Hi,
The risk for relapse is based on the extent of disease (there are subclassifications of stage 3, based on
number of lymph nodes involved and variations on how deep were the layers of the bowel wall involved in the
primary site), his age, the presence of other diseases like heart disease, hypertension, etc.).
An estimate of disease recurring is a 5 year recurrence rate. This estimates the percentage of patients who
get a relapse within 5 years. So that if there are 100 patients with cancer, and the recurrence rate is 50%,
about 50 of the 100 patients would have cancer again within 5 years. Most relapses occur within the first 2-3
years.
If he is about 60 years old without any other diseases, and with minimal involvement of lymph nodes (1-3 lymph
nodes showed cancer):
5 year recurrence rate without any chemo is about 49%, with chemo this is reduced to 23%
If he has more lymph nodes (more than 10 nodes showed cancer):
5 year recurrence rate or death without any chemo is about 96%, with chemo this is reduced to 67%.
Bear in mind these are estimates that the disease has returned, not risk of death due to the disease. There is
also an estimate of this, which you asked in your other post.
The chances of getting pain would of course be a function of the recurrence rate. Cancer pain would also
depend on the what structures the cancer may involve. For colon cancer, most of the metastasis would involve
the liver, it is usually detectable before the pain occurs. Bone metastasis commonly has cancer pain, but
colon cancer does not usually involve bone. Other sources of pain would be extension into the nerves near the
primary site, local extension is typical for rectal cancer not for colon cancer.
However way things go, if the cancer returns –pain would always be addressed so I don’t think this should
distress you. The neuropathy is likely due to the chemotherapy (this is not cancer pain). It may be helpful to
give Vitamin B supplements (if it is due to Fluorouracil - a drug commonly used in colon cancer), but if it is
due to the Oxaliplatin, there is no specific therapy, however it is expected to improve with time. Best to
avoid what triggers it, such as cold temperatures.
If the cancer returns, average survival is about 2 years. Keep in mind though, that when the cancer returns
and it is limited (say a single nodule in the liver only), there is a chance of cure with surgery which could
provide a survival superior to the 2 year average. So if it comes back, a re-evaluation must be made to help
you make the most appropriate decision.
