Given that our situations are nearly identical, albeit 10 years apart, I have replied
into your prior quotes for reference.
skb wrote: After a solitary lung met and its removal by VATS, is adjuvant chemotherapy recommended?
NCCN guidelines for 2018 does not give clear recommendations.
In 2010 with my single VATS removed lung met, this was controversial and called "pseudo-adjuvant" chemo which I did take
Given that Folfox treatment was already done (6 rounds) and it could not prevent this recurrence, I do not know how helpful it would be if I did the same treatment again.
I had full resection and elected Xeloda for neoadjuvant chemoradiation and post surgery adjuvant chemo.
When I had the lung met recurrence 3 years later, I chose to do 12 cycles FOLFOX as I had not had it previously and was determined to throw the book at the cancer !
skb wrote:1) CEA: My CEA has never been elevated. ...SAME = never elevated anytime so far since 2007 diagnosis
2) Gene sequencing information- ...in 2007 not done routinely as it may be now, so no info
3) Lymph node spread: Never detected ...SAME = never detected with MRI, CT, PET, or in surgery pathology samples post resection
skb wrote:Is there any experience from anyone here on this topic?
We are the poster kids for "Watch and Wait" versus "Cut and Chemo"
Different protocols, 10 years apart... BUTT ... with a commonality of low rectal primary tumors,
a period of NED, then a single metachronous lung met.
You had cCR and I had pCR with regards to determining if the tumor was gone.
We both had neoadjuvant chemoradiation and an "adjuvant" chemo after primary tumor resolution.
We both got recurrent lung mets.
You did not have surgery for the primary, but had it for the met.
I had surgery for the primary and the met.
You are deciding at the post VATS stage, 2 months out.
I am giving some input 9 years out from last chemo for my lung met.
My take :
explore other chemo / immuno therapies which could be targeted based on your genetics testing, with my preference being to do SOMETHING
Enact an AGGRESSIVE monitoring program with as many modalities and experts as you can muster to the cause.
JMO my friend
BTDT and still here to talk about it
In Harmony on the Journey