Need Opinions

My dad was recently diagnosed with stomach cancer on 4/30/08. He has had a CT scan and a PET scan since. The PET scan results were better than the CT and currently the cancer is localized within the stomach with a possible 1 cm met to a lymph node. We have 2 options in moving forward and I would like to solicit advice:

1) direct surgery to remove the entire stomach, then chemotherapy after my dad recovers from the surgery

2) pre-operative chemotherapy/radiation for 6 weeks, then surgery, then more chemo/radiation

If we opt for the second option, we have to do a laparoscopy biopsy first which we cannot do until 5/29 (due to the surgeon's schedule) to determine if the 1 cm lymph node is indeed a met. Then, we would schedule the chemo or surgery which may not happen for another month! We're concerned with the lag time as we don't want the cancer to spread any further. But at the same time, I've been reading that doing chemo before surgery is a good way to shrink the tumors and prevent any further spreading.

At this point we are feeling that option 1 would be best but we we want to make sure we choose the best option since this is a huge decision. Any suggestions to this would be much appreciated.

 

On 5/14/2008 jasmine212 wrote:

My dad was recently diagnosed with stomach cancer on 4/30/08. He has had a CT scan and a PET scan since. The PET scan results were better than the CT and currently the cancer is localized within the stomach with a possible 1 cm met to a lymph node. We have 2 options in moving forward and I would like to solicit advice:

1) direct surgery to remove the entire stomach, then chemotherapy after my dad recovers from the surgery

2) pre-operative chemotherapy/radiation for 6 weeks, then surgery, then more chemo/radiation

If we opt for the second option, we have to do a laparoscopy biopsy first which we cannot do until 5/29 (due to the surgeon's schedule) to determine if the 1 cm lymph node is indeed a met. Then, we would schedule the chemo or surgery which may not happen for another month! We're concerned with the lag time as we don't want the cancer to spread any further. But at the same time, I've been reading that doing chemo before surgery is a good way to shrink the tumors and prevent any further spreading.

At this point we are feeling that option 1 would be best but we we want to make sure we choose the best option since this is a huge decision. Any suggestions to this would be much appreciated.

 

Would you really have to wait a MONTH to receive chemo after the laporoscopy? That seems like an awfully long wait, especially if he's already been diagnosed with cancer IN the stomach. I'd question that! Did you ask about the surgery risks with taking the entire stomach out? They are pretty high and it is a major surgery...not to mention the complications that arise afterward. It's difficult to connect the esophagus to the intestines. I read a lot about a certain trial (the name is escaping me right now), where patients were given 3 rounds of chemo before surgery....and then 3 rounds afterward.....it seemed to work well....you may want to check that out - google it, ask your doctor, ask another doctor. I would strongly suggest getting a second opinion and push to get your Dad seen right away...do whatever you have to, he seems to be at a very treatable stage.

 Best of luck with getting his treament started...it seems to be the most difficult part of the entire process! I will pray for your family and your Dad.

Thanks so much for your advice, thoughts and prayers. My brother and I are doing all of the research we can before we meet with the surgeon for a consultation tomorrow. The good news is that we are also attending a oncology forum tomorrow where they will be presenting my dad's case to a group of oncologists for multiple opinions/recommendations.

I definitely agree that the most difficult part of this entire process seems to be getting it started. We just hope we can get started before it gets any worse. But we are hopeful that with prayer, support and positive attitude, we will get through all of this!!!

Base on some studies in England as I knew, the second option seems to have a better chance to survive longer. "please do not rush", get more proffesional opions.

 

On 5/16/2008 loc0322 wrote:

Base on some studies in England as I knew, the second option seems to have a better chance to survive longer. "please do not rush", get more proffesional opions.

I had chemo first, 4 rounds, then the surgery, then 2 more rounds of chemo along with radiation.  They told me if I was older, I'm 39, they may not have been as agressive with the radiation, but they thought I could handle it.  That was over 6 months ago and I am doing rather well all things considered.  I went into remission after two rounds of chemo, Erbitux and Avastin.  They gave another two rounds and then I had surgery, I had a lot of scar tissue they were afraid would give the cancer another breeding ground. So they removed my entire stomach and my spleen.

SO in my case the before and after treatment worked very well.  This will also give the doctors info on how well the chemo works before they do the surgery so if they can't remove the entire tumor they know they will get the rest with the latter chemo.  I hope this helps.

thx for your message andi68, and that's wonderful news! can you tell me when were you dx'd and how quickly you were able to initiate chemo? my dad was initially dx'd on 4/30, but we are still waiting to do the diagnostic laparoscopy this Thursday to confirm the treatment option. we don't meet with our oncologist to discuss how we will proceed until 6/9 as the dr. is booked solid. we are praying for the best this Thursday. 

 

On 5/26/2008 jasmine212 wrote:

thx for your message andi68, and that's wonderful news! can you tell me when were you dx'd and how quickly you were able to initiate chemo? my dad was initially dx'd on 4/30, but we are still waiting to do the diagnostic laparoscopy this Thursday to confirm the treatment option. we don't meet with our oncologist to discuss how we will proceed until 6/9 as the dr. is booked solid. we are praying for the best this Thursday. 

I was diagnosed on Dec.14, 2006.  The following Monday I was with my Oncology and Surgical team at Hershey Med.  They scheduled an ultrasound scope for me on Dec 26, a colonoscopy Dec 27 and a PET scan on Dec 29.  The initial biopsy they took on Dec 14 was inconclusive, then the additional biopsy they took was also inconclusive, so on Jan 2 they did another scope and took another biopsy.  I started my initial chemo the second week or third week of January.  I took my second round in February. With both rounds I ended up in the hospital for a week with a blood infection.  After this they decided I was inoperable and we took a step back and sought other opinions. 

I chose Cancer Treatment Centers of America in Philadelphia.  The totally right choice for me.  It was there Ihad what I described in my previous post.  They are great.  If you need any more info just let me know.

i think i remember reading a clinical trial in National Cancer Institute under clinical trial adn stomach cancer that stated something like chemo after surgery was better... dont know exactly the cercumstances though,,,, atleast you have the options of surgery,,,, dont under investigate,,, if you have an email I can Fwd you some of the info i have already sent to our nurse,,, --Message edited by CancerCompass staff. For personal protection, email address removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html--