Jolene wrote:Does the sigmoidoscopy requires a full operating theater preparation and admission(in-patient) like the colonoscopy does ? Or is it simply done at the doctor's clinic (out-patient) ? Were you under sedation ? I just googled and it says typically not, but with a scope up in the bum for 10-20 mins that sounds pretty agonizing even though its supposed to be painless. The regular 30 second anal check is already very uncomfortable for me ! Lol !
I was not advised to have a clear liquid diet at all, why is that so.. hmmm !
lakeswim wrote:He had to really look around to find the tattoos. He remarked how everything looked good.
lakeswim wrote:I wrote a lengthy post about my appt @MSK this week but the draft I had saved disappeared. Here's an abbreviated replacement. (I have my first cold post-treatment and it's quite a doozy so I don't have much energy.)
Interesting things to note about MSK:
- My MRI @ MSK was a RECTAL MRI vs. the 3 PELVIC MRIs I have had locally. Apparently, there is a difference. Rectal MRIs provide better scans. They also use a special drug to slow down motility to get better pictures. Rectal MRIs are not available everywhere....
- MRI@ MSK is read by a radiologist who specializes in reading colorectal MRIs.
- Tumor board who will hear my case next week is made up of doctors who deal STRICTLY with colorectal cancers. It is not a general cancer tumor board like the one locally.
(*Please note: I truly value my team locally, but these are important distinctions when you have big decisions to make.)
I saw Dr. G-A, the Head of Colorectal Surgery, the next day. In his opinion, the flex sig is the MOST IMPORTANT data point for him (moreso than the MRI), in terms of determining a complete response. So, after a digital exam, he did a flex sig. I was awake and watched. (This was my 3rd flex sig, but my first without anesthesia and it was really no big deal. I actually prefer the flex sig to the digital exam. And why go through anesthesia if you don't have to?) He had to really look around to find the tattoos. He remarked how everything looked good.
Dr. G-A had spoken to the radiologist on the phone the previous day after my MRI and the radiologist said the entire primary tumor is gone and she was "unimpressed with infiltration of the uterus."
(Note: I did chemo first and then chemo/rad. I am now 3 months out from chemo/radiation. I had a Pelvic MRI after chemo, which found the tumor had shrank "significantly" and then another Pelvic MRI last month - 6 weeks post radiation - that showed the tumor was completely gone. My local team wouldn't offer me W&W due to their opinion that the latest Pelvic MRI was "mushy" and the "indistinct fat plane" may indicate invasion of the uterus. They did NOT consider mine a complete response so didn't see me as a candidate for W&W and recommended surgery.)
Dr. G-A considers my response a complete response and he'd consider me, if I were on his trial, as a candidate for W&W. He did say it is best to do W&W on a clinical trial to assure compliance to the protocol, which is rigorous. But, he said that if I were compliant with the protocol, he considers my response complete and, in his opinion, I may consider W&W. (The MSK protocol is Flex sig - quarterly. Rectal MRI - every 6 months. I need to check my notes on the CTs.) The tumor board will meet next week to discuss my case but the post-doc fellow told me after Dr. G-A left that the board usually shares his opinion. (Also, he said my case is "not complicated.")
Dr. G-A said that their experience shows that salvage surgery is "typically" no more complicated than having surgery now (there are the few that are more complicated, but that's a minority).
There were also a few minor differences in how he would approach my surgery vs my surgeon here if I were to choose surgery. And he also added some info that I hadn't yet heard - specifically that my bladder function will be affected should they need to take my uterus. (So, surgery may affect both bladder on top of bowel function.) Lastly, he refused to make any prediction about the extent I will have LARS (my local team made predictions that it "wouldn't be that bad") as he said it's not easy to predict.
The post-doc fellow brought up all the female side effects of treatment/surgery and told me they have a team @MSK that helps patients deal with these side effects. The team had, in fact, just presented at the tumor board last week. This was nice to hear, given I had to learn about those side effects on this forum while my Rad Onc team here said little/nothing about it.
Given I am sick, I am not making any big decisions this weekend. Plus, I will wait to hear from their board on Monday. Meanwhile, I am making my way (for probably the 3rd or 4th time) through this W&W thread from the beginning to end. Thanks everyone for your different perspectives! It's a difficult decision for sure. But I feel better (and fortunate) to have been seen by doctors at one of the premier cancer centers in the country.
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