Postponing surgery to try chemo for a month

01.30.2012

Hi all,

A very long story short, I’ve decided to try chemo for a month. A lot has happened in the last week and we had some very compelling information just this evening from an oncology team working on my case in Boston (not Sugarbaker’s team). I will not be traveling to Boston tomorrow morning as planned.

There is a relatively new and very promising chemo protocol that they feel would be very worthwhile trying before doing a radical surgery (it’s called FOLFOX with AVASTIN also called Bevacizumab ). It will not compromise my ability to have surgery should we see that is does not respond within the month. If it does, hallelujah. Here is a bit of info I found on line http://clinicaltrials.gov/ct2/show/NCT00826800

Doing it in reverse (surgery then chemo) could put me at much greater risk. After a lot of deliberation I’ve decided to take a chance and bet on this chemo for one month. If it does not respond, then we go back to Plan A with Sugarbaker.

Excerpt from clinical trial (that is now complete):
The purpose of this study is to see if giving chemo-therapy for colon cancer before surgery can shrink the cancer and lead to a higher rate of cure than operating first and then giving chemotherapy. Standard treatment for colon cancer is to first operate, and then, if the tumor is advanced, give chemotherapy for about 6 months. However, surgery delays the time until chemotherapy can start, since the body needs time to heal from the operation. During this time any cancer cells that remain in the body that were not removed by the operation may be allowed to grow. Giving chemotherapy first could attack the cancer cells right from the start, not only at the tumor site that we know of, but also at the site of any cancer cells that may have spread to other parts of the body. Another possible reason why giving chemo therapy first might work better is that the blood vessels that feed the cancer cells are intact before surgery and thus chemotherapy can travel directly to the cancer. This study will also use the drug bevacizumab, in addition to the standard chemotherapy. Bevacizumab has been on the market since 2004 for colon cancer that has spread to other organs, but its use in earlier stage colon cancer, as planned in this trial, is still under study.

Our first priority is getting me into the BC Cancer Agency to start the chemo within the next few days. I do not expect this to be a problem. I don’t know anything else about how it’s administered or the side effects.

Love Sam