Chance of cancer coming back over time

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DarknessEmbraced
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Chance of cancer coming back over time

Postby DarknessEmbraced » Tue Dec 19, 2023 8:42 am

I was stage 2a after surgery in 2014. The oncologist said that I have a 10% to 15% chance my cancer will come back. I hope this isn't a stupid question. Does that 10% to 15% chance go down each year that I remain cancer free after surgery? I didn't do chemo because the oncologist said the side effects weren't worth the extra 3% to 5% chemo would give me.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

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beach sunrise
Posts: 1023
Joined: Thu Mar 05, 2020 7:14 pm

Re: Chance of cancer coming back over time

Postby beach sunrise » Tue Dec 19, 2023 12:30 pm

Thinking it would go down.
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

roadrunner
Posts: 446
Joined: Sun Jan 12, 2020 8:46 pm

Re: Chance of cancer coming back over time

Postby roadrunner » Tue Dec 19, 2023 6:24 pm

This is not precisely quantifiable, and everyone is different. Onc’s number is likely based on their knowledge of studies showing recurrence rates over time in similar situations. Likely, if you are so inclined, you can look at those same studies (or some of them) and see what the numbers were at different intervals post-treatment. But yes, in general, the longer the better. Because your likelihood of recurrence is so low to begin with, my advice would just be to raise a glass to each passing year and not worry about it (but of course do any monitoring/testing that might be recommended by your onc.) : )
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

Pagola44
Posts: 315
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Re: Chance of cancer coming back over time

Postby Pagola44 » Tue Dec 19, 2023 6:53 pm

Yes, the longer you are cancer free the less likely return.
29m Male.
DX: CC, Right Hepatic Flexure, 4cm, T3, G2, M0
Stage III3B , Positive lymph nodes: (2/20)
Baseline CEA value: 1.98
LVI and PNI: absent
Surgical margins: clear
No lynch Syndrome or MSI
Primary surgery type: Laparascopic

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O Stoma Mia
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Location: On vacation. Off-line for now.

Re: Welcome to the "1,000 Club"

Postby O Stoma Mia » Wed Dec 20, 2023 1:18 am

For the 1,000th post, beach sunrise wrote:Thinking it would go down.

Hi Beach Sunrise,

Welcome to the "1,000 Club" !!

Your profile shows that you first registered on this forum in March 2020. It also shows that since that time you have now posted a total of 1,000 messages to this board. (By the way, a total of 40 those messages were comments on pfccr's current treatment protocol thread.)

You have also shared your insights many other times on this forum, for example in this post:

In February 2023, beach sunrise wrote:Have you had the IL's, CTL (Astragulus, PSK),CDs (Butyrate, Reishi), NKTs (Astragulus, Cytokin Suppress, Beta Glucan 1,3 1,6)) ect measured by bloodwork? My target list is based on bloodwork.
Faith42 brings up a good suggestion if available. The Block Center in Chicago uses IV C, ALA and CoQ10 together for some patients and gauge benefit.
Thanks for answering questions. My ND is Dr. Belanger in MA. He in on a molecular/mitochondria level (the root) more than any other I have consulted with and believe me I consulted 6 to maybe 8. Very down to earth and open minded.
I take Atragulus in an extract form ( no taste to me) and Reishi and Coydyceps in a powder form added to coffee (it has an earthy taste). I do anything to keep pill load down where I can. It is rare that Reishi can raise AFP but it can happen so beware of that. I have a recipe to make your own tea from the roots of Astragulus from my ND at Mederi Center if you want it.
For lungs targeting IL-6 and 8 (Neutrofil induced usually but my Neutrofils are in normal range at 82.x). IL's are in upper limit for IL6 but IL8 remains about 20 pts over upper limit.
Geinistein Ultra (IL8 and inhibit a variety of growth factors)
Vascustatin (IL8 and inhibit a variety of growth factors
CoQ10 along with synergistic niacin and B2 (B2 only once a day)
IP6 to keep TGF and plasma VEGF low
Querctrin,bromalaine, nettle mix in cap form from Natera brand taken with NAC
Siliphos
Niacinamide for kick starting NAD (mitochondria support)
Cordyseps to inhibit kRAS
IVC 75g twice per week for inflammation, kRAS, ect. Just good stuff.
Healthy Cholestrol & Triglycerides for IL8 and vWF (vonWillabrand Factor, a glycoprotein)
TCM's: BaiJiang Cao for IL6&8 & vWF (powder)
Hunag Qin for IL8&10 (IL10 starting climbing). (powder) It also keeps PGE2 from getting out of control
Tian Hua Fen for IL6 (powder)
All Inclusive Great Tonify (powder) taken with the other 3 TCMs in a shot glass of water and chug it. It's terrible like pig mud to me but do it anyway :)
Fisetin (IL8)
Theaflavin (IL8)
Luteolin (IL8)
Oxymarine (IL8)
Aloe Ace for increasing CTLs (liquid)
Tri-salts for cell health
I make a flavanoid drink consisting of fruit berry powders such as Resveratrol, Pomagranite, bilberry, strawberry, tart cherry, black raspberry, (extract), lemon extract, ect
Alos been drinking warm white pine needle tea at night for the extra vitamin C and anti-oxidants it provides. I mix ginger, cinnamon and sometimes turmeric with it.

So, this is just a short message thanking you for all of your helpful posts over the past three and a half years, and looking forward now to even more helpful posts in all the years to come.

Take care ...

rp1954
Posts: 1847
Joined: Mon Jun 13, 2011 1:13 am

Re: Chance of cancer coming back over time

Postby rp1954 » Thu Dec 21, 2023 4:05 am

DarknessEmbraced wrote:I was stage 2a after surgery in 2014. The oncologist said that I have a 10% to 15% chance my cancer will come back. I hope this isn't a stupid question. Does that 10% to 15% chance go down each year that I remain cancer free after surgery? I didn't do chemo because the oncologist said the side effects weren't worth the extra 3% to 5% chemo would give me.


A large fraction of the stage 2s that recur have identifiable risks or marker behavior that are unmonitored in std medicine but to varying degrees can be detected in progress to/thru stage 4. Blood panels and markers are harder with rectal cancer than colon cancer patients, especially the first year after treatment(s), because of the RC patients' usual radiation damage om top of any chemo. I am aware of the markers because of my readings on CEA series, and the CSLEX1+CA199 marker pair, mostly in Japanese research (mostly those published in English, Google translate for medical Japanese in 2010 with images of 20+ year old articles was still awkward). e.g. the few heavily CA199+CSLEX biomarked stage II CRC patients were totally wiped out within 6 years even after one year of 5FU chemo(1989-1992 trial) if they did not disrupt the CA199+CSLEX attachment mechanism with cimetidine too.

Even with chemo, with shorter Xeloda or Folfox treatments for stage 2 pts these days, colon cancer patients' blood panels and cancer markers should be less distorted and recover roughly normal behavior sooner these days for those with the resources (cash or insurance) for a better blood test series for the first several years, still stretching out the test intervals longer and longer over time but closer together than "std".
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

CoolHandLuke8723
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Re: Chance of cancer coming back over time

Postby CoolHandLuke8723 » Fri Dec 22, 2023 3:08 am

Starving Cancer Cells Out of Existence
"A common problem with modern cancer treatment is that even if 100% of cancer cells are eradicated at tumor sites and in the blood circulation, a small cadre of cancer stem cells may give rise to recurrence months to years later. Oncologists are never quite sure they have cured this dreaded disease. Failure to kill cancer stem cells is likened to killing all the weeds in a garden but never pulling out their roots. [Ludwig Center, Stanford Medicine]

But now, in a groundbreaking animal experiment, cancer researchers in Italy and the United Kingdom report they have killed cancer stem cells, not with a gene-targeted drug or an engineered monoclonal antibody, but with a common antibiotic plus vitamin C. The results are astounding — antibiotics + vitamin C could be up to 100 times more effective than drugs at killing cancer cells – without the side effects” says a news report. [Daily Mail June 9, 2017]
The antibiotic doxycycline, an analog of tetracycline, is FDA approved and commonly used to quell infections such as facial acne. Doxycycline kills cancer stem cells by interfering with cellular compartments called mitochondria where oxygen is turned into energy. Doxycycline demonstrably suppresses production of key DNA proteins in cellular energy compartments by 35-fold.

However, cancer stem cells are cunningly resistive to treatment. Some cancer stem cells exposed to the antibiotic will convert to utilizing sugar for energy, a process called glycolysis.
Vitamin C, at blood concentrations that can be achieved with vitamin C pills, was then employed to selectively interfere with glycolysis in the final and complete eradication of treatment-resistant cancer stem cells.

The combined treatment “effectively starves the cancer stem cell population,” says lead researcher Michael Lisanti at the University of Salford in Greater Manchester, UK. [Oncotarget June 9, 2017]
As Dr. Lisanti and colleagues explain in their report, doxycycline-treated cancer stem cells are 4-to-10-fold more vulnerable to vitamin C-induced death. Doxycycline drives remaining live stem cells from oxygen to sugar metabolism and mega-dose vitamin C finishes them off.
However, cancer stem cells are cunningly resistive to treatment. Some cancer stem cells exposed to the antibiotic will convert to utilizing sugar for energy, a process called glycolysis. " Full article:
https://www.lewrockwell.com/2017/06/bil ... existence/

If you are worried about a recurrence, perhaps do a cleanse targeting lurking cancer stem cells using this method?

I_will_fight
Posts: 142
Joined: Mon Jun 29, 2020 3:38 pm

Re: Chance of cancer coming back over time

Postby I_will_fight » Fri Dec 22, 2023 7:55 am

DarknessEmbraced wrote:I was stage 2a after surgery in 2014. The oncologist said that I have a 10% to 15% chance my cancer will come back. I hope this isn't a stupid question. Does that 10% to 15% chance go down each year that I remain cancer free after surgery? I didn't do chemo because the oncologist said the side effects weren't worth the extra 3% to 5% chemo would give me.


The convetional wisdom is that it goes down, yes. How much it goes down and for how long seems to be an open question with many variables, there is a lot of information in pubmed for this.

This is just an example of one paper, according to which 91% of all recurrences occur in the first 5 years and about 6% in the next 5.

So, in your case, after almost 10 years you have not had a recurrence, you are very unlikely to have it in the future. The figure depends on location and staging and many other variables, but I hope the general statement is true.

Table 4 Recurrence and metastasis by follow up time

Follow-up time (years) Percentage (%)
before 5 years 91.3

5- 10 years 6.1

10-15 years 1.9

15-20 years 0.8

Background: Local or distant recurrence may develop beyond 5 years after radical resection for colorectal cancer (CRC). There is little evidence of a pattern of recurrence after the routinely recommended 5 years of follow-up. We aimed to investigate the efficacy of the prolonged follow-up beyond 5 years.
Methods: We retrospectively analyzed clinical and survival data of 1,054 CRC patients who underwent radical resections from 1980 to 1996 in our center. The prolonged surveillance was recommended for each patient with a duration of over 20 years.
Results: The follow-up rates of 5, 10, 15, and 20 years were 92.6%, 86.9%, 82.3% and 76.8%, respectively. Overall survival (OS) rates of 5, 10, 15, and 20 years were 68.4%, 57.7%, 52.6% and 45.0%, respectively. Totally, 112 (10.6%) patients developed local recurrences and 174 (16.5%) patients developed distant metastases. The 99.2% postoperative local recurrences and distant metastases occurred within the first
15 years of surveillance. Survival differed between four age groups. Local recurrence was mainly diagnosed among rectal cancer patients, especially in those with lower-third rectal cancer. Metastases were commonly found in the liver and lungs. Patients with colon cancer and stage I/II manifested significantly longer OS than patients with rectal cancer and stage III/IV (both P<0.001).
Conclusions: In this study, postoperative local recurrences and distant metastases was rarely found after
15 years of enhanced surveillance, which indicated a “true cure” if the patient did not develop recurrences and metastases after 15 years.
Keywords: Colorectal cancer (CRC); radical resection; long-term follow-up
46 yo male Spain
06/2020 - 6cm T3N0M0 CC splenic flex
3 and 4 mm lung ground glass
lymp 0/37
dMMR MSH6
KRAS mt G13D
V/LNI absent
PNI present
07/20 - hemicol surg, optimistic surgeon.
11/20 - 4 x CAPOX completed.
12/20 - Clear colonoscopy
02/21 - MRI liver lesion unchanged.
11/21 - Clear CT
02/22- Colonoscopy: Sessil polyp 3mm
05/22- Clear CT
06/22- Negative Signatera
12/22- Negative Signatera
01/23- Clear CT
07/23- Clear CT, normal markers.
09/23 - Negative Signatera
01/24 - Clear CT

DarknessEmbraced
Posts: 3813
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Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Chance of cancer coming back over time

Postby DarknessEmbraced » Sat Dec 23, 2023 9:32 am

Thank you everyone! :) That makes sense. I only saw an oncologist who didn't recommend chemo. Because I didn't need chemo, I was referred back to my family doctor. My family doctor was the one in charge of sending the requisition to the hospital for yearly CT scans and tumor marker blood tests. My surgeon did two more colonoscopies and then my GI did the other ones. I had my last tumor marker blood test and CT scan in 2019. I have colonoscopies every 2.5 years due to ischemic colitis attacks. I won't have any more follow up beyond that.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

Rock_Robster
Posts: 1017
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Chance of cancer coming back over time

Postby Rock_Robster » Sat Dec 23, 2023 9:56 am

To support, my oncologist was very clear that the recurrence % rates only apply from day 0 (first day of NED), and every year that passes without recurrence reduces the actual future recurrence risk (all else being equal of course).

If you think about 5-year recurrence rates, what are the odds of someone who is NED after 4 years and 364 days having a positive scan the following day? Almost infinitesimal I’d imagine.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev

DarknessEmbraced
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Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Chance of cancer coming back over time

Postby DarknessEmbraced » Sat Dec 23, 2023 11:01 am

Thank you, you're right.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

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Peregrine
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Joined: Tue Mar 01, 2022 1:18 am

Re: Chance of cancer coming back over time (Denmark data)

Postby Peregrine » Sat Dec 23, 2023 11:09 pm

.
Image

Time From Surgery to Colorectal Cancer Recurrence by Union for International Cancer Control (UICC) Stage
Vertical dashed lines represent median time from curative surgery to recurrence. Shaded areas represent time points of surveillance imaging at 12 and 36 months after surgery (as per Danish guidelines since 2009).

Ref: https://pubmed.ncbi.nlm.nih.gov/37971197/

Rock_Robster
Posts: 1017
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Chance of cancer coming back over time (Denmark data)

Postby Rock_Robster » Sat Dec 23, 2023 11:29 pm

Peregrine wrote:.
Image

Time From Surgery to Colorectal Cancer Recurrence by Union for International Cancer Control (UICC) Stage
Vertical dashed lines represent median time from curative surgery to recurrence. Shaded areas represent time points of surveillance imaging at 12 and 36 months after surgery (as per Danish guidelines since 2009).

Ref: https://pubmed.ncbi.nlm.nih.gov/37971197/

Makes sense that there’s a spike at common surveillance points.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev

DarknessEmbraced
Posts: 3813
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Chance of cancer coming back over time

Postby DarknessEmbraced » Sat Dec 30, 2023 6:59 am

Thank you Rock_Robster, that makes sense.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

zephyr
Posts: 360
Joined: Thu Aug 18, 2016 7:31 am

Re: Chance of cancer coming back over time

Postby zephyr » Sat Dec 30, 2023 5:27 pm

DarknessEmbraced wrote:I have colonoscopies every 2.5 years...


Based entirely on my own experience, continue to have your colonoscopies every 2.5 years, or more often if you can manage it and if you're not doing any other form of surveillance.
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS
Aug-2016-May-2018 Folfox, 5FU, Folfiri & Avastin
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy
Feb-2023 Folfiri & Avastin
Nov-2023 Xeloda & Avastin


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