What happens at the end of adjuvant therapy?

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Pagola44
Posts: 315
Joined: Mon Jul 03, 2023 7:57 pm

What happens at the end of adjuvant therapy?

Postby Pagola44 » Tue Jan 23, 2024 6:13 pm

I have nearly completed by 12 cycles of folfox (i'm on 10) and got 2 left

But i was wondering what happens at the end of my treatment? I'm going to make an appointment with my oncologist and I assume he will organize scans for me and a colonoscopy to be done sometime this year. Would these happen as soon as i finish? or a few months after I am done?

But going forward, in terms of monitoring is this done through the oncologist, surgeon or local doctor?

Also, should I leave my chest port in just in case? I would hate to remove it just to get it put back in :( ?

Thanks all
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

User avatar
Peregrine
Posts: 255
Joined: Tue Mar 01, 2022 1:18 am

Re: What happens at the end of adjuvant therapy?

Postby Peregrine » Tue Jan 23, 2024 8:08 pm

Last edited by Peregrine on Tue Jan 23, 2024 11:24 pm, edited 1 time in total.

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

Re: What happens at the end of adjuvant therapy?

Postby Rock_Robster » Tue Jan 23, 2024 8:45 pm

So typically here it’s a bit of both. Your oncologist will likely arrange quarterly surveillance scans and blood tests for at least the next 2 years (after which you might review the frequency). You can ask for more frequent bloods if you want - eg monthly. Your surgeon should receive copies of the imaging too.

Your surgeon will likely want to do a colonoscopy at the 1 year mark after surgery, and then if that is all clear they may push the next one out to +2 or +3 years.

If you wanted additional info / peace of mind, you can arrange for a ctDNA test (eg Signatera). However this isn’t covered by Medicare or insurance here, and there’s a good chance your oncologist won’t do much with the result. But of course it’s your body and your money.

Typically they would say if the port isn’t causing you any issues, leave it in until the 5 year mark. However you will need to go in routinely just to get it flushed - depending on the centre this is usually every 6-12 weeks. I had mine out at around 2 years as I had an unlucky blood clot issue so keeping it was more risk than benefit.
Last edited by Rock_Robster on Wed Jan 24, 2024 5:26 am, edited 2 times in total.
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

Pagola44
Posts: 315
Joined: Mon Jul 03, 2023 7:57 pm

Re: What happens at the end of adjuvant therapy?

Postby Pagola44 » Tue Jan 23, 2024 11:52 pm

Rock_Robster wrote:So typically here it’s a bit of both. Your oncologist will likely arrange quarterly surveillance scans and blood tests for at least the next 2 years (after which you might review the frequency). You can ask for more frequent bloods if you want - eg monthly. Your surgeon should receive copies of the imaging too.

Your surgeon will likely want to do a colonoscopy at the 1 year mark after surgery, and then if that is all clear they may push the next one out to +2 or +3 years.

If you wanted additional info / peace of mind, you can arrange for a ctDNA test (eg Signatera). However this isn’t covered by Medicare or insurance here, and there’s a good chance your oncologist won’t do much with the information.

Typically they would say if the port isn’t causing you any issues, leave it in until the 5 year mark. However you will need to go in routinely just to get it flushed - depending on the centre this could be anything between every 6 and 12 weeks. I had mine out at around 2 years as I had an unlucky blood clot issue so keeping it was more risk than benefit.


Oh really? I thought i could take out my port, didn't think i'd need to have it for 5 years, do you know If i can play sport with it? was hoping to 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

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

Re: What happens at the end of adjuvant therapy?

Postby Rock_Robster » Wed Jan 24, 2024 2:54 am

Pagola44 wrote:
Rock_Robster wrote:So typically here it’s a bit of both. Your oncologist will likely arrange quarterly surveillance scans and blood tests for at least the next 2 years (after which you might review the frequency). You can ask for more frequent bloods if you want - eg monthly. Your surgeon should receive copies of the imaging too.

Your surgeon will likely want to do a colonoscopy at the 1 year mark after surgery, and then if that is all clear they may push the next one out to +2 or +3 years.

If you wanted additional info / peace of mind, you can arrange for a ctDNA test (eg Signatera). However this isn’t covered by Medicare or insurance here, and there’s a good chance your oncologist won’t do much with the information.

Typically they would say if the port isn’t causing you any issues, leave it in until the 5 year mark. However you will need to go in routinely just to get it flushed - depending on the centre this could be anything between every 6 and 12 weeks. I had mine out at around 2 years as I had an unlucky blood clot issue so keeping it was more risk than benefit.


Oh really? I thought i could take out my port, didn't think i'd need to have it for 5 years, do you know If i can play sport with it? was hoping to return :(

You can have it taken out if you want to - it’s really up to you. But if you don’t say anything about removing it they probably won’t bring it up for a while. As you say it’s just the consideration that if you needed to do more treatment down the track then you may have to get it placed again.

It really depends on the sport - they usually say most things are fine except heavy contact sports like football, martial arts, etc.
Last edited by Rock_Robster on Wed Jan 24, 2024 5:24 am, edited 1 time in total.
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

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

Re: What happens at the end of adjuvant therapy?

Postby Rock_Robster » Wed Jan 24, 2024 5:22 am


Great links Peregrine.

Peter Mac in Melbourne also has an excellent public (free) survivorship program, with dedicated resources for younger cancer survivors:
https://www.petermac.org/patients-and-c ... -treatment
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

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

Re: What happens at the end of adjuvant therapy?

Postby Rock_Robster » Wed Jan 24, 2024 5:27 am

PS: to your question on timing, in your case provided your post-chemo scans are all clear, you are generally considered to be “NED” from the date of your surgery (not the date you finish chemo). Just one for the calendar :D
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

Pagola44
Posts: 315
Joined: Mon Jul 03, 2023 7:57 pm

Re: What happens at the end of adjuvant therapy?

Postby Pagola44 » Wed Jan 24, 2024 7:10 am

Rock_Robster wrote:PS: to your question on timing, in your case provided your post-chemo scans are all clear, you are generally considered to be “NED” from the date of your surgery (not the date you finish chemo). Just one for the calendar :D


wow really? that's pretty cool so in june i could potentially be 1 year NED :D

Also thanks for links ^
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

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

Re: What happens at the end of adjuvant therapy?

Postby Rock_Robster » Wed Jan 24, 2024 7:16 am

Pagola44 wrote:
Rock_Robster wrote:PS: to your question on timing, in your case provided your post-chemo scans are all clear, you are generally considered to be “NED” from the date of your surgery (not the date you finish chemo). Just one for the calendar :D


wow really? that's pretty cool so in june i could potentially be 1 year NED :D

Also thanks for links ^

That’s it man! Here’s to one year soon of many more.
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


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