4 doctors weighed in:

Why does my wife need chemo? My wife was operated on for colon cancer it went well they removed 12 lymphnodes 4 of them had traces of cancer we just had a petscan and it came back clean no organs affected.Why would my wife need chemo if scan was clean.?

4 doctors weighed in
Dr. Lauren Stegman
Radiation Oncology
2 doctors agree

In brief: PET

Pet scans usually can only see tumor measuring about the size of a small raisin (1 cm).
A tumor this size already contains about 1 billion cancer cells. When multiple lymph nodes are invovled there is a very high chance that there are tiny clusters of cells in other lymph nodes, surrounding tissues, or organs. Chemotherapy or other treatments are often given after surgery to hopefully kill these remaining bad cells. We know that this increases the chances of beating the disease based on randomized trials in which brave people who had colon cancer in their lymph nodes and normal scans after the operation agreed to get chemotherapy or not based on the flip of a coin. Those who got the chemotherapy lived longer and had relapses less often and later in life.

In brief: PET

Pet scans usually can only see tumor measuring about the size of a small raisin (1 cm).
A tumor this size already contains about 1 billion cancer cells. When multiple lymph nodes are invovled there is a very high chance that there are tiny clusters of cells in other lymph nodes, surrounding tissues, or organs. Chemotherapy or other treatments are often given after surgery to hopefully kill these remaining bad cells. We know that this increases the chances of beating the disease based on randomized trials in which brave people who had colon cancer in their lymph nodes and normal scans after the operation agreed to get chemotherapy or not based on the flip of a coin. Those who got the chemotherapy lived longer and had relapses less often and later in life.
Dr. Lauren Stegman
Dr. Lauren Stegman
Thank
Dr. Ariel Lopez-chavez
Internal Medicine - Oncology
1 doctor agrees

In brief: This

This is an excellent question! even though all of the cancer was removed during surgery, when colon cancer spreads to the lymph nodes, there is a higher risk of the cancer coming back at some point.
The reason for this is that even though the surgeons removed all the cancer that they could see, we know that some times there may be some microsocopic cells left behind that neither the surgeon or the pet scan can see. An example of these microscopic cells is what they found in the lymph nodes. In order to kill any potential microscopic cells that could have been left behind in other places and reduce the risk of the cancer ever coming back, we use chemotherapy. Medical oncologists around the world have done a lot of research on this and we have seen that chemotherapy significantly reduces the risk of the cancer coming back and that is why we recommend it to patients like your wife. Now, one thing to keep in mind is that even though chemotherapy reduces the chances of the cancer coming back, it does not bring the chances to 0%. Even with chemotherapy, there is still a chance that the cancer may come back and that is why we need to keep a close eye on patients even after chemotherapy. So, as of right now, we can say that your wife has been "cured" from the cancer accoding to what the pet scan is telling us. Now, your doctors are trying to decrease the chances that the cancer may come back at some point and that's why your wife needs chemotherapy. Thank you for sharing this excellent question. This is a very important topic that the medical community has been investigating for a while and that every patient going through the same situation needs to understand well before getting any chemotherapy. Make sure to ask your doctor to talk to you about the pros and cons of receiving chemotherapy, side effects and risks involved. You need to be well informed before you make a decision on this. All the best, ariel.

In brief: This

This is an excellent question! even though all of the cancer was removed during surgery, when colon cancer spreads to the lymph nodes, there is a higher risk of the cancer coming back at some point.
The reason for this is that even though the surgeons removed all the cancer that they could see, we know that some times there may be some microsocopic cells left behind that neither the surgeon or the pet scan can see. An example of these microscopic cells is what they found in the lymph nodes. In order to kill any potential microscopic cells that could have been left behind in other places and reduce the risk of the cancer ever coming back, we use chemotherapy. Medical oncologists around the world have done a lot of research on this and we have seen that chemotherapy significantly reduces the risk of the cancer coming back and that is why we recommend it to patients like your wife. Now, one thing to keep in mind is that even though chemotherapy reduces the chances of the cancer coming back, it does not bring the chances to 0%. Even with chemotherapy, there is still a chance that the cancer may come back and that is why we need to keep a close eye on patients even after chemotherapy. So, as of right now, we can say that your wife has been "cured" from the cancer accoding to what the pet scan is telling us. Now, your doctors are trying to decrease the chances that the cancer may come back at some point and that's why your wife needs chemotherapy. Thank you for sharing this excellent question. This is a very important topic that the medical community has been investigating for a while and that every patient going through the same situation needs to understand well before getting any chemotherapy. Make sure to ask your doctor to talk to you about the pros and cons of receiving chemotherapy, side effects and risks involved. You need to be well informed before you make a decision on this. All the best, ariel.
Dr. Ariel Lopez-chavez
Dr. Ariel Lopez-chavez
Thank
1 comment
Dr. George Klauber
Agree with excellent answer by Dr Lopez-Chavez. We refer to your wife's present state as "No Evidence of Disease". Obviously we all hope she is cured, but NED is a more accurate description than cured.
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