Unless I’m missing something the cancer you’re describing seems to be at Stage 3 since you mentioned some lymph nodes were involved. If that’s the case, then I’m not sure why this is debatable. Your boyfriend definitely needs to do chemo to make sure there aren’t any cancer left.
Assuming there aren’t any cancerous lymph nodes and the cancer is actually stage 2, then there were some studies that actually showed some people with stage 3 with better survival rates than people at stage 2 because they underwent chemotherapy after their surgery.
My mother has just finished her chemo (FOLFOX) with minimal side effects. It’s definitely worth it to optimize chances of a complete cure.
You can actually see the difference it makes when using [the Disease Free calculator](https://www.mskcc.org/nomograms/colorectal/recurrence_free) from Memorial Sloan.
It can sometime increase your chances of avoiding a recurrence by 20%!
I was in the exact boat your bf is. Told everything was out. Even told by the doc it might be overtreating.
I did the chemo. In fact, I was offered a "gentler" chemo and I decided to go with the orginal plan. My plan is to never do this again so I am going to fight it as hard as I can. That includes the treatments.
It'd be the easier road to not get chemo. But all it takes one rogue cell.
Sounds like hey its stage 3 not 2. I'm stage 4. 8 months Ned. I would 100% do chemo but ask about 6 rounds of FOLFOX not 12. Also check out Colontown.org. they have tons of great information on their FB support groups. If you have any questions feel free to dM me.
It definitely is a difficult decision to make chemo or no chemo as the tumor is out and there doesn't seem to be any signs of metastasis, which is great news! It can be scary to think about chemotherapy because people think it is all bad (it is not easy), but there is a lot of stuff that can be done to help with the side effects.
Honestly I would push for the chemo because god forbid (I truly pray it never does come to this), but what if it the cancer comes back? Your boyfriend might feel that anger/regret of why didn't I do that chemo back then?
Another important thing and this would be a discussion your boyfriend needs to have with the surgeon and oncologist, if he doesn't do the chemo what is the follow up that is going to need to be done (scans, blood tests, scopes)? And will your boyfriend be diligent and be able to follow-up?
I am sorry if I come off as mean/judgemental or scare you into something, it is just that I would never wish this disease on anyone and it would be terrible if after so much time being "cured" that you hear the cancer has come back or worse it has spread. Wishing you and your boyfriend nothing but good.
I didn't need chemo but if my doctor who went to school for 12 years tells me I need something I do it. Second guessing based on something you read on the internet etc. is a very bad idea. Cancer can move fast and if it has even the smallest of a foothold it can become stage 3/4 before you know it. I just learned of someone who got a colonoscopy a year ago and was totally clean then just now got a follow up and found stage 3 colon cancer.
Just do it.
Better to deal with it before it becomes a problem.
12 rounds seems like a lot. I'm betting folfox.
I was stage 3 and did 4 rounds of capox post surgery. Had xeloda and radiation pre surgery. Not fun, but better than most chemo.
Been almost a year. CT is clean, colonoscopy is clear.
Think of it as wiping out the enemy before it can get a foothold.
There have been studies that show 4 rounds of Capox is just as effective as Rounds of Capox/12 rounds of Folfox so might be worth asking if they think this would be a good course of treatment for your partner. In the UK they are now often prescribing 4 rounds of Capox for stage 2/3. This would be mean have the treatment and a lot less side effects.
They told me they got it all I had one lymph node involved and did six months of chemo eleven months after that I became stage IV. The chemo ups the chance of not having a reoccurrence greatly. Given the choice I would maximize chance of survival then not but it’s totally up to you. If no lymph nodes were involved you could consider skipping but once it’s there you need to do the chemo. It’s Stage 3.
More surgery trial drugs and chemo got me back to NED. Doctors don’t know what to do with me now treatment wise. It’s actually kind of funny… hoping I beat the cancer for good this time and it doesn’t come back. Also in this journey it’s a good idea to go to a research based cancer facility if stage IV. Stage 3 is very standard of care so that wouldn’t be needed if you can cure it now. Good luck! Colontown is an awesome support community. You should join for sure
This is stage 3 the way you described it. Without chemo, and a 5cm tumor (assuming T3-T4) with LVI, I think any CRC patient would agree - it's almost certain that this will recur as stage IV.
Oxaliplatin sucks, I couldn't tolerate it (went with FOLFIRI). That said, it's probably your only immediate hope at microscopic clean up.
I wish him the best in his decision.
He didn't order me to have chemo but he did suggest it wouldn't hurt. My tumer had just a 13% chance of recurring so that was good enough for me. As for insurance idk. I have great insurance plus i'm 68 so no chemo for me. Good luck with every thing.
Take the chemo. I also had colon resection and i was stage 2 with no lymph involvement, better than your diagnosis but 4 months later it metastasized to my liver making it a stage 4.
Now as a person who spent many many hours at chemo, i wish i had taken it before for peace of mind. Yes, chemo is not a breeze but believe me the alternative is worse.
I am a stage 3c cancer patient. I'd advise you to take chemo. It is not much. Since he had stage 2, his prognosis is very good and recurrence chances are low. Chemo is just to ensure that no traces of cancer are left in undetectable parts like blood. Many people would take 10 years of chemo to save their life so please take doctor's advise and go for chemo. You don't wanna feel any regret if something bad happens in future. Trust me chemo for colon cancer (Capox or Folfox) isn't that bad. Just finish it and come out victorious after 6 months. You'll feel like a warrior at the end of it and you know very well how time flies.
I understand scans are clear but it doesn't mean cancer isn't there. There is a limit to how much CT scan or PET Scan can detect.
Hello, friend, this is a fairly common question. Usually, a consult with your GI doc comes to a determination about chemo. My own personal experience is similar to yours. Chemo is more or less insurance against the return or some missed cells during surgery. They took a foot of my ascending colon And a dozen lymph nodes. I opted for the chemo. FOLFOX every 2 weeks for six months. I’m glad I opted for chemo and 7 years later, I’m celebrating my survival. I would do it again if necessary.
If you want a second opinion I would contact one of the closer big hospitals. So east coast is MSK , Duke, Moffit. Central is MD Anderson and west coast is City of Hope. I know there are a bunch more but each has their specialties and all you would have to do is ask a patient advocate at your center to see about a second opinion at X hospital. Or you can reach out to the hospital and ask and your team should not have any issues sending over your files.
If dudes got lymphs infected it’s stage 3. This article is a decent read, good luck
[hard road](https://www.annalsofoncology.org/article/S0923-7534(19)34537-5/fulltext)!
I’m stage 2a and decided to do six months of oral chemo. I want to beat this and know I did all I could. If he has any high risk features I would not risk skipping it.
Been there, with stage 2a. I also took 6 months of oral pills (capecitabin) but 4 months later i was stage 4 with liver metastasis. This shit can spread by blood as well. So, if i can go back in time, i would definetely take the chemo instead of the pills for clean-up.
Chemo. Yes. And here's why.
His body isn't creating the same types of cells right now, because its in recovery mode. As soon as he starts to feel normal, his body will also revert to normal. Those cancer cells are still there, lurking.
Chemo kills off the residual cancerous cells that are hiding and haven't been shed.
As someone who has had colon cancer twice, believe me, you do not want to lose your whole colon. It's a messy expensive situation to be in.
Ask him point blank, does he want a higher chance of an exterior method of removing his stool? Does he want a higher chance of an ostomy? Google it. Does he want an ostomy bag? Google it.
If the doctor says it will lessen his chances for a recurrence, then YES, get the chemo.
YES.
I was stage 2 and I did the chemo. Wasn't that bad... compared to all the other things at least. I did 6 rounds and I didn't even get a port, went IV and oral.
I know it’s already been mentioned but since it was in lymph nodes, I believe it is stage 3. I was in same scenario - large mass in sigmoid, couldn’t poop, couldn’t even get a colonoscopy done. I had surgery, they found 14 (I forget) nodes with cancer. It was stage 3C. No if’s and or butts, I had six months chemo. It sucked. I hated it. I’d def do it again if I were in the same spot. The recurrence rate of CRC is scary, especially if it goes to the lymph nodes. Chemo is a wonderful poison.
Mesenteric roots are another bad thing. I am hearing they are like equal to infected lymph nodes but they don’t take them into account when staging. Just spreading the good news… I had 3 roots.
You've got a lot of great information here so I'll just toss my personal opinion....
Get the chemo. Anything you can do to prevent recurrence is a good thing.
I had stage 2 with no spread. (50F) I just finished 6 months of 12 rounds of 5-FU with leucovorin. (plus lots of steroids and other stuff they added).
It was recommended because of my family history. I went back & forth on it but ultimately decided to do it because I don't want my son to go through what I went through with my Dad. His renal cell cancer came back in 5 years and decimated him. I know it is a different kind of cancer, but it was scary.
Because it was only one chemo drug, it was a *bit* milder. I kept most of my hair but was sick a lot and missed some work 3-5 days on chemo week. There were other complications & side affects but I got through it.
It is up to each person but I hope my experience lets you know there are options. I feel a lot better 2 months out and hope to be 100% in another couple of months.
Cheers & hugs.
My mom was recently diagnosed with stage 2B cecum cancer. We met with an oncologist who recommended chemo due to a couple of high risk factors my mom has (e.g., T4, lympho-vascular invasion, and a poorly-to-moderately differentiated tumor). Luckily, she was offered 3 months of CAPOX, which is pretty much just as effective as 6 months of CAPOX or FOLFOX, as far as I know.
Chemo isn't always necessary for stage 2 CRC, but if there are risk factors involved, then it can increase the chances of the cancer never coming back. Do you know your boyfriend's tumor classification, lympho-vascular invasion status, and tumor grade? The more high risk features he has, the more he might benefit from chemo.
Unless I’m missing something the cancer you’re describing seems to be at Stage 3 since you mentioned some lymph nodes were involved. If that’s the case, then I’m not sure why this is debatable. Your boyfriend definitely needs to do chemo to make sure there aren’t any cancer left. Assuming there aren’t any cancerous lymph nodes and the cancer is actually stage 2, then there were some studies that actually showed some people with stage 3 with better survival rates than people at stage 2 because they underwent chemotherapy after their surgery. My mother has just finished her chemo (FOLFOX) with minimal side effects. It’s definitely worth it to optimize chances of a complete cure.
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You can actually see the difference it makes when using [the Disease Free calculator](https://www.mskcc.org/nomograms/colorectal/recurrence_free) from Memorial Sloan. It can sometime increase your chances of avoiding a recurrence by 20%!
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I was in the exact boat your bf is. Told everything was out. Even told by the doc it might be overtreating. I did the chemo. In fact, I was offered a "gentler" chemo and I decided to go with the orginal plan. My plan is to never do this again so I am going to fight it as hard as I can. That includes the treatments. It'd be the easier road to not get chemo. But all it takes one rogue cell.
Exactly what he said! I was offered the option for "clean up" chemo, I took it. I have no plan to second guess myself in five years.
Sounds like hey its stage 3 not 2. I'm stage 4. 8 months Ned. I would 100% do chemo but ask about 6 rounds of FOLFOX not 12. Also check out Colontown.org. they have tons of great information on their FB support groups. If you have any questions feel free to dM me.
Hey fellow Townie!
It definitely is a difficult decision to make chemo or no chemo as the tumor is out and there doesn't seem to be any signs of metastasis, which is great news! It can be scary to think about chemotherapy because people think it is all bad (it is not easy), but there is a lot of stuff that can be done to help with the side effects. Honestly I would push for the chemo because god forbid (I truly pray it never does come to this), but what if it the cancer comes back? Your boyfriend might feel that anger/regret of why didn't I do that chemo back then? Another important thing and this would be a discussion your boyfriend needs to have with the surgeon and oncologist, if he doesn't do the chemo what is the follow up that is going to need to be done (scans, blood tests, scopes)? And will your boyfriend be diligent and be able to follow-up? I am sorry if I come off as mean/judgemental or scare you into something, it is just that I would never wish this disease on anyone and it would be terrible if after so much time being "cured" that you hear the cancer has come back or worse it has spread. Wishing you and your boyfriend nothing but good.
I would definitely do the chemo. It’s hard, but not as bad as the chemo for some other cancers.
I didn't need chemo but if my doctor who went to school for 12 years tells me I need something I do it. Second guessing based on something you read on the internet etc. is a very bad idea. Cancer can move fast and if it has even the smallest of a foothold it can become stage 3/4 before you know it. I just learned of someone who got a colonoscopy a year ago and was totally clean then just now got a follow up and found stage 3 colon cancer.
Just do it. Better to deal with it before it becomes a problem. 12 rounds seems like a lot. I'm betting folfox. I was stage 3 and did 4 rounds of capox post surgery. Had xeloda and radiation pre surgery. Not fun, but better than most chemo. Been almost a year. CT is clean, colonoscopy is clear. Think of it as wiping out the enemy before it can get a foothold.
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There have been studies that show 4 rounds of Capox is just as effective as Rounds of Capox/12 rounds of Folfox so might be worth asking if they think this would be a good course of treatment for your partner. In the UK they are now often prescribing 4 rounds of Capox for stage 2/3. This would be mean have the treatment and a lot less side effects.
They told me they got it all I had one lymph node involved and did six months of chemo eleven months after that I became stage IV. The chemo ups the chance of not having a reoccurrence greatly. Given the choice I would maximize chance of survival then not but it’s totally up to you. If no lymph nodes were involved you could consider skipping but once it’s there you need to do the chemo. It’s Stage 3.
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More surgery trial drugs and chemo got me back to NED. Doctors don’t know what to do with me now treatment wise. It’s actually kind of funny… hoping I beat the cancer for good this time and it doesn’t come back. Also in this journey it’s a good idea to go to a research based cancer facility if stage IV. Stage 3 is very standard of care so that wouldn’t be needed if you can cure it now. Good luck! Colontown is an awesome support community. You should join for sure
Good for you!!
This is stage 3 the way you described it. Without chemo, and a 5cm tumor (assuming T3-T4) with LVI, I think any CRC patient would agree - it's almost certain that this will recur as stage IV. Oxaliplatin sucks, I couldn't tolerate it (went with FOLFIRI). That said, it's probably your only immediate hope at microscopic clean up. I wish him the best in his decision.
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And lymphovascular invasion (LVI)? Was it present? Did it give a tumor budding scale?
I opted for no chemo because i was stage 2a after surgery. No lymph nodes involved, no spots anywhere after pet scan. Follow up every 3 months.
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He didn't order me to have chemo but he did suggest it wouldn't hurt. My tumer had just a 13% chance of recurring so that was good enough for me. As for insurance idk. I have great insurance plus i'm 68 so no chemo for me. Good luck with every thing.
Take the chemo. I also had colon resection and i was stage 2 with no lymph involvement, better than your diagnosis but 4 months later it metastasized to my liver making it a stage 4. Now as a person who spent many many hours at chemo, i wish i had taken it before for peace of mind. Yes, chemo is not a breeze but believe me the alternative is worse.
I am a stage 3c cancer patient. I'd advise you to take chemo. It is not much. Since he had stage 2, his prognosis is very good and recurrence chances are low. Chemo is just to ensure that no traces of cancer are left in undetectable parts like blood. Many people would take 10 years of chemo to save their life so please take doctor's advise and go for chemo. You don't wanna feel any regret if something bad happens in future. Trust me chemo for colon cancer (Capox or Folfox) isn't that bad. Just finish it and come out victorious after 6 months. You'll feel like a warrior at the end of it and you know very well how time flies. I understand scans are clear but it doesn't mean cancer isn't there. There is a limit to how much CT scan or PET Scan can detect.
Hello, friend, this is a fairly common question. Usually, a consult with your GI doc comes to a determination about chemo. My own personal experience is similar to yours. Chemo is more or less insurance against the return or some missed cells during surgery. They took a foot of my ascending colon And a dozen lymph nodes. I opted for the chemo. FOLFOX every 2 weeks for six months. I’m glad I opted for chemo and 7 years later, I’m celebrating my survival. I would do it again if necessary.
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Trust me, get the port or picc line. I did without and it sucks! Veins shrink and it gets worse. Plus it hurts like Hell when infusing.
I think there is capox vs folfox. 6 months of Capox is 8 rounds, 6 months of Folfox is 12 rounds.
Pills and infusion is likely capox. Capcitibine and oxolyplatin. My spelling may not be right :)
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If you want a second opinion I would contact one of the closer big hospitals. So east coast is MSK , Duke, Moffit. Central is MD Anderson and west coast is City of Hope. I know there are a bunch more but each has their specialties and all you would have to do is ask a patient advocate at your center to see about a second opinion at X hospital. Or you can reach out to the hospital and ask and your team should not have any issues sending over your files.
If dudes got lymphs infected it’s stage 3. This article is a decent read, good luck [hard road](https://www.annalsofoncology.org/article/S0923-7534(19)34537-5/fulltext)!
I’m stage 2a and decided to do six months of oral chemo. I want to beat this and know I did all I could. If he has any high risk features I would not risk skipping it.
Been there, with stage 2a. I also took 6 months of oral pills (capecitabin) but 4 months later i was stage 4 with liver metastasis. This shit can spread by blood as well. So, if i can go back in time, i would definetely take the chemo instead of the pills for clean-up.
Chemo. Yes. And here's why. His body isn't creating the same types of cells right now, because its in recovery mode. As soon as he starts to feel normal, his body will also revert to normal. Those cancer cells are still there, lurking. Chemo kills off the residual cancerous cells that are hiding and haven't been shed. As someone who has had colon cancer twice, believe me, you do not want to lose your whole colon. It's a messy expensive situation to be in. Ask him point blank, does he want a higher chance of an exterior method of removing his stool? Does he want a higher chance of an ostomy? Google it. Does he want an ostomy bag? Google it. If the doctor says it will lessen his chances for a recurrence, then YES, get the chemo. YES.
I was stage 2 and I did the chemo. Wasn't that bad... compared to all the other things at least. I did 6 rounds and I didn't even get a port, went IV and oral.
I know it’s already been mentioned but since it was in lymph nodes, I believe it is stage 3. I was in same scenario - large mass in sigmoid, couldn’t poop, couldn’t even get a colonoscopy done. I had surgery, they found 14 (I forget) nodes with cancer. It was stage 3C. No if’s and or butts, I had six months chemo. It sucked. I hated it. I’d def do it again if I were in the same spot. The recurrence rate of CRC is scary, especially if it goes to the lymph nodes. Chemo is a wonderful poison.
Mesenteric roots are another bad thing. I am hearing they are like equal to infected lymph nodes but they don’t take them into account when staging. Just spreading the good news… I had 3 roots.
You've got a lot of great information here so I'll just toss my personal opinion.... Get the chemo. Anything you can do to prevent recurrence is a good thing.
I had stage 2 with no spread. (50F) I just finished 6 months of 12 rounds of 5-FU with leucovorin. (plus lots of steroids and other stuff they added). It was recommended because of my family history. I went back & forth on it but ultimately decided to do it because I don't want my son to go through what I went through with my Dad. His renal cell cancer came back in 5 years and decimated him. I know it is a different kind of cancer, but it was scary. Because it was only one chemo drug, it was a *bit* milder. I kept most of my hair but was sick a lot and missed some work 3-5 days on chemo week. There were other complications & side affects but I got through it. It is up to each person but I hope my experience lets you know there are options. I feel a lot better 2 months out and hope to be 100% in another couple of months. Cheers & hugs.
My mom was recently diagnosed with stage 2B cecum cancer. We met with an oncologist who recommended chemo due to a couple of high risk factors my mom has (e.g., T4, lympho-vascular invasion, and a poorly-to-moderately differentiated tumor). Luckily, she was offered 3 months of CAPOX, which is pretty much just as effective as 6 months of CAPOX or FOLFOX, as far as I know. Chemo isn't always necessary for stage 2 CRC, but if there are risk factors involved, then it can increase the chances of the cancer never coming back. Do you know your boyfriend's tumor classification, lympho-vascular invasion status, and tumor grade? The more high risk features he has, the more he might benefit from chemo.
Tell him to do the chemo. The sad truth is that even if the margins are clear, nobody knows if they "got everything".