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This question was answered on Sat 04, Oct 2008 06:49pm by Dr Paul S, MD

Chemo length with T1 N1 MO status


    
Asked by polarprincess (Female; 42; otherwise healthy ) on Sat 04, Oct 2008 12:45pm

hi, I was recently dx with Stage IIIa Colorectal cancer from a polyp. (3 cm tubulovillous adenocarcinoma removed by endoscopy because all biopsoes were benign-then came back T1 pathology. Moderately differentiated. I did go to a big cancer hospital for my LAR (no residual carcinoma identified but with 1/26 lymph nodes positive so N1 and also MO) They recommended 1-2 months fulfox then chemoradiation, and then 2-4 months fulfox. My local oncs said that they usually only use Folfox for the big cancers because of the toxicity issues, but are willing to give me the FUlFOX if that is what I want, but think 2 cycles prior to chemoradiation and 2 after is plenty for my situation. Everything I have found online suggests that with chemoradiation 8 cycles of FULFOX is standard. I feel worried that she is being so conservative with me, and wondering if it is warranted with my T1 N1 status. Thanks
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Answer by Dr Paul S, MD  on Sat 04, Oct 2008 06:49pm:

Hi there. The FOLFOX regimen is not overkill in your situation and I believe this is the most appropriate treatment in your case. Even if the primary tumor is just small (T1), the presence of the positive lymph node makes your situation at high risk of cancer recurrence and cancer spread (hence a stage IIIa status). Regarding the number of FOLFOX cycles, I think you should be first on the same page with your doctors regarding what they mean by 'cycles'. The FOLFOX regimen is given every 2 weeks for a total of 12 'sessions' of chemotherapy spanning 6 months. The standard treatment is 6 months of FOLFOX or 12 sessions and for a stage IIIa cancer, 2 months before radiation and 2 months after (totalling only 8 sessions of FOLFOX) may not be sufficient. Regards.

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