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Thread: chemo and radiation prior to surgery

  1. #1

    chemo and radiation prior to surgery

    I have unknown stage of rectal cancer and the doctors are saying chemo and radiation will be our first plan of attack. I guess it's all in the location. has anyone else had this treatment?

  2. #2

    another question

    The only test result i have received back so far is a high CEA. Does that mean it's spread?

  3. #3
    Regular User
    Join Date
    Jan 2010
    My cancer was in the colon and I do know that treatment is different. My understanding with rectal is that radiation is first, then surgery. I have also heard it done where chemo was after surgery, maybe before and after surgery? Not sure.

    A high CEA now could be due to your primary cancer and really doesn't give an idea of the spread of the cancer. Tests like a CT scan or PET scan give the best idea of lymph node, liver, lung involvement. The colorectal surgeon also will check these areas when they do the surgery.

  4. #4
    thank you sense i found out on monday i have been goggling a lot sometimes i think i am over reacting. I have been healthy and active all my life and am scared to death of what i am facing.

  5. #5
    Administrator Top User brainman's Avatar
    Join Date
    Oct 2005
    Blog Entries
    As I understand it, a CEA test only shows that there is a probability that you have colon or rectal cancer and to follow the effects of treatment(s). It is not used diagnostically either for a primary tumor or metastatic tumors. It is also not very specific because it can be high for several types of cancer... not just colorectal ones.
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
    My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
    My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
    My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029

  6. #6
    my name is ed 31 yrs old . went threw chemo radation from last year 08 in dec. to feb 9 of 09. my tumor was really low so radation really hurt me there was a bad burning feel cheymo was not bad though. then had 6 weeks to prepare for surgey.

  7. #7
    New User
    Join Date
    Jan 2010

    Rectal Cancer

    Hi Donna
    I had rectal cancer and the first phase of my treatment was to have radiation and chemo. I had 6 weeks of both. I was able to take oral chemo pills at home, and had to go to the hospital daily for radiation treatments. I only had to be at the hospital for about 20 minutes a day and the actual radiation only took about 5 to 10 min from start to finish. For most of the six weeks I felt normal, but starting about the 5th week I began to have diarrhea. I adjusted my diet and took Imodium to manage the diarrhea. The week following the radiation I had burns (like sunburn in the lower region) so I stayed home and rested in bed. For me the entire process was not too bad.
    Feb 08-Diagnosis Rectal Cancer, liver mets
    Mar-May 08, Xeloda
    June 08, Hysterectomy, Bowel Resection, Temp Ileostomy
    July-Oct 08, Abscess drain tube surgery
    Oct 08-Feb 09, Folfox
    Apr 09, Liver resection
    June-Sept 09 5FU
    Feb 10 Ileo Reversal

  8. #8
    43 years old here and diagnosed last March with colon cancer, but very low-bordering on the rectum area. I had 6 weeks of daily radiation and 24/7 chemo with the pump.
    Then I had surgery to remove the tumor and about 20" of my colon and most of my rectum, and now am going through 8 cycles of Oxi. 6 down 2 to go, then the reversal.

    I think for lower colon cancer, the chemo/radiation is fairly standard. In my case, the radiation didn't shrink the tumor as they had hoped, but it did something because the pain I was having before chemo/radiation stopped, as did the bleeding. But towards the end of the radiation, extreme pain when ever I had a bowel movement, and I have heard that the radiation really messes up your insides...but less than cancer does!

  9. #9
    Thank you all,
    I know I have a long road ahead of me. I have just started to take laxatives due to the tumor is very painful and blocking normal bowel movements.

    On a good note my family kidnapped me and took me to Flagstaff to play in the snow. Not the smartest think since I have my PET tomorrow and wasn't supposed to over exert myself. Well thats me in a nut shell some body tells me no and well....... yes I do.
    I have many questions and I'm sure I will be spending a lot of time here.
    Again, Thank you!

  10. #10
    Regular User
    Join Date
    Oct 2009
    I am 35 with rectal cancer. It was detected through a colonoscopy and I immediately started treatment. I started with 8 chemo treatments every 2 weeks. Then I was given 3 weeks to recover for surgery. They removed all of my colon and rectum and categorized the cancer as stage 3c. 2 weeks after surgery they started radiation and 5FU chemo for 7 weeks. Then I had 8 more chemo treatments.

    Originally my CEA was very high (787) but during treatment and after surgery it continued to fall.

    I wish you luck and pray for a successful recovery.
    1/15/09 - Colonscopy Biopsy (Stage IIIc Colon Cancer)
    1/26/09 - FOLFOX - 5-FU, leucovorin, oxaliplatin, avastin
    5/5/09 - Removal of Stage IIIC Colon Cancer Tumor & Permanent Ostomy. 13 lymph nodes removed 12 positive for cancer.
    8/6/09 - Started 6 weeks radiation w/5-FU pump
    9/21/09 - FOLFOX regimen - 5-FU, leucovorin & oxaliplatin.
    10/12/09 - FOLFIRI regimen - 5-FU, leucovorin & irinotecan.
    05/07/10 - Stage IV cancer in bones and lymph nodes.

    Age Diagnosed 34. Current Age: 35

  11. #11
    Top User topazil's Avatar
    Join Date
    Aug 2009
    The old regimen used to be to do surgery first then chemo and radiation, now it seems the old way is out and they do the chemo and radiation first, at least that is what my Oncologist has told me. I had the surgery first then chemotherapy so cannot tell you any experience or what to expect but I can tell you about CEA:

    What is CEA?

    CEA stands for carcinoembryonic antigen. CEA is a type of protein molecule that can be found in many different cells of the body, but is typically associated with certain tumors and the developing fetus. The word "carcinoembryonic" reflects the fact that CEA is produced by some cancers ("carcino-") and by the developing fetus ("-embryonic").

    How is CEA measured?

    CEA is most frequently tested in blood. It can also be tested in body fluids and in biopsy tissue.

    What is the normal range for CEA blood levels?

    The normal range for CEA in an adult non-smoker is <2.5 ng/ml and for a smoker <5>20 ng/ml before therapy are associated with cancer which has already spread (metastatic disease).

    What conditions can cause an elevated CEA?

    Both benign and malignant (harmless and cancerous) conditions can increase the CEA level. The most frequent cancer which causes an increased CEA is cancer of the colon and rectum. Others include cancers of the pancreas, stomach, breast, lung, and certain types of thyroid and ovarian cancer. Benign conditions which can elevate CEA include smoking, infections, inflammatory bowel disease, pancreatitis, cirrhosis of the liver, and some benign tumors in the same organs in which an elevated CEA indicates cancer. Chemotherapy and radiation therapy can cause a temporary rise in CEA due to the death of tumor cells and release of CEA into the blood stream. Benign disease does not usually cause an increase above 10 ng/ml.

    What are the limitations of CEA testing?

    CEA is not an effective screening test for hidden (occult) cancer since early tumors do not cause significant blood elevations. Also, many tumors never cause an abnormal blood level, even in advanced disease. Because there is variability between results obtained between laboratories, the same laboratory should do repeat testing when monitoring a patient with cancer.

    For some people it is an ongoing indicator of how their cancer is doing ~ (like me) for others (Like REB) their CEA has never risen so is not a good indicator of how the cancer is doing.

    Hope this helps a bit and you are in my thoughts and prayers and yeah for having some fun before the PET scan (grins)
    Total hysterectomy July 23 2008, mass in colon.
    Colonoscopy Aug 2008
    Rigid Sigmoidoscopy with a laparoscopic-assisted partial colectemy with enbloc small bowel resection Sep 2008
    Diagnosed: Stage IV Colon Cancer mets to lungs and liver. (T3,N2,M1,G2) KRAS Mutation
    Started chemotherapy: 09/14/09 Folfox-6/Avastin then Camptosar/Avastin & last Folfox-6/Avastin
    On Hospice, started 11/12/10
    Last PET scan: Oct 12th
    Most recent CEA Level: 09/27/10: 696.7 up from 08/16/10: 284.8

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