Mom - Stage 3 Diagnosis

[bbc]

Hello - My 83 old mother had a sigmoid colectomy last week. I just got the pathology report - T3 tumor with spread to 5/15 nodes. Here are lines from the diagnosis -

1. COLONIC ADENOCARCINOMA WITH MUCINOUS FEATURES, INVADING THROUGH THE MUSCULARIS PROPRIA INTO PERICOLONIC ADIPOSE TISSUE, MARGINS ARE NEGATIVE

2. FIVE OF FIFTEEN LYMPH NODES POSITIVE FOR CARCINOMA (5/15)

I realize that chemo is the standard treatment at this stage. My question was that given my mom's age (she is otherwise quite healthy) whether this is the best approach or are there alternative treatment options.

I have to schedule an appointment with the oncologist next week to discuss next steps. Also, I asked the surgeon to order a biomarker test as I did not see that in the report.

Thanks,
bp

[Lee]

Hi and welcome. Sorry for the reason you are here.

How is your mom's recovery from surgery?

Yes chemo would be the best approach, FOLFOX, butt at her age, I almost would not advise it. It can be hard on the body. Maybe chemo-lite, something like 5FU only.

Yes get an opinion from an Oncologist. What does your mom want to do?

Good luck,

Lee

[michelle c]

That was very similar to my diagnoses. I was 44. My oncologist recommended chemo as I was “young”. However, I remember him saying that if I was older, such as in my 80’s, he would not recommend it. He said that I could have been cured from surgery alone and that chemo was like an “insurance”. Have a good talk with her oncologist and consider the options. Chemo was hard, definitely not a walk in the park. Best wishes to your mother.

[bbc]

Thank you Lee for your response.

She is nine days after surgery and the recovery is going well. She had the Robotic Colectomy so that is partly the reason for this.

I did speak to an Oncologist yesterday and we will setup an appt next week to discuss the options. He did mention - FOLFOX, CAPOX as possible treatments for my Mom, evaluating progress and then changing if necessary.

My mother is not keen on getting chemo but is willing to go through the options. The surgeon has opined several times that that most oncologists would not offer it. My sisters and I have been wavering between getting it and not getting it. Ultimately, we all agree it is my mother's decision to make. We will just present her with the options.

Mom - 83 years old
Stage III - T32Na
Surgery - Sigmoid Colectomy 08/31/2020

[bbc]

Thank you Michelle for the response.

The uncertainty here is the response to Chemo that my mother will have. If it was hard for you, it certainly will be harder for my Mom.

The option that Lee gave - 5FU only may be one that is something I will discuss with the Oncologist.

The surgeon did tell me that the chemo will increase the 5 year survival rate by 20%. The surgery itself gives her a 50% survival rate. So, as I tell my mother, we have completed the most
important thing we could do.

[Lee]

I am a 16+ yr survivor. When I was diagnosed, FOLFOX was deemed experimental. It had not been approved by the FDA yet. At that time, it was assumed generally only "old" people got this cancer. When I was diagnosed, I remember the GI doc telling me, we are seeing more & more younger people (under the age of 50) getting this cancer.

Anyway, one of the things I learned back then, as your body ages, speed of cell reproduction slows down, this includes cancer cells. I kind of learned then, many elderly people who had this cancer, not uncommon to died from other medical issues relating to age, & not this cancer. Just throwing that out there because your mom is 83.

At 83, some people are healthy, young and active, my father in law was one of them. He was still driving across the country at that age. He is 94 now. He's not allowed to drive anymore, but still living independent. I know another women who is 88, she is driving local only, butt again still living independent, her Dr(s) have told her she could easily make it to a 100 yrs in pretty good health. I have another friend, her older sister at 83-84 is starting to show memory loss issues, she might be going to a assist living in the next few yrs.

Yes talk to the onc, talk to her primary, butt mostly talk to her. I was young when diagnosed, they threw the kitchen sink at me. I beat it, butt I feel my body is 10 yrs older than my actual age. If I got another cancer diagnoses, I would look at options, butt would probably do something like that chemo lite. Make me comfortable, butt no kitchen sink. Another good friend, her older sister in law, early 80's got a cancer diagnose & chose to do nothing. Another type of cancer, retired RN, stage IV. Her response, just make me comfortable. At your mother's age, it's a personal decision. If you don't have the will to fight, the treatment/cure could very easily kill you.

Just food for thought,

Lee

[CRguy]

Respectfully, I would read what Lee has to say in making your decisions ... BUTT ... AND ...
The only REAL decision that matters ... is your Mom's.

Been here a few years less than Lee
Guided my father through Stage IV mesothelioma

What is "possible to do "
may not always be the best course of action for the patient's well being.

SO .... JMO (please read all my posts to get a "BIO" on me )

FOLFOX for an 83 year old would not be my own first choice
1. having HAD 12 FOLFOX cycles myself ... and
2. having had other chemo (Xeloda) myself twice

Again this IS a discussion and I am just giving my own opinion

Best wishes for your Mom
In Harmony
CRguy

[boxhill]

I did 12 rounds of FOLFOX at 65. It wasn't pleasant, but it wasn't that bad, either. I never had nausea. It get more wearing as you go on, definitely. There is a lot of thought out there that 6 rounds is enough in an adjuvant setting, like your mother's. She could consider have 6 rounds, possibly without oxaliplatin. Oxy causes most of the nasty side effects, but only improves the stats by a few percentage points.

If your mother is generally in good shape and enjoying life, it is quite possible that she could quite easily tolerate 6 rounds of 5FU alone with nothing worse than a couple days of admittedly crushing fatigue per cycle, while improving her outcome.

My mother is 97 and lives alone in her own house, where she does everything herself but some of the yardwork. Age is just a number. Best of luck to your family.

[jens22]

Wow...Her pathology report is exactly like mine. I had chemo but I was much younger. I was told the cancer is gone..we removed it...chemo was just a mop up. 85 year olds don't need to be mopped up. Hopefully it was a slow grower.

[boxhill]

Excuse me, Jenns22, but I don't think one can make a blanket statement about who "doesn't need to be mopped up" based on age alone. No one comes with an expiration date. You may think 85 is death's door. My mother is 12 years older than that, and living an independent and fulfilling life. BTW, the woman in question is not 85, she is 83.