We met with the oncologist today.
As of right now, Jon’s done. No radiation. No chemo.
Given his stage, the cure rate from surgery alone = 90-95%.
If I understood correctly, the potential detrimental effects of radiation & chemo equal any benefit he might receive – so they’re just not indicated in his situation.
There was a bunch of discussion re: statistical info/numbers that I would have generally enjoyed – but I became seriously agitated when it turned toward who benefits from what and why certain treatment isn’t indicated in certain situations. I know it’s irrational, but I felt like we were reducing human lives (MY HUSBAND’S HUMAN LIFE) to a number. A number who might benefit from aggressive treatment, but a number not worth worrying about given the larger picture. The thing is – if 3 out of 100 people might benefit, I WANT ONE OF THEM TO BE JON. I don’t want to hear that it’s not “worth it” because the odds aren’t in favor of him potentially being one of the miniscule who benefit.
Irrationally, I don’t give a shit about cost/benefit(ish) talk when there’s even a slightly remote chance chemo and radiation could marginally help reduce risk of recurrence.
But I understand why it just doesn’t work that way.
We’ve been told to imagine the colon as a garden hose with several internal layers.
Very basically, his cancer had spread beyond the innermost layer (mucosa) into the muscle – but not beyond.
So, as I’ve said – stage I.
Stage II or III? He’d definitely be a candidate for both chemo and radiation because his chance of recurrence increases to 25-30%. HUGE bullet was dodged here. Just a little more growth and we’d be facing a much different scenario with tiny cancer cells potentially floating around undetected.
Because there was no spread to lymph nodes, etc., it can be assumed that all cancer cells were scooped out 2 weeks ago. They likely/hopefully never had a chance to break free, generate and spread.
There’s a caveat, though. I’ve previously mentioned that his CEA level was 69 going into surgery – very high. If his level is above 3 post-surgery (something we’ll know next week – they just drew blood today) they will check one more time. If it remains elevated, chemo and radiation will probably happen. Very basically – something funky is going on somewhere if the level remains elevated.
The oncologist has never experienced this sort of situation (and doesn’t utilize CEA levels over pathology to determine treatment) so was hesitant to speculate because he isn’t sure how he’d proceed – but he continues to be very surprised Jon’s level was 69 with stage I cancer. He warned us that we’re not quite out of the woods yet (but probably).
They scheduled an appointment with a geneticist, so hopefully Jon will soon know if there’s a genetic mutation situation going on. If so, his kids (and other family members) can be tested. If no mutation is found, my understanding is that his kids (and other family members) won’t have to worry (as much).
We talked about health + lifestyle + diet and whether any of that played a role in his development of cancer. Short answer: no. Diet/lifestyle studies aren’t reliable, are retrospective in nature, of course – and just generally don’t provide good data. Right now, there’s zero indication that diet/lifestyle played any role in Jon’s situation.
We were told there’s nothing he can do to reduce risk of recurrence, either. The oncologist mentioned what I’ve read – that a diet high in fat has been linked to colon cancer – but he brushed that information off as inconclusive.
My general takeaway re: his recommendation for Jon: don’t be a dumbass. Stay in shape, eat well, take care of your body.
He essentially cleared him to do what he wants, so we made a stop on the way home.
If his CEA level isn’t currently elevated – which I’m going to hope/assume is the case – he’ll be seeing the oncologist every 3 months for 2 years for a CEA level check + lung scan. Any elevation in CEA will = a PET scan.
After two years of zero recurrence, he’ll switch to appointments every six months for 3 years.
After 5 years, he’ll be done with the oncologist.
He’ll have a colonoscopy every year for a while and will have one every 2 years potentially forever.
Overall – I’m extremely happy. I’m relieved to know that he doesn’t have a greater chance of future incidences of cancer than me (or the general person) once he reaches his 5 year milestone – and that the odds are so much in his favor throughout the next 5 years.
At this point, the oncologist believes it to be highly unlikely that Jon will ever experience colorectal cancer again since he will be so carefully monitored and screened going forward.
Honestly – I will probably never shake the fear that has taken root. Ever. But that’s ok.
We’re trying to make some incremental changes around here as we determine what makes sense.
I’ve been slowly weeding out our plastic containers – several went into our recycle bin this morning.
Just can’t do it anymore.
Jon REALLY wanted to go to a Mexican place for lunch + margaritas – since he CAN for the first time in weeks – but we didn’t.
Instead, he poached a couple of eggs in marinara sauce that he’d doctored with mushrooms, etc. and ate that with spinach. I thought it sounded disgusting, but it turned out to be pretty good. I think he saw a picture somewhere that inspired this.
I had a typical lunch.
We had a big hunk of meat from the farm to utilize, so Jon made carnitas for dinner. Too lazy to deal with pictures (and it’s dark, anyway) – but it was better than the Mexican place.
It’s going to be ok.