant chemo. It’s not a picnic but it is doable. Everyone reacts differently, and a good oncologist will monitor your reaction and side effects closely. There are lots of good meds and methods for monitoring side effects.
Last edited by heiders33 on Fri Dec 14, 2018 6:04 am, edited 1 time in total.
37 year-old female
May 2017: Dx rectal cancer T3N2M0
6/17: 28 days chemorad
9/17: LAR/loop ileostomy
10/17 - 2/18: XELOX six rounds
3/18: reversal
5/18: CT liver spot, blood counts normal
8/18: Abnormal PET, CEA 2.4
9/18: liver resection/HAI pump
10/18: Clear CT/sigmoidoscopy
10/18 - 4/19: 6MO FUDR/5FU
7/19 - Clear CT
9/19 - Clear colonoscopy/colonography
10/19 - Clear CT
11/19 - CEA 9.8, PET abnormal, confirmed local recurrence

Posts: 673
Joined: Sat Dec 23, 2017 6:01 pm

Re: Adjuvant Chemo

Postby Caat55 » Thu Dec 13, 2018 10:24 pm

It's hard to know what's right but I decided to go with the adjunct therapy. If in 2, 5 or 10 years I have cancer again it won't because I didn't do everything I could now.

Good luck,
55 y.o. Female
Dx 9/26/17 RC Stage 3
Completed 33 rad. tx, xeolda 12/8/17
MRI and PET 1/18 sign. regression
Surgery 1/31/18 Ileostomy, clean margins, no lymph node involved
Port 3/1/2018
Oxaliplatin and Xeloda start 3/22/18
Last Oxaliplatin 7/5/18, 5 rounds
CT NED 9/2018
PET NED 12/18
Clear Colonoscopy 2/19

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Maggie Nell
Posts: 1134
Joined: Wed May 27, 2015 1:57 am
Location: Melbourne, Australia

Re: Adjuvant Chemo

Postby Maggie Nell » Thu Dec 13, 2018 11:01 pm

Are you terrified of chemo and radiation because you have seen how that went with
other people; heard the grisly 'war' stories? Your body and your experience will be
your own and the oncologists and oncology nurses can really fine-tune things.

You won't know if adjuvant chemotherapy is the path until you have a sit down with
that oncologist. It's important that you feel comfortable with an oncologist and be
confident in seeking out another one for second- third opinions. Now is the time
when it's on to advocate for yourself and pull together a health team that you trust.

You've found this forum - that's a way good start! Be brave, and when you can't
be brave: come here.
DX April 2015, @ 54
35mm poorly diff. tumour, incidental finding following emergency r. hemicolectomy
for ileo-colic intussusception.
Lymph nodes: 0/22
T3 N0 MX
July 2019 : pending liver U/S, colonoscopy
rut roh

michelle c
Posts: 1890
Joined: Wed Dec 02, 2009 3:58 am

Re: Adjuvant Chemo

Postby michelle c » Sat Dec 15, 2018 5:26 am

I was terrified of chemo but it was recommended as I was stage III. It was described to me as mop up chemo. I know there are no guarantees but wanted to do everything I could to stop it appearing elsewhere. I had 12 treatments over 6 months. I won't lie, I hated every minute of it but it really was a no brainer for me. It is totally up to you though. Talk to the oncologist and decide from there. Write down all your questions before you go. It was recommended that my chemo start within 5-6 weeks post surgery.
25 May 09 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
3 Jun 09 LAR - Stage III 3/10 lymph nodes
6 Jul - 10 Dec 09 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 12 port removed & hernia repair

Posts: 2381
Joined: Fri Jul 21, 2017 3:43 am

Re: Adjuvant Chemo

Postby NHMike » Sat Dec 15, 2018 11:16 am

I had chemo before surgery and not doing the chemo and radiation wasn't an option. A surgeon wouldn't operate on me without radiation and chemo first. So I knew what chemo was like. I had adjuvant chemo as well but it was rougher because the drug strength was higher and there was an additional drug. I have some lingering side-effects that might be permanent but I can live with them. Spend some time reading through the accounts of going through it. It is no picnic - I'd say that it's rough; and you will have an adjustment period with the ileostomy. But lots and lots of people here do it and get through it.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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