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Kaye2003 04-04-2004 01:39 PM

Xeloda & Lymph Nodes
Hi everyone. I have two more questions for you guys if its okay. We went to see my husbands chemo oncologist today for his five week post op check up to schedule his adj chemo treatments. He is going to let my husband take Xeloda again since his results the first time were so good. We took him the report showing clear margins. (Had transanal excision surgery due to rectal cancer was on Feb. 25, 2003).

We were sitting there with the Doc telling us how happy he was for us and then he asked “what about the lymph node?” We asked him “what lymph node? Nobody had ever mentioned a lymph node to us.” He told us that the lymph node was somewhat enlarged on the ultasound (which results were sent to him by our surgeon) and that it was right beside the tumor, but that we should not worry about it because the surgeon would have removed it if it was necessary. He said he was sure that when the surgeon was in the area during surgery he saw that the lymph node looked normal or was burned up due to the radiation and that it was not surprising that the lymph node could be normal or gone because of the chemo and radiation my husband had before surgery. (CT before treatment and surgery showed liver and lungs clear).

We have 100% trust in our surgeon. He is one of, if not, the best in our State. He specializes in nothing but colon problems and surgery and has even wrote a book on colon problems, cures and surgeries. The man is excellent in what he does. We just can not imagine that this doctor would leave anything in my husband unless he was as sure as he can be that it was normal.

Okay everyone, here are my questions:

Has anyone ever taken Xeloda after surgery? Four months, two weeks on, one off.

I’ve read different stories by survivors that talk about lymph nodes looking enlarged on the ultrasound but where normal or gone after radiation and chemo treatments or that these lymph nodes were not removed and did not need to be during surgery. Has this happened to any of you?

We have called the surgeon, but it will probably be Monday before we hear back.

Thanks for all your help. You guys have given me more peace and understand than all the doctors.

God Bless all.....

ktee_uk 04-04-2004 02:29 PM

Re: Xeloda & Lymph Nodes
Hi Kaye

We experienced kind of the same thing. When husband was first diagnosed with bowel cancer he was told it "may have spread to liver". After scan it was confirmed that it had. After his bowel resection they told us that the scan also showed up a node on his lung !!!! Alarming to say the least. However our liver surgeon reasured us that he would not be operating on his liver if he thought the cancer had spread to his lung already and that we should not worry about the node as it was too small and insignificant.

Well, after his liver surgery we were discussing what happens next, ie radiotherapy combined with more chemo, when they let slip that he had TWO nodes on his lung. Another bomb shell to take cover from.

It seems to me that the docs don't like to tell you everything in one go which i kind of understand in a way as it is very much a case of information overload straight after diagnosis. I have now got to the stage that I just cannot get excited about any good news about my husband because I am waiting for a big downside to any good news. He had clear scans of bowel and liver within last two weeks but I am afraid to even raise a smile just in case something else comes along to bite my behind.

i think we have to learn to deal with the knocks as practically as we can but also to deal with the highs in a down to earth manner and just keep our noses down to the grindstone and keep plodding on.

But back to your husband Kaye. I am sure the chemo man was right and that he wouldnt just leave it in there. He may even have taken it out, swollen or not, as a matter of routine testing/biopsy...... i think they did that with my husband during his liver resection.

Hope the above doesnt cloud your confusion any.


CancerDad 04-08-2004 07:48 PM

Re: Xeloda & Lymph Nodes
I am 31 and was diagnosed with Stage IIIC Rectal Cancer post rectal resection and lymph node removal. The transrectal ultrasound revealed NO lymph nodes that looked "enlarged." I had chemo and radiation prior to surgery to shrink the tumor which they believe penetrated the rectal wall. After they removed the lymph nodes, 6/10 nodes came back positive for metastatic adenocarcinoma. Bottom line is the surgeon can't tell by looking-- he/she can see if the tissue is "burned" from the chemo, or if the node appears enlarged, but you don't know until a pathologist looks at it. I'm assuming if they did a transanal excision, the tumor must have been very small and barely penetrated the mucosal wall. Did they stage him?
The fact he's had pre-op chemo and radiation, and post op chemo is great to make sure they got everything. Best of Luck!

Kaye2003 04-08-2004 09:50 PM

Re: Xeloda & Lymph Nodes
Yes, my husband had transanal excision surgery on Feb. 25. They never did give us a stage. The turmor had shrank due to rad and chemo to the size of a dime. His doctor did call this week. He went thru all his test results again and said there were no signs of any enlargement of any lymph nodes on the test or visible during surgery. He did mentioned something about lymph nodes being along side the tumor would have been burned up with rad therapy.

My husband starts his post op chemo the first week in May. Will be on Xeloda for four months.

What has been the result of your situation? I hope and pray that all is going well for you..

Thanks for all your reply, and yours also kytee.

God bless

CancerDad 04-10-2004 06:51 PM

Re: Xeloda & Lymph Nodes
Hi Kaye:
I also must do post-op chemo. They want to put me on a "very aggressive" regimen because the oncologist was not happy that I had so many positive nodes, even with pre-op chemo and radiation. I have a dual port catheter implanted in my chest before receiving any chemo to receive the cocktail they will give me. I currently have an ileostomy-- which will be reversed in a couple weeks. I had such a difficult time healing after the first major surgery-- non healing of the rectum, incision that opened up, etc.-- that they decided to wait to start my next round of chemo. Apparently, there is no data that supports a better outcome if you start treatment 3 months post tumor removal or 6 months. Luckily, I am in the OR a lot for my Sales career, so I know and have consulted a lot of surgeons/friends.

Currently, because they had to remove all my lymph nodes and messed with all my nerves as a result, and the tumor was so low, I cannot urinate (I have to cath every 6 hours) and am impotent. They told me that a transanal approach was not an option for me because of the tumor placement, my young age, and the depth of the tumor in the rectal wall. The first chemo I had was 5FU/Leucovorin and Oxaliplatin. The next round will be 5FU/Leucovorin and Camptosar.

Five year survival rates for stage 3C Rectal Cancer range from 20-55 percent with a greater rate of recurrence for rectal cancer than colon cancer. The surgeon did get decent margins though, so I am optimistic that things will work out ok-- not looking forward to the chemo, as I'm sure your husband isn't either. There are so many new drugs just released that the rates can only go up.

How old is your husband and how is he healing post radiation and surgery? Has he had a PET scan?-- If not, I would demand one.

Best of luck to your husband and you. I wish you well in holding up through this. I know from my wife, it's not easy.

God Bless and Happy Holidays!

ktee_uk 04-11-2004 12:57 PM

Re: Xeloda & Lymph Nodes
Hi all

Just thought i would post a positive note about survival rates. The way it was explained to me was that the data is collated over five years and averaged out. We all know that the current survival rates are getting better and better all the time............ If they based the 5 year suvival data on just the current year just gone then they would be probably be quoting well over a 50% five yr survival rate ...... consistantly.

My husband refuses to look at the data unless it is collated from the previous 12 months. He considers himself already to be a firm candidate for long term survival........ he is at stage 4 :) He wants to be a statistic that pushes that percentage figure up to a 100% survival rate. Stay positive.

Regards to all

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