OT Chemo question

This is off topic, but I feel I know many of you and am interested in your opinions. I realize the decision is all mine but still wonder what you guys might do in this situation.
In early July I had appendicitis. Emergency surgery was performed and I recovered well. I went to my surgeon a week later for a routine follow up and was told cancer was found in the appendix and it was high grade goblet cell (very rare). He ordered chest, abdominal, and pelvic CT which all were clear. A CEA blood test was normal. He recommended a right hemicolectomy to check for positive lymph nodes. I had the surgery last week and all pathology was negative.
Today I had my second visit with my oncologist who described 2 adjuvant chemo regimes, Folfox and Xelox. Folfox would be 6 months of treatment and Xelox 3 months. He does not recommend Xelox even though it’s effective because he think the side effects are terrible for many.
He also said at this stage of my cancer journey there is no cancer found. I am stage 2A and have statistically a 20% chance of recurrence if I do nothing. He said I am in excellent health and may tolerate the chemo OK, but significant chance I could be left with permanent neuropathy in feet and hands and perhaps some other negative residual effects.
If I have the either one of the chemo choices, it may reduce my recurrence odds by 5%. That is debatable he said as some clinicians think it offers no reduction in recurrence risk. Others think it does.
He said he has treated “tons” of stage 2 patients without adjuvant chemo and only one has had a recurrence. I asked if he personally would take the chemo if he were in my shoes and he said no, but as my oncologist he has to offer it to me.
I want to discuss with MD Anderson but I’m running out of time since the ideal time to begin the chemo is 4 weeks from surgery. It’s already been 6 weeks since my appendectomy, which I assume is when the clock began. He said after 12 weeks it is of no benefit to start adjuvant chemo.
My wife and children said they wouldn’t do the chemo. Too much risk of damage for such little benefit. I am on the fence.

HR, my niece had appendix cancer, but under entirely different circumstances. First, as you say very rare. Only about 1,000 per year in the USA. Of the four types, the goblet cell is among the least aggressive and is generally slow growing. Unfortunately, my niece had a combination of the worst types being signet-ring cells and mucin.

As I understand there are basically two ways it is discovered. First, the way you did, incidental to an appendectomy at an initial stage before any metastasis or symptoms. In those cases the treatment success is very good. My niece unfortunately presented with end stage metastatic disease and symptomatic. At that stage nothing works.

I assisted her husband with research as this all came about at exactly the same time my wife had a double mastectomy and I was dx with PCa. At that time the top places were UCLA, Stanford, MD Anderson and with a Dr. Paul Sugarbaker at the Washington Cancer Institute. He has developed a special surgical and chemo treatment (named for him) for this cancer when it has invaded the peritoneum area and is considered to be the leading expert. My niece consulted with both Stanford and UCLA. She chose UCLA as she lived in The Los Angeles area. She also had a phone consult with Dr. Sugarbaker.

If I were you, I would get into contact with MD Anderson and consider these other venues at least for an initial phone consultation. You can get your information to them and they may be able to provide direction quickly without physically seeing you. I infer that what you want is guidance on the use of adjuvant chemo.

Interesting that your medical oncologist has treated several cases. Please refresh my memory as to your location.

I wonder if judging the pathology of appendix cancers is simple compared to PCa? Is there a preeminent appendix pathologist who could examine your slides?

Just a thought.

I was hoping I'd hear from some of the guys who've had chemo and how they did with it. So far everyone in my family and close friends would not do it. They fear that because I'm so active and such good health, exercise every day, travel a lot with my wife, etc., I will have to endure not only the 6 months of chemo but perhaps another year to recover to the state of health I now enjoy, maybe never regaining it 100%. They all think it's just not worth losing 18 months of quality of life for 5% lower risk.

HR, I also found a good description on www.rarediseases.info.nih.gov. Search for goblet cell carcinoid. Recurrence and survival statistics are tough as many of the cancers are significantly advanced at diagnosis. Positive indicators are when the tumor is less than 2 cm and no evidence of spread. The NIH report on Goblet cell shows 76% at five years, but does not breakdown by stage at dx.