11 years of colon cancer, a summary made on January 10, 2021

This page is meant for anyone who has suggestions/comments on how I may extend my life expectations. And perhaps someone may benefit from my history. Send any comments to joop.kroes@gmail.com

My colon cancer history started during a sabbatical in 2009 at UC Davis (California, USA) where an old fashioned toilet made me look at my slightly red colored stool. Two weeks later, on October 29, I left a clinic near Sacramento with a clear result from the colonoscopy: a large mass at 55 cm almost blocking the colon. A few days later I flew back home and a Hemicolectomy-surgery was carried out in hometown hospital Rijnstate in Arnhem. A heavy chemo therapy followed in 2010. Unfortunately in 2011 another surgery was required: Hemihepatectomy to remove 2 metastases in segments 2 and 3. This was carried out in the University Medical Centre Radboud who was specialized in liver cancer surgery. I stayed there as patient until today. In 2015 the treatments for my disease went from curative to palliative and I started receiving systemic chemo therapies.

During the past eleven years I received about 64 chemo therapies given in 8 different compositions. I received 2 radiation treatments and underwent more than 30 CT-scans and 4 PET-scans.

An overview of all treatments during 2009-2020 is given in Table 1.

In 2015 I applied for a second opinion in NKI/AVL and informed about proton-therapy in Heidelberg (Germany). Proton-therapy was on option for metastases. NKI suggested gene-analyses.

In 2009 and 2015 limited gene-analyses were carried out with a biopsy from 2009 and showed: no mutation in KRAS and NRAS, wildtype BRAF and RAS, MisMatch Repair (MMR) status is: MSS.

In 2017 a sequencing was carried out by the Dutch CPCT (https://www.cpct.nl/) using a biopsy from 2016. This showed: a Tumor Mutational Load of 9, no PDGFRA amplification, so it seemed unfortunately no option to participate in DRUP study (https://clinicaltrials.gov/ct2/show/NCT02925234).

I just received a chemo therapy of Irinotecan, but I think that its efficiency is dropping. So I am soon going to be in need of alternatives.

 Table 1. Colon cancer history Joop Kroes 2009 – 2020

Year	Month	Treatment
2009	11	Hemicolectomy (left, descending, 6 cm) adenocarcinoma, stage: pT3N1M0
2010	01	adjuvant chemo: 8x capecitabine oxaliplatin
2011	07	Hemihepatectomy. liver metastases resection of segments 2,3
2015	07	stereotactic radiotherapy 3x18Gy due to growth 2 lung metastases
2015	09	progression of mediastinal and hilar lymphadenopathy
2015	12	radiation pneumonitis, treated with prednisone
2016	05	Thoracotomy right with resection of nodes in mediastinum, hilar station
2017	07	PET-CT shows increase in lung and suspected pericardial metastasis
2017	10	2000 ml pericardial fluid drained via puncture
2017	10	start chemo therapy capecitabine-bevacizumab via PICC line
2018	12	therapy pause  (low disease load normal CEA)
2019	06	therapy restart with S-1 (Teysuno alternative for Capecitabine)
2020	01	therapy continued with Cetuximab
2020	06	Cetuximab stopped due to increasing metastases in lungs which block trachea
2020	07	radiotherapy 8 x 3Gy on lung metastases
2020	08	start chemo therapy Irinotecan