Pelvic Wall Treatment Best options

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jumpman50512
Posts: 43
Joined: Thu Jan 10, 2019 10:36 pm

Pelvic Wall Treatment Best options

Postby jumpman50512 » Tue Aug 10, 2021 10:17 pm

Hello Everyone

Well, I just finished talking to my doctor. She did not seem to eager to do surgery on me since the cancer is back on the pelvic wall. There were a lot of blood vessels there and they could not even do a biopsy. But he is 100% sure the cancer is back. So my regular oncologist gave me a 30% chance of being on chemo for life, 30% chance of the cancer disappearing and never returning, and 30% chance of surgery (which I don't think my surgeon wanted to do). I will be on folfili and chemo pills. The doctor told me it's not that bad and it's manageable. I did 12 rounds of folfox and that was horrible. The final rounds were so hard I was barely able to do it. Anybody also has had pelvic cancer disapear? I feel fine good thing just a little warmth and discomfort where the pet scan lit up.
Stage IV Survivor Currently (Diagnosed @ 29) currently 36
1 Met to the Liver
Colo-Rectal cancer surgery
12 rounds of chemo + Radiation + Oral Chemo
12/1/21 Colonoscopy Clean
2/1/21 CT scan Clean
2/1/21 CEA at 5.8
4/1/21 CEA currently at 8.8
5/27/21 CEA currently at 13
Signatera Positive :cry:
Clean CT Scan 4/15/21
It's back :cry: 6/24/21
7/10/21 - 4/10/21 = 10 rounds of folfiry
On Xeloda for a while :(
Chemo pills + chemo + Vectibix currently

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

Re: Pelvic Wall Treatment Best options

Postby catstaff » Wed Aug 11, 2021 9:40 am

Disappear with no treatment??? Or after the Folfiri?

Is it too close to the small intestine for radiation? If this is your only recurrence and conventional SBRT is not an option (due to the aforementioned proximity of the small intestine) would proton therapy be possible? I guess a big drawback to that is it's expensive and may not be covered by insurance in many cases.

Most patients whose comments I have seen, including my husband, find FOLFIRI+bev to be a lot easier than FOLFOX. It does not cause peripheral neuropathy. He has completed 9 rounds, has responded (though not completely). His main side effect is fatigue and low energy with some poor appetite sometimes. He may have a few side effects that are bev-specific as well (beyond the common one of nosebleeds) but so far are manageable. He has a met/recurrence against the sacrum so there are too many blood vessels in the area for surgery.

What is the pill, capecitabine? Technically that would be called XELIRI when done with irenotecan.

Sometimes they do just capecitabine or 5FU with bevacizumab. I think member Rickimaroo is currently doing that for a similar recurrence (he prefers 5FU infusion, as I recall).
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-

jumpman50512
Posts: 43
Joined: Thu Jan 10, 2019 10:36 pm

Re: Pelvic Wall Treatment Best options

Postby jumpman50512 » Wed Aug 11, 2021 1:08 pm

I hope it does not show up on the pet scan with the chemo. That is my goal. I don't think surgery is an option here. Since they could not even do a biopsy at all.

And i just called from the doctor seems like no pills at all. Around 5 hours of chemo. Then i go home with the bag for 48 hours. I hate that bag so much. And yup that is my only re occurence from what i know of. It is outside the colon but i am unsure why the doctor said that but i am hoping that happens. Did your husband get diarrhea? i am worried about that since i have diarrhea sometimes since they did my liver surgery.
Stage IV Survivor Currently (Diagnosed @ 29) currently 36
1 Met to the Liver
Colo-Rectal cancer surgery
12 rounds of chemo + Radiation + Oral Chemo
12/1/21 Colonoscopy Clean
2/1/21 CT scan Clean
2/1/21 CEA at 5.8
4/1/21 CEA currently at 8.8
5/27/21 CEA currently at 13
Signatera Positive :cry:
Clean CT Scan 4/15/21
It's back :cry: 6/24/21
7/10/21 - 4/10/21 = 10 rounds of folfiry
On Xeloda for a while :(
Chemo pills + chemo + Vectibix currently

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

Re: Pelvic Wall Treatment Best options

Postby catstaff » Wed Aug 11, 2021 1:16 pm

He hasn't had a big problem with diarrhea even though that's one of the most common side effects of irenotecan. He complains more about constipation, which is more associated with 5FU and perhaps some of the auxiliary drugs. He has a colostomy, however, so perhaps doesn't notice it as much as someone who has to "run to the can" (what a nurse said is a nickname for irenotecan).

I would find it very unlikely your recurrence would disappear without treatment unless it isn't actually cancer (you said they could not biopsy it, which of course means we can't be certain). But it may disappear with the treatment if it's small and not growing very fast.

Five hours seems like a lot but perhaps it includes all the other things that happen (access a port if you have one or start a line, bloodwork, talk to the doctor, etc.) Actual infusion time for my DH is half an hour for bevacizumab, then two hours for leucovorin+irenotecan, then they attach the 5FU pump. He hates the pump too but puts up with it.
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-

jumpman50512
Posts: 43
Joined: Thu Jan 10, 2019 10:36 pm

Re: Pelvic Wall Treatment Best options

Postby jumpman50512 » Wed Aug 11, 2021 1:32 pm

yea i know i been on the pump before. Well i hope its small since it did not even show up on a ct scan at all. Only on the pet scan is when it showed up. And yeah this one will be a little long since its my first treatment in around 3 years. Oh well i guess if its bad i will tell the doctor. Well thanks for the reply
Stage IV Survivor Currently (Diagnosed @ 29) currently 36
1 Met to the Liver
Colo-Rectal cancer surgery
12 rounds of chemo + Radiation + Oral Chemo
12/1/21 Colonoscopy Clean
2/1/21 CT scan Clean
2/1/21 CEA at 5.8
4/1/21 CEA currently at 8.8
5/27/21 CEA currently at 13
Signatera Positive :cry:
Clean CT Scan 4/15/21
It's back :cry: 6/24/21
7/10/21 - 4/10/21 = 10 rounds of folfiry
On Xeloda for a while :(
Chemo pills + chemo + Vectibix currently


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