Cancer

Where Things Stand

Chemo closed at 9 rounds of FOLFIRI — final round June 4, 2026
CRS+HIPEC surgery July 15, 2026, Champalimaud (Lisbon) — CC-0
Pathology July 28, 2026 — PCI 5
Now: recovery and surveillance, scans every 3 months

The Plan, and What Happened

The plan was 12 cycles of FOLFIRI chemotherapy, given every other week, for a total of approximately 24 weeks. Timing shifted when bloodwork required a pause — the liver gets a vote. Cycle 4 resumed after a 43-day hold.

After 3 cycles, early scans confirmed the cancer was responding — the tumors were shrinking. After cycle 8, a CT and MRI showed complete imaging response: no visible nodules. My oncologist cancelled the remaining cycles and I moved to the surgical pathway. One final round went ahead on June 4 before the pre-surgery window. Nine cycles in total, not twelve.

That is the pattern to understand if you are on this road: the chemo is not the finish line. It is what earns you the surgery.

Surgery After Chemotherapy

When chemotherapy is effective and disease burden is low enough, major surgery is the next step. There is typically a 6–8 week window between the last chemo infusion and surgery to allow the body to rebuild before a major operation. Mine was six weeks: last infusion June 4, surgery July 15.

Cytoreductive Surgery (CRS) ± HIPEC

This procedure targets peritoneal (abdominal lining) disease.

• Surgeons remove all visible cancer within the abdominal cavity.
• This may involve portions of the colon, peritoneum, omentum, or other affected tissues.
• Liver tumors, if present and treatable, are addressed separately through resection or ablation.
• In selected cases, heated chemotherapy (HIPEC) is circulated within the abdomen for approximately 60–90 minutes to target microscopic disease.

This is a complex, high-risk operation. It is only offered when the potential benefit justifies it.

Recovery Expectations

• Surgery time: approximately 8–14 hours
• ICU stay: often 1–3 days
• Total hospital stay: about 10–21 days
• Temporary drains or feeding tubes are common
• Fatigue, weakness, and muscle loss are expected during recovery

Most people return to baseline daily function within 3–6 months, with full recovery taking up to 12 months. The surgery blog posts cover what mine looked like week by week.

When This Surgery Is Considered

Surgery is only offered if:

• Chemotherapy demonstrates the cancer is responsive
• The amount and location of disease make complete removal realistic
• You are medically and physically fit for major surgery and the recovery that follows

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Treatment Timeline

Every treatment and imaging event from the first FOLFIRI infusion to final pathology.