Stage 4 Chemo Break??

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Joined: Mon Apr 06, 2020 3:48 pm

Stage 4 Chemo Break??

Postby csfl » Tue Jan 05, 2021 1:36 pm

My sister’s local oncologist recommended the “chemo for life” approach when she was diagnosed stage 4. (She did say that she could take short breaks occasionally.) We met with a doctor at MSK for a second opinion. He said that since nothing was showing on her most recent scan, he would be inclined to recommend a 3 month break and then re-scan. She has been tolerating the Folfiri pretty well after being taken off Folfox due to Oxi reaction. The MSK doc is supposed to talk to her local onc. My sister is nervous to stop chemo in case the cancer starts growing again. Any advice for chemo breaks for stage 4 patients?
Caregiver for 45 y/o sister
1/20-diagnosed stage 4 CC signet ring type (1 spot on liver/1 precardiac ln)
MSS with no other mutations
2/20-right hemicolectomy due to partial blockage
3/20-5/20 5 rounds Folfox/Avastin
5/20-current-switched to Folfiri/Avastin due to Oxi reaction
11/20 CT scan showed no evidence of nodal/liver mestasis

Posts: 460
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Stage 4 Chemo Break??

Postby Claudine » Wed Jan 06, 2021 9:36 am

Good morning,
My husband (also stage 4) has been on break for a year now, after 18 cycles of Folfiri plus Avastin. His CEA values are rising but his scan his stable; his onc said, « we treat for quality of life, and we don’t treat numbers » and in the chart wrote that he recommends the break continues until something does show up on scan. He told my husband that studies do not show any benefit of doing chemo when the only sign of cancer is a high CEA.
I have to say, my husband is very happy not to have chemo; we also feel that should he need to resume it, the break gave his body lots of time to build his strength back up (he cycles a lot, 10-20 miles a day), grow back his hair and beard, and this way he did not develop resistance to a treatment that worked well for him.
Just a personal opinion, but we’re all for a break! His onc does not seem to be a « chemo pusher », either...
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 12/17: nothing to report

Posts: 98
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: Stage 4 Chemo Break??

Postby Brearmstrong » Wed Jan 06, 2021 8:14 pm

I have also been on chemo break since last surgery in August. Microscopic cancer cells were found in the wash during surgery but I had been on chemo for four years so my oncologist has me on a break to regain strength and weight, etc. i also was lucky to have Signatera testing but after surgery was still slightly positive at 0.1. So, we know it will show up again at some point. It is scary but just trying to squeeze the most out of this time for as long as it lasts. Surreal though to feel like a normal person again.
48 F Jan 17 2 sons
tumor appendix/colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
FOLFOX Apr-sep 17
Clean CT Jul 2017, oct 17, CEA 3.4, 8.1. May 18 2.3,1.0,1.3, 1.3, 1.0, 2.3, 2.2, 2.1,2.2,1.6,1.4,1.5,2.8,2.2
Oct 2017 clean CT
Nov 17 PET para aortic nodes Stage IV
Folfori w/avastin Dec 17
May 18- surgery on nodes xeloda continues
Aug 18-CT NED Clear CT's Nov 18-May 20
July 20- it’s back! Rt ovary Full hysterectomy CEA 1.7 chemo break

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