Follow up/preemptive chemo for patients in partial remission

This is a bit of a long shot.

My question is whether anyone in a similar position to me has been given chemo as a second, perhaps preemptive, attack on the remaining cancer, either privately or as part of NHS funded treatment? 

After I finished my chemo, which thankfully put me into partial remission, I was put into a "watch and wait" scenario. I have CT scans every six months and I'm basically waiting for the cancer to start growing before I restart chemo. I've been in this situation for about 18 months and my body has almost fully recovered from the side effects of the chemo. I am obviously really happy about this unexpected outcome but I'm beginning to wonder whether "watch and wait" is the right approach for me.

We know that a quite large cancer is still there where the oesophagus meets the stomach and that it is wrapped dangerously around my aorta. I'm now fit enough to endure another few rounds of chemo which might shrink the cancer again, or at the very least discourage it from growing. If I wait until it has grown enough for the change to show on a CT scan, its growth may be unstoppable.

I thought I'd ask on here before I discuss my thoughts with my oncologist. I've done extensive searching using Google and Google Scholar and have so far drawn a blank. My thoughts are that if I were to present as a new patient with a similar sized cancer in the same place, I'd probably be offered chemo to try to shrink it. So why not repeat my treatment as if I were a new patient? 

Thanks
Dave

 

Parents
  • Hello Davek,

    Lucie has asked us if there is anything we can say.

    In advanced cancer, as a general rule after initial (first line) chemotherapy, no further treatment is given until the cancer progresses (starts to grow again).  As you know, because of the side effects, there is a trade off between treatment potentially doing some harm and potentially doing some good. Chemotherapy tends to work best on rapidly dividing cells and not so well in a cancer that isn’t growing fast. So although a pre-emptive strike is a logical idea, it might not work well enough and could be a waste of ammunition that would come in handy later on. But every case is unique and it is always worth talking things over with the specialist again, so do bring this up when you see them and let us know what they say.

    Take care,

    Julia

Reply
  • Hello Davek,

    Lucie has asked us if there is anything we can say.

    In advanced cancer, as a general rule after initial (first line) chemotherapy, no further treatment is given until the cancer progresses (starts to grow again).  As you know, because of the side effects, there is a trade off between treatment potentially doing some harm and potentially doing some good. Chemotherapy tends to work best on rapidly dividing cells and not so well in a cancer that isn’t growing fast. So although a pre-emptive strike is a logical idea, it might not work well enough and could be a waste of ammunition that would come in handy later on. But every case is unique and it is always worth talking things over with the specialist again, so do bring this up when you see them and let us know what they say.

    Take care,

    Julia

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