Not happy with oncologists plan

FormerMember
FormerMember
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Hi all. I don’t post on here often but am reading everyone’s posts Regularly. But I really want your opinions and advise on this matter.
To cut a long story short my partner got diagnosed with bowel cancer September last year following a bowel obstruction aged 42, Stage 3 T4 N1 M0. Had curative surgery but was unable to have mop up chemo due to complications following surgery.
Anyhow in June this year they discovered a few tiny mets on his liver and suspected a met in the peritoneal area. He began chemo (folfiri) and 5fu late June and has so far had seven rounds.
We know that the mets have shrunk as they had to do an early scan in August due to a bowel blockage caused by scar tissue from previous surgeries.
Now we met again with our oncologist yesterday, we were pushing and pushing for what he plans to do in the future, whether any operations are in order etc. He said he doesn’t plan on anything else other than the chemo. He says it is working well and said he will continue with that until it stops working. He said surgery is too risky, it won’t cure it and could just cause the cancer to spread. He said if something is working we would not want to stop it. He is saying because the cancer is in more than one place you can’t operate.
We mentioned that we read all the time on groups that people are having surgery with cancer spread all over the place, he was just saying how risky it is and that we only hear about the success stories and that people that die from these surgeries aren’t around to write their blogs etc.
We feel that we are too young to just accept chemo for the rest of my partners life and feel that more should be done to enable us to fight this.
For the time being we are going to wait for the next ct scan in November and see what the results are, if our oncologist is still reluctant to budge then we will see our gp about getting a second opinion.
What are your thoughts please? Has anyone been in a similar situation where they’ve been told the plan is just maintenance chemo?

  • Hi

    Totally my opinion but we felt there was two clinical schools of thought on how to manage a stage 4 diagnosis. Some but not all oncologist rightly feel that a patient who is chemo responsive should remain with a treatment that is working and I get why . But some surgeons feel that operating if there is curative intent is also an acceptable course of action if the risks are fully explained to the patient . 

    My mum was not just chemo responsive but I think it would be fair to class her as a top responder . You can imagine her oncologist was rightly happy with the results and wanted her to continue using chemo . However my mum wanted a surgical opinion and as they would only operate at that time with curative intent she felt it was a risk she wanted to take . The surgeons explained in detail the risks but also talked us through how often they encountered it . In weighing up she felt she wanted to select a route which held a chance of a cure . In the full knowledge that if unsuccessful she would have to return to chemo for life on/ off . But if successful for a period of time possibly extended her life and potentially reduced the tumour burden the chemo might have to tackle . Also chemo comes with a set of explained risks . It was not an easy decision but hearing the full surgical opinion let her make a fully informed choice. She weighed everything up and proceeded from there .

    It might be good to hear if there is a surgical opinion . It clarified a lot for us and helped her make her decision. You get the opportunity to ask surgically what sort of complications they encounter and how they manage that . Not all surgical complications can’t be managed . But they did go into the details of what could potentially happen and the stats of that occurring .  Even the worse case scenario was fully explained . But that is the process of consent .

    One other factor my mum selected to include was she was rough on chemo and recovered better from surgery ! She also went through this with the lung surgeon . For some reason he wanted her on a clinical trial of observation . But his co worker was happy to operate .

    I think the hard part in a stage 4 setting is you don’t have protocols , just clinical judgements so you really have to go down a route you are comfortable with having fully understood both sides .

    The other factor is to get an opinion from a specific surgeon specialising in that area !

    So much to take on board it gives you a total headache .

    But some do live to write those blogs !!! 

    Take care ,

    Court 

    Helpline Number 0808 808 0000

  • Ps I should also stay that my mum’s current oncologist having the insight of her condition over eight years now keeps scanning her as she does well with surgery and likes to get in early . Oh the roller coaster never stops. 

    i too have read if people that are literally up in the hundreds of chemo cycles as they work well with it and it does not disturb their quality of life . That was not my mum . It worked wonders but made her ill . It’s very individual. 

    Helpline Number 0808 808 0000

  • FormerMember
    FormerMember in reply to court

    Your mum is inspirational, she is such a fighter isn’t she and obviously has such a wonderful family around her to support her. It’s all so overwhelming, so much information, you just don’t know what to do for the best.  I completely get where the oncologist is coming from, but what happens when this chemo stops working, I am not prepared to take that risk. We are due to see him again in November, I have a long list of questions, I need to get a surgeons opinion on it.  I need to k ow what other options there is, I am not happy with the just sticking with chemo for life decision.  I will stand by lee all the way, and to me, what lee says goes, and if he’s not happy to settle for that then neither am I and together we will make sure we cover all that there is to fight it.  Lastly can I ask if your mum has to continue with chemo to keep things good, or do they just get in and operate when they see the need to?

  • Sounds like a really sensible plan . The more information the better .

    She has never had any post op chemo . And actually never had any chemo since 2010 . They did not give her it after the lung met as unlike the liver mets it was really slow growing and they said she would not get any clinical benefit as it works best on faster growing tumours . She was fine with that . I did observe that a lot of people have some post op chemo now but again it seems variable on who is treating you .

    You are an incredible support and together you will find the way through for him . 

    Take care ,

    Court 

    Helpline Number 0808 808 0000