local cancer

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worriedson714
Posts: 49
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

local cancer

Postby worriedson714 » Tue Jul 06, 2021 2:36 pm

Hello
My dad is do to start chemo on the 13th to what the oncologist called " control " the cancer and I have been wondering . My dad's cancer is local high in the pelvis same area it's always been . Anyone know if having localized cancer improves the odds of chemotherapy being successful ? Last chemotherapy was folfox and the response to it was poor does anyone know if that decreases the odds of this chemotherapy working ?
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
9/21- Removal of prostate and bladder- Permanent Urostomy still cancer left
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg
10/13/21 Chemo stopped

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

Re: local cancer

Postby beach sunrise » Tue Jul 06, 2021 11:28 pm

What chemo therapy are they planning this time?
Has he gotten a 2nd opinion from a board certified crc surgeon?
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

worriedson714
Posts: 49
Joined: Mon May 03, 2021 4:27 pm
Facebook Username: jasonbeck

Re: local cancer

Postby worriedson714 » Wed Jul 07, 2021 9:12 am

beach sunrise wrote:What chemo therapy are they planning this time?
Has he gotten a 2nd opinion from a board certified crc surgeon?


Folfiri has been mentioned and his crc surgeon is board certified but he did get a second opinion from henry ford cancer center it was the same . They want to do radiation but cause they think there is good odds of it damaging the small bowels my dad is unwilling so chemotherapy is the only other option .
My Dad was DX - 3/19 stage 3 rectal cancer
Folfox - 6/ 2019 threw 10/2019
Rad - 4/ 2019 threw 5/2019
12/ 19 - Abdominal Perineal Resection - Cancer left and permanent colostomy
9/21- Removal of prostate and bladder- Permanent Urostomy still cancer left
5/28/21 - Positive Biopsy Mostly necrotic tumor
6/14/21 - Sepsis with obstructive uropathy needed nephrostomy tube
7/19/21 Kidney infection
7/28/21-Started folfiri
8/3/21 - Blood Clots in lungs and leg
10/13/21 Chemo stopped

Gravelyguy
Posts: 382
Joined: Thu Jul 05, 2018 6:03 pm

Re: local cancer

Postby Gravelyguy » Thu Jul 08, 2021 9:52 pm

Hi sorry to hear about your dad’s lack of response to chemo so far. You might want to Look into proton beam therapy. It is not offered in too many places but causes much less damage than conventional radiation. I had proton beam radiation at Mayo Rochester with very few side effects.

Hope this helps,

Dave
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 CEA .9 still NED!
6/11/19 CEA 1.0
12/19/19 CEA 1.0 still NED!
6/17/20 CEA 1.1 still NED!
12/15/20 CEA 1.1still NED!
12/16/21 CEA 1.2 still NED!

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: local cancer

Postby catstaff » Fri Jul 09, 2021 8:47 am

My husband has a met in a similar location. We were also told that chemo and radiation were the only options due to a concentration of blood vessels in the area (against the sacrum).

His primary also did not respond to folfox, but the mets, including the "butt met," seem to be responding to folfiri. At least, they responded extremely well to the first five cycles (confirmed by a CT, not just decreasing CEA). We may have had a setback -- he missed a cycle due to a small bowel obstruction (not caused by cancer) resulting in a CEA increase, and the next cycle they omitted bevacizumab and his CEA increased a bit more. This cycle the bev was a go so we'll have to see what happens to his CEA. That's a digression, my main point was that there was documented shrinkage due to folfiri+bev.

Whether it's local or not doesn't really have any predictive value for response as far as I know. It depends on the specific mutations, the immune system response, probably lots of unknown factors. If it's a true local recurrence it would be genetically similar to the primary, but even the primary can change with time as mutations accumulate. And some tumors that don't respond to folfox respond to folfiri and vice versa, again mostly for unknown reasons.

I am hoping to persuade the oncs to do a mop-up radiation treatment on the larger mets, especially if it looks likely that the lymph nodes are controlled. They may be able to do conventional SBRT safely for him (as you know, avoiding the small intestine is critical) but if not, I am very interested in the proton-beam treatment. In our case they may be reluctant to refer him for that since he has other mets and they tend to have an attitude of "no point in removing one if it doesn't cure". I just fear that the "butt met" will be harder to control long term. But if there's only one met that would not be an issue in your case.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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