Surgery Scheduled

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Rikimaroo
Posts: 24
Joined: Tue Dec 20, 2016 8:48 pm

Surgery Scheduled

Postby Rikimaroo » Tue May 09, 2017 7:44 pm

Hello,

Just wanted to update everyone and get some understanding. My Chemoradiation completed on 3/9 with great results. Tumor shrunk and so did lymph nodes that were suspicious.

Surgery is scheduled for 6/6/2017 and it is a Laparoscopic and TME with coloanal anastomosis. I just want to make sure this is right. I am a bit nervous of why a TME is needed as well, but I am not sure, if they are usually done together.

Of course I am very apprehensive about surgery.

The radiation therapy was so painful in the booty when passing stool, but I am better now, that was done 3/9.

MRI results 2nd time around:

IMPRESSION:
1. MRI rectal cancer T category is T2
2. Maximum EMD of invasion is 0 mm
3. Minimum tumor to MRF distance is 21 mm
4. Low rectal tumor component No
5. Mesorectal lymph nodes/tumor deposits: Negative (resolution of
suspicious mesorectal adenopathy)
6. EMVI: Absent
7. Extra-mesorectal nodes: Suspicious-moderate interval regression of
left obturator and internal iliac adenopathy.
8. Tumor regression grade: TRG 2 - good response to therapy.

MRI results 1st time

IMPRESSION:
1. MRI rectal cancer T category is T2 or early T3.
2. Maximum EMD of invasion is 0 mm.
3. Minimum tumor to MRF distance is 0 mm (i.e. potential CRM is
threatened).
4. Low rectal tumor component No.
5. Mesorectal lymph nodes/tumor deposits: Suspicious.
6. EMVI: Positive.
7. Extra-mesorectal nodes: Suspicious.


Any advice would be great.

Thanks,
Rikimaroo
38 y/o male, 3 kids 7,9,14
12/12/16 Colonoscopy, DX Tumor recto sigmoid 9CM from anal verge
12/16/16 Biopsy Results in Malignant, no staging
12/22/16 Pet Scan; 12/28/16 MRI; 12/29 T3N1M0 Stage III possibily
1/2017 Chemo Radiation Planned prior to surgery
1/26/2017 Chemo 3500 MG Xeloda/Radiation Begins
3/9/2017 Completed Chemoradiation, good response
5/1/2017 Met with surgeon to follow-up Surgery schedule 6/6/17

Basil
Posts: 207
Joined: Thu Mar 16, 2017 12:33 pm

Re: Surgery Scheduled

Postby Basil » Tue May 09, 2017 8:10 pm

I don't have any advice or wisdom to offer because I'm a half step back but I will give a friendly chest bump to someone traveling in a similar lifeboat.

I'm t3n1m0 rectal seven cm from the verge Dx 3/16/17. Opted for a trial with FOLFOX instead of chemorad. Just finished round 3 of 6 neoadjuvant (Folfox sucks by the way). I'll defer to the drs before celebrating but my body says the tumor is shrinking. Surgery scheduled for early August.

I'll be looking for your follow posts!
40 y/o male, kids 6&9
Dx 3/16/17, rectal cancer S3,t3,n1,m0
PROSPCT trial (FOLFOX in lieu of chemorad)
FOLFOX 4/5/17 - 6/26/17
LAR 7/31/17, temp ileo
pathological complete response
Adjuvant chemo cancelled (IDEA Study)
Ileo reversed 9/25/17
NED

Rikimaroo
Posts: 24
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery Scheduled

Postby Rikimaroo » Tue May 09, 2017 8:16 pm

Thanks brother, we going to make it through this. I updated my signature with more accurate information.
38 y/o male, 3 kids 7,9,14
12/12/16 Colonoscopy, DX Tumor recto sigmoid 9CM from anal verge
12/16/16 Biopsy Results in Malignant, no staging
12/22/16 Pet Scan; 12/28/16 MRI; 12/29 T3N1M0 Stage III possibily
1/2017 Chemo Radiation Planned prior to surgery
1/26/2017 Chemo 3500 MG Xeloda/Radiation Begins
3/9/2017 Completed Chemoradiation, good response
5/1/2017 Met with surgeon to follow-up Surgery schedule 6/6/17

[Ana & Alex]
Posts: 81
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: Surgery Scheduled

Postby [Ana & Alex] » Tue May 09, 2017 8:27 pm

Dear Rikamaroo,

I'm getting surgery latter today and I've finished radiation on 6/3. Studies show that waiting until 60 days is safe. In a Congress at a central Hospital of Vienna about rectal cancer there was a talk about waiting longer when patients show a good response to chemo radiation.

Standard of care for rectal tumors above 3.7 cm in our Hospital is a Total mesorectal excision through a low anterior ressection. This means they are taking the Rectum and Mesorectum with all included Lymph nodes in the rectal area (TME). LAR is for low anterior ressection and this means usually performing TME in the low sitting tumors of the Rectum leaving the sfincters intact.

This may be done laparoscopicly and through the Anus, which is then called transanal minimal invasive surgery (TAMIS).

I feel you, when you talk about being apprehensive about surgery. I'm glad that I'm getting it done so that I can move forward. These last weeks were really hard for me, weighing options and making a decision.

Try to think about what are your short and long term objectives and to find peace within them when going forward.

God knows I'm trying :)
All the best for you, I'm really glad chemo radiation made a number on your tumor :)

Keep pushing forward,
Stay strong

Ana
Dx @ 29 yo. Mum (22. Mo) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d

Rikimaroo
Posts: 24
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery Scheduled

Postby Rikimaroo » Tue May 09, 2017 10:28 pm

I like to clarify it's a TaTME with laparoscopic, not a TME. Does that mean I keep some of my rectum? Since tumor is 9cm from Anal Verge I am assuming so. It's just confusing the doctor did show that some rectum will stay.
38 y/o male, 3 kids 7,9,14
12/12/16 Colonoscopy, DX Tumor recto sigmoid 9CM from anal verge
12/16/16 Biopsy Results in Malignant, no staging
12/22/16 Pet Scan; 12/28/16 MRI; 12/29 T3N1M0 Stage III possibily
1/2017 Chemo Radiation Planned prior to surgery
1/26/2017 Chemo 3500 MG Xeloda/Radiation Begins
3/9/2017 Completed Chemoradiation, good response
5/1/2017 Met with surgeon to follow-up Surgery schedule 6/6/17

scohow66
Posts: 17
Joined: Fri Apr 07, 2017 9:54 am

Re: Surgery Scheduled

Postby scohow66 » Thu May 11, 2017 6:24 pm

Hi - I just had TME via LAR robotically with temp loop ileostomy. I was T2N0M0, but had really good response to chemo rad so final path was T0N0M0. Went with full blown surgery to know for sure if LN impact and whether post surgery chemo would be needed. Its major and I am still in recovery, but doing well. ileostomy is manageable and back eating pretty much what I want. I had all of my rectum removed, save for about 5mm at very bottom so basically a colo anal connection. Expect some challenges when i have the reversal, but taking day to day right now.

Best of luck! Not a lot of great options with this kind of thing, you have to do what you are comfortable with. I could have done excision, but would have been left with unknowns on LN and possibly greater risk of recurrence. LAR was the right call for me.

Take care,

Scott
51 Year old male
Dx with RC 10/2016 (T2N0M0)
Port implanted 11/2016
Rad with 5FU December 2016-January 2016
LAR robotic with temp loop ileo 4/2016
ypT0N0M0 - cPR to chemo/rad
Ileostomy reversal 10/2017

Lee
Posts: 5258
Joined: Sun Apr 16, 2006 4:09 pm

Re: Surgery Scheduled

Postby Lee » Fri May 12, 2017 5:24 pm

All the best with your upcoming surgery. If you are up to it, start walking and getting yourself in good health and shape.

For me, radiation was the worst. Made surgery and chemo easier.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

Rikimaroo
Posts: 24
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery Scheduled

Postby Rikimaroo » Mon May 15, 2017 12:18 pm

Thanks everyone for the well wishes. I have a Flex Sig coming up for ink marking, and pre op stuff. Flex Sig they say they put you to sleep. So apprehensive about all of this.
38 y/o male, 3 kids 7,9,14
12/12/16 Colonoscopy, DX Tumor recto sigmoid 9CM from anal verge
12/16/16 Biopsy Results in Malignant, no staging
12/22/16 Pet Scan; 12/28/16 MRI; 12/29 T3N1M0 Stage III possibily
1/2017 Chemo Radiation Planned prior to surgery
1/26/2017 Chemo 3500 MG Xeloda/Radiation Begins
3/9/2017 Completed Chemoradiation, good response
5/1/2017 Met with surgeon to follow-up Surgery schedule 6/6/17

Rikimaroo
Posts: 24
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery Scheduled

Postby Rikimaroo » Thu May 18, 2017 10:09 pm

Hello Everyone,

So I did Flex Sigmoidoscopy today for tattooing and to check if tumor is still there. The tumor is totally gone. My mind is racing as at one point this is GREAT news, but worried about if the doctor is going to push on to do surgery and why if no tumor. Awaiting biopsy results again from the flex sig, but if negative, I think I should ask about watch and wait, because I rather not do surgery if I am cured by chemo radiation. This is great news, and I am very happy that I had CCR. Like some others here. I really hope things turn out like Weisssoccermon and PRS and some others, I would love to not do surgery and move on with my life.

I have totally changed my diet, no red meat since December 2016. Drink Soursop Tea, that my mother makes from the tree leaves, and 4 water bottles a day. Battle goes on, but I am going to do everything I can to never have a recurrence.

Will update once I here from Surgeon next week regarding results.
38 y/o male, 3 kids 7,9,14
12/12/16 Colonoscopy, DX Tumor recto sigmoid 9CM from anal verge
12/16/16 Biopsy Results in Malignant, no staging
12/22/16 Pet Scan; 12/28/16 MRI; 12/29 T3N1M0 Stage III possibily
1/2017 Chemo Radiation Planned prior to surgery
1/26/2017 Chemo 3500 MG Xeloda/Radiation Begins
3/9/2017 Completed Chemoradiation, good response
5/1/2017 Met with surgeon to follow-up Surgery schedule 6/6/17

Lee
Posts: 5258
Joined: Sun Apr 16, 2006 4:09 pm

Re: Surgery Scheduled

Postby Lee » Thu May 18, 2017 10:37 pm

Okay, I was diagnosed over 13 years ago, believe me A LOT has changed since then. My advice, if surgeon says surgery, you might want to consider it. Believe me, they deal with this stuff all the time. If you want, get a 2nd opinion (& I HIGHLY recommend this) and if the 2nd opinion is the same, take that as a cue. YOU NEED THE SURGERY TO BEAT THIS. If no, you decide from there. Butt if your cancer is aggressive, possible lymph nodes, etc, than chances are you have a few floating cancer cells in your body. You've only got one shot the 1st time to get this right. Give 110% now. Not when you are dealing with a distant met.

Hope this helps, all the best,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!


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