What happens if we opt out of Radiation Therapy - Please rea

bean66 · Regular Joined: 22 Apr 2007 Posts: 12

Hi everyone. I just want to give you little background prior to the question- please bare with me....

In June of this year my dad underwent a successful mini-Whipple procedure. He was diagnosed as Stage III, N1, M0. After his surgery he was given "clean margins." He also had 33 Lymph Nodes removed 4 of which were cancer. 29 without cancer.

His current scans and lab work show that his cancer markers have been trending down from about 135+ right after surgery to about 113 now. He has steadily been gaining weight and his CAT scans have all appeared clear. He currently does not have a port but rather everything is adminstered via his veins. He has chemotherapy once a week for about 1/2 hour with Gem. He began his third "cycle" today. He is relatively active - driving, social, able to eat and such.

Question- We have had a few conflicting recommendations regarding the next step of Radiation Therapy.

The initial physician (Head of Radiation at a city hospital where the surgery was performed) after surgery advised Radiation is almost obsolete in Europe as there are no concrete results indicating improvment from treatment. Radiation is not absolutley necessary, if wanted can be done at any point in time.

AT the Cancer Center where he is being treated for Chemo - This physician of (Radiation) advised he absolutley should have radiation therapy for 5 1/2 weeks combined with chemo. I asked what was the specific reason he felt radiation would help with my dad - he said because the cancer had spread to his lymph nodes prior to them being removed during the whipple. (Keep in mind this physician is basing his opinion on the notes from the surgeon after the initial whipple. He advised he has not reviewed any current scans)

This last response is something we had not heard before. In fact my dad's current Oncologist said radiation was his choice basically and he felt he was doing so good he did not necessarily need it. Also, if he opted not to do radiation he could continue chemo for 6 mths.

Obviously, this is the patients personal choice and my dad is leaning toward not having radiation because he is feeling so good and "knock on wood" no sign of problems but, we are now confused.

Has anyone opted not to do radiation after their whipple?
If so what was the out come?
Any advice or helpful hints for us?

I know we are so much more fortunate than many folks on here but, we don't want to make a wrong move since dad is doing so well.

Any help is appreciated....

God Bless

JKB · New User Joined: 23 Nov 2007 Posts: 5

The reason for this conflivt is there are 2 conflicting trials.

one showed effect of chemoradiation (EORTC) and the other showed an increase in mortality in the group that got chemoradiation.

There are some techinal issues about both the publiced articles, but it is a rather long thing to go into.

either choice is probably ok, as long as chemotherapy is given. The risk of side effects with no marked benefit is a risk however.

the reason adjuvant chemotherapy is given is to "kill" any cancer cells left in the body after surgery. Chemotherapy treats the whole body where as radiation treat a loalised area.

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