Chemo after bowel surgery- Better with or without?

[StayPositive]

It has been 8 weeks since my sigmoid has been removed. The surgeons were very happy with the surgery so was I. They said my lymph nodes were all clear (16 of them) so I may not need chemo but they will give me chemo if I really want it.

They explained the benefits and risks of chemo to me. It will result in a marginal increase in my chances of complete cure- the chances of relapse will reduce from about 15% to 13%. The side effects may be serious, but they can stop the treatment if anything goes too bad so it should be safe.

It is a life decision and I am struggling to make one. Time is running out as the chemo has to start within 3 months of surgery. I am determined to do everything that I can to reduce the chances of the cancer coming back. At the same time, is the benefit of about 2% more chances really worth 6 months of chemotherapy? They said it won't have long term impacts on my body but I am hearing different things from different people and getting more confused every day.

I would appreciate if you could share your views/suggestions.

StayPositive

[RJG]

Hi StayPositive,

My opinion - take the chemo until you experience any side effects that you can't handle.

The chemo will help mop up lone-wolf cancer cells that might be lurking anywhere in your body. This reduces the risk of metastisis. Depending on what particular cytotoxins they give you, you might not have any serious side effects. Given that they are offering this to you as an option, then if side effects do get too much for you, then you could stop (after seeking advice from your oncologist) and at least they might have done you some good up to that point.

But it is your call. Let us know what you do decide and why.

Best wishes,

Rick

[sch]

Hi StayPositive,

Did the surgeons feel as though it would be beneficial?

Have you discussed with your oncologist/doctor (the surgeon my have done so already)

If the specialists don't feel as though there's any benefit, I'm not too sure I would put myself through chemo for the hell of it.

Having said that, a15% reduction is a 15% better chance of not needing further treatment after chemo.

If you decide to have chemo, stay in close contact with your doctor and if you have symptoms you can always stop the treatment, as RGB mentioned.

Chemo sucks, having cancer sucks worse.

What stage is your cancer? Stage 1 or 2a from your description

-s

[StayPositive]

Hi sch,

Thanks for your suggestion.

It is stage 2 and the oncologist suggested that there is very small increase in chanes of complete cure (about 2%), if I go through chemo. In numeric terms, chances of relapse reduces from about 15% to about 13%.

Speaking to a numbe of people who have gone through chemo, I am getting tempted to skip it for the marginal benefit it will provide. The oncologist said it will be oral chemo- with 3 weeks cycle, for the next 6 months. I haven't met anyone who has done oral chemo- may be it is lower dose and less severe?

Thanks,

StayPositive

[sch]

Hi StayPositive,

Let me think back (briefly) to my diagnoses and the rational I went through and see if that helps, because we're similar enough.

I was diagnosed following a colonoscopy and was referred to a specialist surgeon.

The original diagnosis was that the cancer was caught early, and that I may not even have to have chemo. They would see after surgery.

After my surgery, they found the tumour had made it through the wall of the large bowel and was nudging up against 1 or 2 lymph nodes, but they were unsure if it had made it into the lymph node.

Prior to my surgery my surgeon had presented me with a number of options for treatment.

1. Keep my large bowel and CT scan every 3 months for 2 years. He acknowledged that statistically if the cancer was going to come back, it would come back in the same place.
2. Remove the large bowel and regular CT scan.
3. Remove the large bowel and chemotherapy for 6 months (12 cycles) after I had recovered from surgery. Like yourself, this was only a 2% drop in risk.

Because I was young (OK - I'm calling 40 young) when diagnosed with bowel cancer and because I have lynch syndrome (HNPCC) I elected to take a reasonably aggressive stance because the chances of it coming back were high.

2% drop in the risk of cancer, given my circuimstances seem pretty damn good to me, because my of age and situation and because the risk of the cancer coming back in 5 or 10 years time was quite high.

I hope this helps you.

-sch