EMVI positive - chemo or not?

Hi, , I had the same diagnosis T3N0V1M0, but with rectal cancer.  Click on my name for details. I was offered, and took, the 30 weeks of 5FU to increase chances of survival. I also opted for the AddAspirin trial if this is an option for you. If you have any questions after reading, please ask.

The main reason for being offered chemo for rectal cancer with V1 is that the lower bowel is trapped in the pelvis, and the risk of spread via the blood stream is higher than for colon cancer higher up.

Big ((hugs)) to you both, it is very treatable, I have just had a year clear, yippee!

Hi 

Welcome to the forum . Sounds as though your husband is doing really well . Long may it continue . 

The other thing to remember if he commenced treatment and felt the risks outweighed the benefits he can stop it at any point in time . He has control over that aspect of the risk benefits analysis. 

Take care ,

Court 

Many thanks for your response and many congratulations on your year!  Can I ask how did you cope with the 5FU? My husband lost a lot of hearing and has profound tinnitus after radiation treatment some years ago and he really could not cope with the chemo impacting his hearing, causing ear pain or balance issues - I understand this is an issue when it’s combined with other chemo drugs but info seems conflicting on 5FU alone.  Also did you feel ok on the week or so in between treatments? Have been advised that there is no right answer - have to go with what we feel and we are flip flopping one way or the other every day! Would be very interested to hear of your experience and really appreciate your taking the trouble to respond - we are only 6 weeks or so in from the shock diagnosis and this forum is so helpful. All very best wishes to you. 

Thank you very much for your reply.  I think we are leaning towards this - I understand that the side effects are cumulative to some extent so if he starts and cannot cope he at least investigated the downsides by experiencing them.  Many thanks and all the very best to you. 

Sorry Gemmary. I have read your info and see that the chemo was not easy - well done for finishing it! Only outstanding question is really if it affected your hearing/balance at all? Many thanks

Hi 

I will ask my mum about the balance and tinnitus aspect . My dad also has it so I think she would have been aware of it . I will check . She had oral chemo over two years and I would say for her the biggest issue was colic like stomach pains but I hasten to add she still had her primary tumour that was shrinking and irritated. So I think that may have been a factor as it was easier the second year . She had to moisturiser her feet and hands a lot . But she got into a good routine with it . Also they can adjust the dose which my mum had the second year . That made a big difference to her . I would encourage him to keep communicating with his team on chemo . This took my mum a while to feedback side effects but once she gave them the opportunity they were quick to make adjustments. 
I will ask and get back to you .

Court 

, no my hearing or balance were not affected. My ears have always been my weak point throughout my life, getting otitis media on a regular basis, but the ears were not affected. The chemo was weekly by IV and I could work during this. The concession I made was swopping my day at school from a Friday to a monday as chemo was on a Wednesday. The school day was hard but I was determined to keep some normal. The rest of the time I work for myself so could balance it. Because of the long duration it got worse as time went on, but still very doable.

If you have any other queries please ask. You will note that they reduced the dose twice, and I missed 3 single weeks (which got added onto the end!) So you have some flexibility. As court says, you can start and see how far you get. I had a 15 week treat, a 20 week treat and an end treat which I still have! 

I have no knowledge of capecitabine or oral uptake. Your other consideration is whether you want to go into hospital each time, or take a pill at home. I think the support of the chemo nurses was a big factor in getting through this for me, despite the weekly trek. Sorry lots to consider!

This is also a similar biopsy to my colon tumour. I had a left hemicolectomy in May '19. At that time, there was no spread & it was determined as a non aggressive cancer/ non hereditary....yet likewise, I had EMVI. I saw my Oncologist shortly after, who went into all the risks pertaining to Chemo. & adamantly insisted that in my case, it was absolutely not necessary to undergo, as like you, I was told that at 3.5%....it was a very low increase overall. I obviously went along with her expert advice, & did not insist on having a treatment that she thought was uneccessary. However, in Mar '20, following a CT Scan, it was discovered that I had two very small tumours in one of my lungs.....& then I underwent 6 months of oral capecitabine. Fortunately, this managed to reduce the sizes to an extent that I had a Lung Ablation procedure in Oct '20, which was successful. I am now due another CT Scan in two weeks....& obviously getting a bit nervous. Would this have happened if I had chemo straight after my resection? Who knows....it's impossible to predict. BTW, I had no side effects with the Capecitabine, until my 6th cycle....when I had bad Palmar Plantar in my hands & feet, (despite continuous moisturising throughout.)

Good luck with your decision.

Hi 

I had rectal cancer surgery in July 2017. T3m0n0 emvi involment. My surgeon said he wanted me to have chemotherapy

( 6 months capecitabine).The oncologist said it was my decision. After much thought I followed the surgeons advice. My thought being if I have a recurrence then it would be down to bad luck and I would not be wondering if the outcome would have been different with the chemotherapy.

Get all the information you need from your doctors and specialist nurse and discuss with your family . It is a decision only you can make . There is no right or wrong decision . Your own peace of mind is what matters.

 I had my check up with the surgeon last week. All ok.

Hope this helps

take care lattee