Post op treatment with no lymph node involvement and clear margins

Discussion Board Forums General Discussion Post op treatment with no lymph node involvement and clear margins

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  • #88757
    esamolytz
    Spectator

    My successful resection was June 9. Clean margins and no diseased nodes! I haven’t had a follow-up with my oncologist yet, but from what the surgeon has told me, they are not sure whether to do chemo. When you wrote that 7 of 10 docs do use chemo after a curative resection, I started wondering even more whether I should fight for chemo if my onc says no. Not that chemo is fun, but I obviously want the best chance of no recurrence for as long as possible. Are there resources you could recommend so I can learn more?
    Thanks!
    Elaine

    #88756
    marions
    Moderator

    We know that the majority of physicians ( 7 of 10) recommend adjuvant therapy after curative resection. However; as of yet we do not have any data supporting the benefit of the treatment.
    This clinical trial conducted in Germany with a Netherland cohort will give us the answer we are looking for:
    https://clinicaltrials.gov/ct2/show/NCT02170090
    For reasons of patient recovery adjuvant therapy is initiated 6 to 8 weeks post resection.
    Hugs,
    Marion

    #88755
    kvolland
    Spectator

    Michelle –
    Sounds like you guys have a plan. Mark was on blood thinners through about half of his 6 months of chemo due to his clot after surgery. We didn’t have any issues other than he got nose bleeds off and on but they usually stopped without an issue.
    Weight is always an issue. Mark was 245# when he had his surgery. He got down to about 190ish after surgery then leveled out finally at about 210# after just chemo. When he did the chemo (5FU) with the radiation he got down to 158# but like I said he had rare and severe reaction to the chemo….they told he could stop but he refused. We got him back up 210 after that. We did a lot of protein shakes. And you might out GNC or other health food store for flavored protein powders….we used several different flavors in his protein shakes.
    KrisV

    #88754
    momsrecovery
    Spectator

    Thanks so much for your feedback. Right now my mom couldn’t handle chemo/radiation because she’s still recovering and weak but she’s improving a lot. She definitely needs to gain some weight. She’s also on blood thinners for a clot and will likely be on them for months. She’s 66 and besides the post-op complications she’s in very good health. I think shortly down the road she might be in a good position for treatment if that decision is made. Her oncologist said if chemo is suggested, she would suggest only using Gemcitabine and not doing any radiation.

    Thanks again for your feedback KrisV.

    #88753
    kvolland
    Spectator

    Michelle –
    Oh Gosh, congratulations to your mom for having a great surgery. The recovery was a little ugly but the clear margins and no nodes make it wonderful.
    My husband had his surgery in June 2014 with clear margins the second time and 2 nodes positive. He too had a rough recovery. They told him 5-7 days in the hospital and he had 14 total…he couldn’t move for three days due to pain in his shoulders then got a blood clot in his arm from the PICC line. He did chemo (gem/oxaliplatin) then did radiation with chemo (5FU). His theory was that he wanted every chance there was to beat this cancer.
    What I can say is that when/if it comes back it is usually fairly aggressive and hard to manage after that. Whether then extra treatment helps I don’t know but it’s the best shot at beating it. I would look at your mom’s age and general health. Do you think she could handle it? Everyone reacts differently to the chemo from really bad to walking through. My husband had very little problems with the Gem/Ox but the 5FU darned near killed him (he had severe and rare reactions to it).
    It’s a tough decision and one many people have had to make. Good luck and keep us posted.

    KrisV

    #11400
    momsrecovery
    Spectator

    Hi everyone. I wanted to ask for opinions on post op treatment for my mom. Her klatskins resection was done in late April and her pathology came back with no lymph node involvement and clear margins. The tumor was 2cm and she went straight to surgery at her diagnosis. She had several post op complications which kept her in the hospital for a month (septic shock and hemorrhaging requiring emergency surgery). She’s finally home to recover and had her first appointment with an oncologist. Based upon her pathology results, the oncologist is leaning towards not doing any chemo or radiation but will revisit this in 1 month when my mom is stronger and in a physical position to even consider treatment. Scans and blood work would be done to monitor recurrence. I don’t know how common her pathology results are and what research is out there for those in a similar situation. We plan to seek a second oncology opinion but I’d love any input on this course of treatment with her pathology.

    Thanks so much.

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