Hopepray wrote:In a dilemma myself after onc surgeon says get surgery on the safer side. As biopsy during flex sig following a neoadjuvant or preop chemoradiotherapy(1500mg cap per day plus 50.4 gy in 28 days) said negative for disease, even an mri and pet ct done four months apart agree.
However I am a bit unsure now as to what approach to take. The docs both medical and surgical say we would say get surgery but the decision lies with you.
prs wrote:Hopepray wrote:In a dilemma myself after onc surgeon says get surgery on the safer side. As biopsy during flex sig following a neoadjuvant or preop chemoradiotherapy(1500mg cap per day plus 50.4 gy in 28 days) said negative for disease, even an mri and pet ct done four months apart agree.
However I am a bit unsure now as to what approach to take. The docs both medical and surgical say we would say get surgery but the decision lies with you.
Hi Hoperay, great news that you had a complete, or near complete response. Also nifty624 has offered you some very useful advice, and a third alternative of much less invasive surgery!
I'm not quite sure how long it has been since you finished radiation, but I know my surgeon on the same day she told me I'd had a CCR, also recommended I start mop up chemo treatment immediately. If there are any stray cancer cells floating around in your system, it's probably better to hit them with the chemo sooner rather than later.
Hopepray wrote:Prs we finished CRT 28th March 2020, so it's been 11 weeks after treatment, and now we are thinking of doing the mop up chemo. Yes stray cancer cells are the worry for us as well, especially since it looked like 1 Node was involved in the workup investigations after the first DX. Is mop up or Adjuvant Chemotherapy a standard approach or more like a good to have treatment ?
prs wrote:If I'm not mistaken, I believe a lot of patients who have the surgery also have mop-up chemo.
CRguy wrote:prs wrote:If I'm not mistaken, I believe a lot of patients who have the surgery also have mop-up chemo.
Depending upon Stage, location, grade, mets or other "questionnables" I would have to say the answer is generally
YES to adjuvant chemo of some sort after resection.....
SO you are not mistaken !!
Cheers
CRguy
Hopepray wrote:Thx CRGuy, I have a vague question "Can cancer become more aggressive if anything remains after preop CRT especially if no surgery is done and W&W is followed." for which I didn't find good answers from my search in the forum. Perhaps you have seen such posts? Why I got this question is because one of the surgeons who said we need to get surgery mentioned this!
Hopepray wrote:
Prs we finished CRT 28th March 2020, so it's been 11 weeks after treatment, and now we are thinking of doing the mop up chemo. Yes stray cancer cells are the worry for us as well, especially since it looked like 1 Node was involved in the workup investigations after the first DX. Is mop up or Adjuvant Chemotherapy a standard approach or more like a good to have treatment ?
Jogey wrote:Watch and wait update
Hi Everyone,
Just an update on how my watch and wait is going. I was diagnosed stage 3 rectal cancer with spread to 2 lymph nodes and T3a in November 2018 and finished radiotherapy at the end of January 2019. Incredibly fortunately I had a clinically complete response. I chose to have 3 months of chemotherapy last summer/autumn as my oncologist said new research showed that would increase my chances. Am screened every 4 months MRI, sigmoidoscopy, CEA. and annual CT scan. So far very pleased to say I am all clear. My bowel function is very good and I don't have any symptoms to report.
I take the care oncology clinic drugs and also low dose aspirin and vitamin d daily.
I have read research on lifestyle to prevent colorectal cancer recurrence and I avoid red meat and sugar, have lots of fruit and vegetables, whole grains, fish, especially oily fish. I also eat tree nuts and have four coffees a day.
I walk an hour most days and do resistance training once a week. Most of this is based on research from Dr Charles Fuchs at Yale.
I have had a few nasty scares along the way which I won't go into but so far I am very pleased to say the news has been good and I actually feel really well.
Watch and wait is quite tough mentally, in that you are constantly having all these scans and oscopies and you never know what they are going to tell you. I especially hate the sigmoidoscopy as you get the results straight away and you could tell if something is wrong but you are lying there on the table with a camera up you. Obviously CT scans are also particularly frightening as they are looking for metastasis.
Having said all that I feel incredibly lucky to have so far avoided surgery and have full bowel functionality and no pain. I just really hope my luck continues to hold.
Can I also wish you all the very best results for your treatments whatever the details of it. And for any other watch and waiters out there I hope it is very successful for you.
Take care. Jogey
prayingforccr wrote:I was diagnosed with stage locally advanced 3 rectal cancer in november of last year and was lucky enough to be accepted into a clinical trial and treated at memorial sloan kettering where I underwent chemoradiation therapy involving 5 weeks of capecitabine, a radiation enhancing trial drug designed to keep cancer cells from repairing themselves, and 53 grey of radiation.
After 6 weeks, I had an mri. The doctors were all excited at the prospect of a complete response based on the mri, but upon a sigmoidoscopy and DRE, despite a robust response, there was still persistent disease, unfortunately.
After another month, I have begun folfox chemotherapy, the goal of which is to shrink/destroy what is left of the tumor.
This is known as consolidation chemotherapy.
So, the batting order is different.
CRT then folfox
My doctors and I are in full agreement that we will have done EVERYTHING possible to avoid radical surgery.
I am PRAYING for a complete response as I have decided after much reflection that I would rather end my life than undergo a surgery that would leave me with a bag.
Has anyone had a complete response after only a partial response from CRT, and THEN undergoing folfox?
I know it’s unorthodox, but I am trying to set expectations.
Thank you for reading and any responses
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