When doctors don’t agree

Posted by sgreger1 @sgreger1, 3 days ago

My husband has Stage IV coloncancer and he did 8 cycles of Folfox that ended in June (ended only because walking our dog, he was upended and hit his head on the pavement and suffered a TBI). He’s been on a chemo holiday since then. It’s been 3 months. His head injury seems to be completely healed (physically- no additional brain bleed). We have 2 medical teams (one at City of Hope and one at Ironwood Cancer Center) with different out looks . One says no surgery to get clear margins after the neo adjuvant treatment and one says, clear it to avoid the possibility of blockage (in the cecum). City of Hope wants to start another chemo slightly different than Folfox, because they don’t want to chance the liver met waking up. Ironwood thinks surgery could go ahead soon and we can deal with the liver mets with radiation. I need to say too, his latest MRI showed ND, his CEA was 1.8 but climbed back to 3 and his ctDNA was at .101

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nycmusic | @nycmusic | 2 days ago

These differences are really hard to sort out…I have no expertise here, but personally feel that surgery can be so beneficial…often, cancer patients can’t get to surgery, due to mets and other causes….sometimes they need to shrink a tumor first or clear up some other conditions first…maybe you need another opinion to get clarity- this can sometimes be available by Zoom, without traveling far away…. Wishing you the best, whatever you chose to do.

premi | @premi | 2 days ago

Any day getting rid of the tumour will reduce your future risks.You can restart the chemo after six weeks.I would choose a hospital who is willing to operate.Irrespective of the stage some cancers are kind to us and allow us to lead a near normal life in spite of challenges.All the best for you both

sgreger1 | @sgreger1 | 2 days ago

The tumor has already been reduced to ND, not detected by CT and ctDNA of .101. So there is a fraction of cancer circulating. The systemic chemo, folfox did that. The circulating cancer cells are probably from a tiny liver met. So some of the doctors don’t think at this time that surgery would be so beneficial. Tho, one of them does.

isadora2021 | @isadora2021 | 1 day ago

In reply to @nycmusic "These differences are really hard to sort out…I have no expertise here, but personally feel that..." + (show)

@nycmusic @sgreger1 I’m no expert either. I’ve had a look on the internet and it seems that City of Hope is known for its expertise in aggressive surgery to deal with aggressive cancer tumours. That it’s advising against surgery at the moment and advising continuing with a chemo similar to Folfox (possibly Folfiri which I had as my 1st line) is interesting.

@sgreger1 I would definitely try and get a 3rd opinion asap (taking into account the 2 you have received) from another major top ranked cancer research and medical hospital, such as Mayo Clinic.

This is far too important to take a punt which advice is better.