Mop up chemo question

[_Jelen90]

Hi everyone,

My husband just got his path report from the APR surgery he got 2 weeks ago for rectal cancer.

So his tumor was completely gone due to chemorad and everything was clear EXCEPT one positive lymph node. So my question is : is he automatically gonna get mop op chemo ? And second question : they only got 7 lymph nodes out...from what I am reading here a lot if ppl got at least 12?

[Rikimaroo]

You get 12 if the oncologist suggested chemo prior to surgery so six before surgery and six after surgery of FOLFOX typically. at least that is how mine went. I would do mop up chemo just to play it safe. six rounds should do the trick.

[natelaugh]

My dad oncologist and from my reading, chemo is either 6 cycle/3 months or 12 cycles/6 months is depending on what stage and how aggressive the cancer.

Nate.

[WriterGirl1969]

Hi everyone,

My husband just got his path report from the APR surgery he got 2 weeks ago for rectal cancer.

So his tumor was completely gone due to chemorad and everything was clear EXCEPT one positive lymph node. So my question is : is he automatically gonna get mop op chemo ? And second question : they only got 7 lymph nodes out...from what I am reading here a lot if ppl got at least 12?

Hi Jelen90. Know that my response is based on what I've learned through my own experience and questions. I am not a doctor nor an oncologist.

I also had only 1 harvested lymph node positive. I had more taken overall, but the idea is that if the cancer spread to one lymph node, generally they will want to do mop-up chemo to ensure there are no stray cancer cells remaining in the lymphatic system, since this is the superhighway that travels throughout the body, and so one area they want to keep free of cancer.

With regard to the general total of nodes taken, I've read other posts discussing how this varies. Mostly it depends on what the surgeon has access to during surgery, and taking enough to get a good sampling. If you're unsure about this, the best thing you can do is ask the surgeon during a follow-up visit, or call and ask them if you can have the surgeon answer this question. They should be able to give a better idea of why they went with the number they did, and if they feel it was enough to get a good status.

I did a six-month course of mop-up chemo due to my one positive lymph node, and also how far into the colon wall the cancer had penetrated. I did mono-therapy (Xeloda without the Oxa due to pre-existing neuropathy) and opted for oral vs. IV so that I could minimize impact to normal lifestyle. I did fairly well with it for the most part, and am now 3 years NED. So even if hubby does need to have a course of chemo based on his results, try not to let it get you down. I know as soon as I saw my results my eyes zeroed right in on that 1 positive node, and what it meant regarding chemo, but if it means beating the last of those little buggers out, that's a good thing. Keep the faith, keep breathing, and take it one day at a time. And of course, ask lots of questions like the ones above.

Smiles, hugs and prayers,
Tracy

[_Jelen90]

Hi everyone,

My husband just got his path report from the APR surgery he got 2 weeks ago for rectal cancer.

So his tumor was completely gone due to chemorad and everything was clear EXCEPT one positive lymph node. So my question is : is he automatically gonna get mop op chemo ? And second question : they only got 7 lymph nodes out...from what I am reading here a lot if ppl got at least 12?

Hi Jelen90. Know that my response is based on what I've learned through my own experience and questions. I am not a doctor nor an oncologist.

I also had only 1 harvested lymph node positive. I had more taken overall, but the idea is that if the cancer spread to one lymph node, generally they will want to do mop-up chemo to ensure there are no stray cancer cells remaining in the lymphatic system, since this is the superhighway that travels throughout the body, and so one area they want to keep free of cancer.

With regard to the general total of nodes taken, I've read other posts discussing how this varies. Mostly it depends on what the surgeon has access to during surgery, and taking enough to get a good sampling. If you're unsure about this, the best thing you can do is ask the surgeon during a follow-up visit, or call and ask them if you can have the surgeon answer this question. They should be able to give a better idea of why they went with the number they did, and if they feel it was enough to get a good status.

I did a six-month course of mop-up chemo due to my one positive lymph node, and also how far into the colon wall the cancer had penetrated. I did mono-therapy (Xeloda without the Oxa due to pre-existing neuropathy) and opted for oral vs. IV so that I could minimize impact to normal lifestyle. I did fairly well with it for the most part, and am now 3 years NED. So even if hubby does need to have a course of chemo based on his results, try not to let it get you down. I know as soon as I saw my results my eyes zeroed right in on that 1 positive node, and what it meant regarding chemo, but if it means beating the last of those little buggers out, that's a good thing. Keep the faith, keep breathing, and take it one day at a time. And of course, ask lots of questions like the ones above.

Smiles, hugs and prayers,
Tracy

Thank you Tracy !! That was a very informative response and I really appreciate that you took your time to share your experience.

I am just a little overwhelmed with everything right now, deep inside I was hoping everything would be over after chemoradiation and surgery but it is what it is..we gotta keep fightin'!

[Green Tea]

I think the general opinion is that if the patient has any high risk factors in the pathology report, then some sort of adjuvant chemotherapy is indicated.

In your husband's case, there are at least two high risk factors in the path report: (1) Lymphovascular invasion, and (2) less than 12 nodes evaluated in the pathology report, so I think it would be standard practice to administer one of the recommended first-line adjuvant chemotherapy regimens for about 3 months. He has already had some neo-adjuvant (pre-surgery) therapy so he would not need to have the full 6 months of post-surgery adjuvant chemotherapy normally recommended for Stage III patients.

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=62173&p=490740#p490740

[WriterGirl1969]

Thank you Tracy !! That was a very informative response and I really appreciate that you took your time to share your experience.

I am just a little overwhelmed with everything right now, deep inside I was hoping everything would be over after chemoradiation and surgery but it is what it is..we gotta keep fightin'!

I definitely can identify with that. I remember hearing I would have to do chemo and feeling as if I'd somehow failed all the people who had been routing and praying for me. I had so sincerely hoped the surgery would be it, and that getting clear margins would mean everything would be fine.

Of course, everything still was fine. I just had to keep fighting, as you so appropriately said.

The times right after diagnosis and surgery are, I think, the hardest. The waiting, and uncertainty, and pure whirlwind nature of it all. But every day after that contained a little bit more normalcy as things got back into normal routines, even if some of those routines had to change a bit. And of course, there were still moments. This group had a lot to do with keeping me moving. This is where I received the most information, which gave me my power back. This is where people going through the same thing gave me support and love and words of wisdom.

Just keep putting one foot in front of the other, and know you can come here anytime you need info, support, or just to vent.

Smiles, hugs and prayers,
Tracy

[Cured]

Jelen90, Chemo is not fun. But living with good health for several years is nice.
My surgeon is also a cellular biologist. He says that once the cancer gets into our lymph nodes, then micro-tumors circulate in our bloodstream.
The mop-up chemo often works, so I suggest doing it. I went 10 years healthy. I believe the sleeping micro-tumors were awaken by my pneumonia vaccine. I have no clinical evidence to prove this, but for Rectal cancer to return after 10 years is rare. I received the 13 valent vaccine 5 months before the tumor became evident in my brain, after expanding into my lungs, which pumped them.

Praying that your life goes on.