I am a wait and watch adopter who avoided colon/rectal surgery three years ago when there was a complete response to the neoadjuvant therapy. I was initially diagnosed as T3N0M0. Although there was no surgery, there was a 6-cycle Xelox adjuvant chemo as well.
Unfortunately, a metastatic nodule was detected in my lung CT last year and it was removed with a VATS surgery. There was no chemo afterward. The frequency of my CT scans have gone up though.The nodule was detected two years after initial diagnosis. It was not detected in It was growing slowly and tested positive in biopsy.
I wanted to update this thread and let everyone know that not all wait and watchers are enjoying a cancer-free life. Hoping for the best.
Hi SKB - So sorry to hear about the metastatic nodule !
And thanks for sharing your story which is a good reminder for all of us not to take WW for granted. Your WW treatment approach sounds really similar to mine and I will as will all of us I'm sure, to keep up with all the checks and scans. I do have a tiny suspicious nodule on my CT scan which apparently is too tiny to warrant biopsy and further follow-up. Docs said it could also be lung scars from coughs. I had done two CT in the last one year since my diagnosis to follow up and due to the radiation required for the scans, the healthcare team advised I shouldn't be doing too many of it.
Can I ask out how frequent will your future CT scans be and seeing as it's metastatic and not local recurrence - are you monitoring only the lungs and are there any talks for surgery of the rectum ?
My CT scans are 3 months apart now. Each scan is scheduled only at the readout of the prior scan.
After the VATS surgery to remove the metastatic lung nodule, the two scans that I have had were "eye to thigh"- including chest, abdomen and pelvis.
I have been also having sigmoidoscopy of the rectum every three months for the last three years. This is to monitor local recurrence. Since that area has been cancer free ever since the neoadjuvant therapy was completed in 2017, there has been no talk of rectal surgery.
There is another person in this forum in Norway who had one metastatic lung nodule removed with VATS after the completion of Wait and Watch for organ preservation. Her id is Beccashocked.
One cant say for sure whether the metastasis could have been prevented by performing rectal surgery instead of wait and watch in the first place. It is possible the spread to lungs was seeded before the time we were faced with the decision to choose between wait-and-watch and radical surgery.
If you need to talk or need any additional information, please feel free to message me.
3/21/17: Dx T3N0M0- distal rectal cancer, 4.5cm tumor, 2.5 cm from anal verge
4/18 to 5/22/17: chemoradiation - Xeloda 1800mg twice a day for 25 days, 200 Cgy/day
6/28/17: biopsy shows no invasive adenocarcinoma
8/09/17: MRI - no primary tumor left, starts wait and watch
8/17/17 to 12/1/17: mop-up chemo with Folfox and oxaliplatin (IV infusion), every two weeks
5/19 expanding right lung nodule, 8mm
8/19 VATS wedge resection
9/19 Clean PET, NED, no detected alterations of BRAF, KRAS,NRAS, PIK3CA, PTEN