prs wrote:My experience with "Watch and Wait" is only with the Habr-Gama protocol for rectal cancer patients who show a complete clinical response to chemo radiation. I believe that Dr. Habr-Gama has published strict guidelines for "complete clinical response" and that she developed these guidelines after years of experience using this technique. I know my colorectal surgeon has studied these guidelines and uses them to assess her patients. I'm not sure what exactly they are, but I know they include the fact that the tumor must have completely shrunk away, and that the color of the remaining scar tissue is very important.
It didn't take much to persuade me to go this route when my surgeon explained that if the cancer did return she could still perform "salvage" surgery that would be the same as if I'd had surgery in the first place. I do faithfully go to my three month check ups, it's been a year now and "so far, so good". I have just about recovered from the six months mop up chemo, and my life is pretty much back to normal.
prs wrote:Determination of a clinical complete response is by visual observation only. I understand Dr Habr-Gama published photos and very complete descriptions of what the doctor needs to observe before declaring a CCR. My surgeon told me that these strict guidelines included a determinations of the color of the scar tissue, and the whiter it was the better.
lakeswim wrote:prs wrote:Determination of a clinical complete response is by visual observation only. I understand Dr Habr-Gama published photos and very complete descriptions of what the doctor needs to observe before declaring a CCR. My surgeon told me that these strict guidelines included a determinations of the color of the scar tissue, and the whiter it was the better.
After TNT (chemo and then chemo/Rad on the front end), my tumor (and it was a big one, apparently) is completely gone - per an MRI and a flex sig and a digital rectal exam - but due to the fact I don’t have a distinct fat plane between rectum and uterus, mine is not considered a complete response and I am not being offered W&W. (They don’t do biopsies - at least my surgeon said she doesn’t.)
I am working on an appt w/MSK (for a final opinion / confirmation) in a few weeks. But surgery is likely (I should think definitely ) in my near future.
prs wrote:Hi Jolene, FYI a flex sig goes in plenty far enough to fully examine the rectum, so no need for a full colonoscopy. A flex sig is a mini colonoscopy for rectal cancer patients.
Annie50 wrote:mozart13 wrote:
I'm so confused Mozart
I had CCR at top hospital The Christie with top surgeon and onco looking after me and MDT team he took 8 biopsies under anaesthetic to check and then no cancer cells so said W &W but no extra chemo as he says why when no evidence .. he did say I could speak to onco but seems so confusing ? Helllp ... xxx Annie xxx
Wonder why my surgeon mentioned that he wil be doing another colonoscopy in due time if I receive a complete clinical response ?
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