@advocate4her I’m so sorry about all the complications. I hope your wife is feeling better. This thing is just so overwhelming and it feels like you’re constantly surprised by something else. And praying you guys continue to get clear scans and recovery is a smoother road from here on out.

What kind of chemo did that have her on? It’s been recommended that we apply to a trial for people who’ve just had surgery and no visible evidence of cancer (R0 and R1– we have a positive perichynmal margin)- it’s a combination of chemo + immunotherapy or chemo + placebo (double blind study). We’re pursuing it because we trust our doctors (MSK- but we also have experience with Mayo and have nothing but great things to say) but I do wonder, with no guarantee that we get the trial drug (if approved for the study), if we are underestimating what adjuvant radiation can do for the positive margin on the surgical bed. Our doctor said there’s not a lot of evidence for or against radiation in these adjuvant positive margin cases, and I certainly see his point that systemic drugs may be the better bet. I just want to do the best due diligence that I can. Each decision is such high stakes.

Our doctor’s choice of chemo is the capacetabine. We’re still waiting on genetic testing. They put your wife on immunotherapy immediately? Our oncologist presented us with 1. Monitoring or 2. Chemo or 3. Clinical Trial— the cliff’s notes version of the convo and with the caveat that he is going to talk to our surgeon too. Our surgeon is also enthusiastic about the trial but also quickly mentioned radiation seems like it may be somewhat effective for positive margins- so there seems to be a very slight difference of opinion there.