Stage IV colon cancer: Surgery vs. Chemo ?

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tony.rts
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Joined: Thu Dec 28, 2006 10:53 am
Location: NH

Stage IV colon cancer: Surgery vs. Chemo ?

Postby tony.rts » Thu Dec 28, 2006 11:09 am

Not asking for medical recomendations just help making this decision.
Hope this question is appropriate for this web site.
My wife of 34 is diagnosed of stage IV colon cancer, had stage I cc in March 2006, removed 18" of colon, said she was ok. Now we are here.
12/8/06 CT reveiled tumors on liver in bile duct and abdonen. They think 3/06 cc was the primary. We have been recommended by 2 good hospitals in Boston to start colon chemo as soon as next week. We have one surgical recommendation from NYC for major liver surgery for the 2 liver tumors, remove as many as possible of the abdomen tumors and do regional chemo with catheders. Very different opinions. We have one more surgical consultation meeting next week in NYC.
She is young strong "healthy" and positive.
Not sure what to do. Thank you sincerely.

Lifes2short
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Location: Salt Lake City, UT

Postby Lifes2short » Thu Dec 28, 2006 1:33 pm

Tough call. The chemo might shrink the tumors and make them easier to operate on. Since she is young and strong, she will likely tolerate the chemo well.

On the other hand, this is obviously a very aggressive cancer (assuming she had clean post surgical CT last spring). I can certainly understand the desire to get the cancer out as soon as possible. Regional chemo is usually tolerated better than systemic, but it's a bit scary when you think how fast the cancer has metastasized and where else it might be spreading. I think I'd personally opt for systemic chemo - whether before or after surgery.

It sounds as if they can't get all of the cancer during surgery. So delaying chemo just gives the cancer more time to spread during the time she is preparing for and recovering from surgery.

I certainly can't give medical advice, nor do I know the details of your wife's diagnosis. But if it were me, I'd likely opt for the chemo unless they can guarantee that all of the cancer is operable. I had fairly aggressively growing lesions in my liver from April through September. I began Folfox treatments in October and the lesions have all shrunk. It makes sense to me to try to at least try to stop the rapid spread of the cancer first before operating. However, I would certainly recommend that you aggressively watch the progress of the chemo. You should be able to see response after only two or three treatments.

However, if the docs think they have a chance to remove all the cancer surgically and immediately, I think I'd opt for the surgery. Best to get rid of it sooner rather than later.

Good luck. I understand that this is a very scary time for you and your wife. Please keep us posted.

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pjpeace
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Postby pjpeace » Thu Dec 28, 2006 3:29 pm

that is a hard call. if it was me personally i'd do surgery then chemo. that's what i wish they could've gotten all mine out at the first surgery but had to shrink the remaining tumor for the next surgery.

she'll probably will have to do chemo anyway just to make sure they get rid of all the other cells and so it won't spread any more. so that's why i'd think surgery first. cause chemo will be a factor anway. i'm the impatient type though and like 'just get it all out now!!!'

but don't know all the details just really think about all the options and really what is best for her. you guys will make the right decision. Boston is great for health care...i miss my primary care doc up there! but wouldn't trade my wonderful group of guys here for the world =)

best wishes!
Paula
"When you've been abandoned in the desert and the vultures are circling and squawking at you...raise you fist at them and yell "I'M NOT DEAD YET!!!"
Stage IV @ 30 yrs. 6/06 Ms. April 2008
Recurrence to pancreas 2/09 & 6/10

missjv
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Joined: Tue Sep 12, 2006 10:38 am
Location: FLORIDA

Postby missjv » Thu Dec 28, 2006 6:08 pm

hi,
well speaking from experience i would do surgery and chemo. i just had liver resection and am starting chemo to liver and systemic chemo. surgical removal is the only way a cure might be possible chemo alone will not cure metastatic colon cancer it will possibly relieve symptoms for a while but thats about it. i am only 40 and i went for the most aggressive form of treatment available and as of now i have no signs of cancer. the liver surgery is rough it is painful but if the tumors can be removed then that will be her only chance. i went all the way from florida to sloan kettering and im glad i did at least now im cancer free yes there is a possibilty the crap could return and also possibility of it never coming back i am having chemo as a precaution to get any small microscopic cancer that might be floating around, i also had chemo before surgery and had a great response. please do all your research and get opinions because the way this cancer is treated could mean life or death. good luck!

missjv

bossan
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Postby bossan » Fri Dec 29, 2006 4:37 pm

All these opinions show the many ways people are treated and perhaps cured from this. My onc has several patients in remission from stage iv who used chemo and no surgery.

My point is there is no straight path, otherwise we could all take it and deal with it.

We hear all kinds of opinions, unltimately we have to listen to our hearts and hope for the best...

Love and healing to all!
How Beautiful Can A Being Be?
My Personal Forum: http://z8.invisionfree.com/colorectalk
My Story (scroll to the bottom of page 1) http://www.colonclub.com/forum/viewtopi ... sc&start=0

meighan
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Joined: Wed Apr 19, 2006 12:31 pm

Postby meighan » Fri Dec 29, 2006 7:19 pm

First off i am so sorry you and your wife are going through this... i hate this disease i truly do. Hard decisions you are facing and it is so hard to know you are doing the right thing.One thing that sounds good is going to nyc and boston and they are both giving you options so that is a plus. Your wife never had chemo correct?? so there is no history to how she responds to chemo...... with that said i always was under the impression if operable operate....but i am no expert. We too live in NH, my husband had stage III in march of 06 we are in the seacoast and were originally scheduled to have surgery here and then we went for a second opinion in nyc at sloan. We left that appointment made it to the elevator and turned around and scheduled surgery there....it was a gut reaction and although hard we knew it was right in that moment. They seemed more aggressive and more intune to how we wanted to fight.We make the best decisions we can with what we have in front of us.You are in the right places with boston and nyc in the end the treatment plan you choose should make sense to you both and feel right. My best wishes to you and your wife.


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