Stage 4 bowel cancer

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Is surgery always best?

Hi everyone,

Just wondering if any kind folks on here can help me get my head straight after another crazy day on planet BC.

I "finished" treatment in April, and my post-treatment CT scan showed massive progression while on FOLFOX (ovaries, peritoneum and 2 small new liver tumours). I'd been hoping to have CRS/HIPEC, but today I was turned down by my local hospital, the Christie. I'm hoping to get a second opinion from Jamie Murphy at Imperial by the end of this week, otherwise I'm back in the chemo chair on Monday.

The thing is, up until today, I'd been hell-bent on surgery, but when my oncologist explained the decision today, it all sounded quite reasonable... that because my cancer is so aggressive, it's better to get it under control with chemo before thinking about surgery. Is it also the case that if the cancer cells are active, microscopic bad cells would still be hanging around after surgery which will cause recurrence later on anyway? She didn't say anything about lymph nodes showing up on the PET scan.

All of this may be irrelevant, as Prof. M may say no anyway, but I just wondered if people had any insights on which to base my decision in the event that I am in a position to choose. It's just that once he makes his decision I'll need to decide quickly one way or the other. Hope this all makes sense, it's been a long day! Thanks for reading : )


Hi @rosa123 this is a good question! I'm sorry to hear about your recurrence too. So I'm not in exactly your situation but I know with s4 there is quite often a plan to do chemo and then surgery either to make more successful or to contain etc. So if surgery is not it may become one after chemo.... it really does depend. I had radio.for a recurrence but after another few nodes popped up the plan was chemo. Further radio isn't ruled out but given that the disease has spread further my team felt chemo was best option.

I have had a second op with Jamie Murphy and tbh if he thinks chemo is in ur best interests, he will tell you straight. He's v to the point but he's also v supportive and kind. He has a reputation for taking on surgery that maybe others won't but my experience is that he isn't cavalier at all but v thoughtful and he will tell you if he thinks surgery is possible but not in your best interests ATM.



Hi @louise28 thanks for getting back to me. That's really reassuring to know re Jamie Murphy. I'll just have to wait and see what he says... Hope you are doing OK :x::x:


Hey @rosa123 have a read of my profile May help. I was turned down for HIPEC twice as lymph involvement and lovely surgeon at Christie explained v well to me , stopping chemo to do hipec when I had active lymphs involvement would shorten life with cancer being able to move about and spread. I had many years of chemo and then a peri only recurrence so when just peri active, Christie did hipec then. I’m told it’s all about timing! I have seen Christie do hipec and combined liver resection but they can be cautious like Basingstoke vs JM being more radical. But see what is said! I have sadly seen over the years people pass away following operations where cancer progressed in other areas. But I have also seen JM take on Ops when chemo isn’t working and it’s last chance so he will take risks in a good way too! :x::x: