Post surgical gameplan

I met with oncologist to discuss follow up treatment. He wanted to do some additional testing on the tumor that was removed at surgery. Specifically, he wanted to test for microsatellite instability (MSI), which is involved in DNA mismatch repair. He said there’s a population of patients with colorectal cancer patients, about 15% that are high MSI and these patients do not respond well to follow up chemo with FOLFOX. However, neoadjuvant treatment shrunk the tumor so much that there may not be enough tissue left to do additional testing. He put a call into the pathologist who read my slides to see if indeed there was enough tissue remaining to test for MSI and was waiting to hear back from him. In the meantime, treatment would proceed 

The upshot is that that I have an appointment on May 9th. Hopefully, there will be enough tissue remaining that the test can be performed and we can get the results back before the 9th. As is stands now we will be moving forward with the standard 6 month FOLOFOX chemo regimen (12 cycles), e.g. every 2 weeks I go into the office for a 4-6 hour infusion of Oxaliplatin, Leukovorin and 5-FU in the chair followed by a 46 hour infusion of 5-FU (European carryall). He said that patients may experience problems with neuropathy around the 7th or 8th cycle and since I’m diabetic we’ll need to watch this closely and may need to stop chemo at that point. I’m not sure when I will be starting chemo. All I know is that it will be sometime after May 9th.