saltygirl wrote:...She has t4 tumor involving uterus and bladder. She has had a year of chemo. Finally was suppose to have a surgery. But her surgeon is giving her the options to wait for 6 weeks. Her latest pet scan is negative. But can she really be cured without a surgery? Why is the surgeon waiting for 6 weeks? It seems that the surgery would be very radical. The surgeon claims to wait and see… wait for what? I am confused about the whole situation. She is in UK.
Curative surgery is the usual goal for patients accepted for surgery. With extra tricks, starting with targeted cimetidine, the Life Extension type extras, IV vitamin C, and ADAPT+++, I would say a series of locally/nearly curative surgeries is feasible for multiple sites on "hopelessly metastatic patients", that are usually not considered operable by ordinary surgery departments.
Usually, for colorectal patients, 6 weeks standoff before/after surgery is prescribed because of Avastin (bevacizumab) added to chemo for metastatic CRC, before or after, respectively. Without Avastin and maybe some of the other mabs, 2-3-4 weeks are common in various locales, depending on the country, chemo and patient condition.
After a year of Folfox/Folfori + Avastin that patient is likely a beat up patient that needs some weeks for recovery depending on how max'd out they were.
There are published examples of 5FU chemo, mostly in Japan, where chemo was done right before,
during (!), or after successful surgery with decent patients and good results.
Just for everybody's education, we substituted other less toxic materials for oxi-, iri- and Avastin to fight mCRC with a milder, daily oral chemo, analogous to ADAPT+++. For the 2nd surgery we began dialing back some things e.g. aspirin 7 days before surgery and did the last, bigger chemo dose with 200 mg of oral UFT (oral 5FU prodrug) along with IV vitamin C, 24 hr before surgery (per NPO requirement). Our surgeon even allowed pre-op cimetidine orally instead of the now usually promoted proton pump inhibitors for surgery. When the surgery was a success, with no complications, IV vitamin C started several hours after recovery, and a night's sleep, my wife restarted her TID oral chemo package at 24 hrs post-op. For both surgeries, the surgeons especially prescribed post op Celebrex.
With Xeloda, which has a longer metabolic cascade, or some other surgery sites, I'd wait a little longer.