Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

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ocstacy
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Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby ocstacy » Fri Jun 23, 2017 10:13 pm

Just wondering if anyone had a full response with Neoadjuvant chemo/radiation with surgery following for Stage 3a rectal cancer (low grade)
Our oncologist mentioned something about a full response possibly happening. Did you notice the tumor shrank after a certain week after radiation?

I used to work in radiation oncology 15 years ago and rectal cancer was very rare (colorectal) I saw a lot more breast and prostate patients and chemo was way different back then.
I would love to hear any inspiring stories. :wink:
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

mozart13
Posts: 158
Joined: Fri Dec 09, 2016 7:38 pm
Location: Toronto

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby mozart13 » Sat Jun 24, 2017 3:19 pm

I went through simillar scenario, during chemo/rad treatment, I was passing something like flakes, purplish color.
There are few people on this board that had cCR, here is the link to that forum :
viewtopic.php?t=53498

Also here is the link to predictable outcome based on initial response :
https://www.cinj.org/sites/cinj/files/d ... 182012.pdf

Good luck to you, if you have any specific question feel free to ask.
55 year at the time of diagnosis, male
Diagnosed with T1,T2 N0 M0 rectal cancer
Total neoadjuvant therapy or TNT (chemoradiation followed by systemic chemotherapy)
Negative since Feb. '17
No surgery
Watch&Wait approach 8)
I don’t come much to the forum , so if this is not updated it means I remain negative!
Wish good luck to all!

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CRguy
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Joined: Sun Feb 10, 2008 6:00 pm

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby CRguy » Sun Jun 25, 2017 12:11 am

My own SitRep would be :
May 2007 - colonoscopy / biopsy confirms rectosigmoid adenocarcinoma, CT, MRI, many blood tests follow
June 2007 - 6 weeks neo-adjuvant chemoradiation with Xeloda ( 3600 mg/day ), blood tests, CTs
August 2007 - TME via LAR of primary tumour, originally Stage IIIC, temp ileostomy,
pCR ( pathological complete response to chemo-rad )


So if you are asking if neo-adjuvant chemoradiation works to accomplish a positive outcome ...?

Answer = Yes it can .. BUTT each situation is different.

Now please note I had pCR not cCR ( had the surgery and was confirmed by pathology review of the actual tumor site )

cCR is a clinical impression after treatment, without the full pathology being known ... BUTT a lotta scans and blood tests done to get a comfort zone about the results. The big discussion being : does a patient with cCR then also have surgery ?
I did and still had a recurrence 3 years later which was picked up by active aggressive monitoring.

Welcome to the forum
All the best to MOM and her new challenges.

Keep us in the loop and hopefully we can give you some feedback which will help you both

Best WIshes
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

Cj51
Posts: 893
Joined: Thu May 13, 2010 5:58 pm
Location: Midwest

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby Cj51 » Sun Jun 25, 2017 11:19 am

Yes. My treatment mirrored what you've described in your signature, and I had a complete pathological response. This was in 2010, Stage 3b, Adenocarcinoma. All scans and scopes since then have been clear.

Best of luck to you and your mom,
Cj
DX Stage IIIb RC, T3N1M0, April 2010, 51
6 wks Xelox/rad 6/10
resection, temp illeostomy 8/10 Complete response!
12 rounds FOLFOX for clean up 9/10, Allergic to Oxi, started Xeloda only 12/10
Ileo takedown 9/28/11
4/2020 NED

hawkowl
Posts: 132
Joined: Sun Dec 14, 2014 5:29 am
Location: MN/FL

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby hawkowl » Sun Jun 25, 2017 10:27 pm

Yes, I had a pCr after neoadjuvant therapy (completed just over 2 years ago). Good luck!!
Dx 12/2014 T3N2MX (distant LPLN) low rectal
12/2014-4/2015: FOLFOX (8 cycles)
4/2015-6/2015: 28 cycles of chemoradiation with xeloda, SBRT
8/2015: Robotic APR with iliac node dissection; path showed ypT0,ypN0 (complete pathological response).
11/2015 scans clear, CEA 2.1
11/2015 parastomal hernia repair
3/2016 CEA 1.7, scans stable...
6/2020 5 years of normal CEA and stable scans
Now dealing with pyoderma gangrenosum.
Totally disabled due to oxaliplatin induced neuropathy and dysautonomia

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ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby ocstacy » Mon Jun 26, 2017 12:10 pm

Wow, thank you so much for all the confidence and replys! I actually had to google what PCR meant? lol. Pathololgical Complete Response is what we are praying for !

Thank you ,
Stacy
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

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Kick'nAssCancer'sAss
Posts: 248
Joined: Tue Feb 25, 2014 4:38 pm

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby Kick'nAssCancer'sAss » Mon Jun 26, 2017 5:03 pm

I have seen numerous studies that put a pCR at anywhere between 15-30%.
Good Luck
53M Dx RC Halloween 2013
CT & BONE scan
MRI/T3N0M0 1 suspicious LN
5 wks chemo/rad
LAR open TME Feb 26/14
temp bag
0/24 nodes pCR/pathological
Folfox (8) Mar 28-Jul 4 /14
Aug/14 clear CT scan
Aug 27/14 reversal
Feb/15 clear scope
July/15 Feb/16 Feb/17 Feb/18 clear CT scans
Feb/18 clear scope
Sept 19 clear CT scan & DISCHARGED :P
Mar/23 clear scope
CEA 1.6 @ dx
1.6,1.4,1.7,2.4,2.9, 2.7 2.3 2.5 2.2 2.1 2.5 2.6 2.7
2.7 Sept 19
0-4 normal
https://kickingasscancersass.blogspot.com/

Chickspeed
Posts: 43
Joined: Sat Jun 17, 2017 5:16 am

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby Chickspeed » Tue Jun 27, 2017 3:33 am

I don't have pathological reports yet. I had surgery June 20th. Before Neoadjuvant radiation/xeloda for 25 treatments my growth was described as:

"5-6 cm long. The lesion was circumferential"

The surgeon said at first they couldn't find the growth, and eventually did. He said it shrunk that much it was difficult to detect. So it went from 5-6 cm easy to see to barely detectable.

I hope you have great success!!
12/15/2016 Mod Diff tumour 5-6 cm 10-12 cm fr AV T3 tumour cea 1.4
12/29/2016 CT no spread ln normal
1/19/2017 MRI confirms mass and shows 3 enlarged LN (suspected to be infection draining)
3/6/2017 25 sessions chemoradiation
6/20/2017 LAR with temp loop ileo
7/10/2017 Path 20mm margins tumour 0.1 CM with microscopic invasion of submucosa
aug-dec 2017 6 rnds xeloda
1/9/2018 CT all clear
1/18/2018 Colonoscopy clear
3/27/2018 ileo reversal
CEA continues to be normal

PainInTheAss
Posts: 673
Joined: Tue Jul 02, 2013 3:08 am

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby PainInTheAss » Tue Jun 27, 2017 8:10 am

ocstacy wrote:Wow, thank you so much for all the confidence and replys! I actually had to google what PCR meant? lol. Pathololgical Complete Response is what we are praying for !

Thank you ,
Stacy


I was too before surgery. I thought it was a golden ticket from the dismal stats for a stage IIIc since it boosts prognosis from 35-60% to 90% (for IIIc) I was disheartened when my surgeon said they found trace cancer cells. I was depressed for months until I finally saw my Oncologist. He explained that even a very good response, like I had, boosts prognosis. So it's not all or nothing. A complete or good response to chemorad is a sign that you have "wimpy-ass" cancer that is ready to die, but even a poor response can still lead to cure with standard treatment.

I was told about 20% have a complete pathological response, so 1 in 4 or 5.
47yo single mom of 4 (24, 21, 18, 16) at Dx
6/13 - RC T4b IIIc 5LNs on PET CEA 5.4
8/13 - Finish chemorad
10/13 - APR/hyst+ovaries/perm colostomy 2/12 nodes+
6/14 - Finish Xelox 6 rds
1/15 - CT clear CEA 0.2
10/15 - CT/MRI clear CEA 0.7
4/16 - CT clear
10/16 - CT/MRI clear CEA 0.6
5/17 - PET clear? Follow up MRI to verify inflammation

hawkowl
Posts: 132
Joined: Sun Dec 14, 2014 5:29 am
Location: MN/FL

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby hawkowl » Tue Jun 27, 2017 6:06 pm

Yes..any "downstaging" that occurs due to neoadjuvant therapy will result in a better prognosis, even if it is not a complete response.
Dx 12/2014 T3N2MX (distant LPLN) low rectal
12/2014-4/2015: FOLFOX (8 cycles)
4/2015-6/2015: 28 cycles of chemoradiation with xeloda, SBRT
8/2015: Robotic APR with iliac node dissection; path showed ypT0,ypN0 (complete pathological response).
11/2015 scans clear, CEA 2.1
11/2015 parastomal hernia repair
3/2016 CEA 1.7, scans stable...
6/2020 5 years of normal CEA and stable scans
Now dealing with pyoderma gangrenosum.
Totally disabled due to oxaliplatin induced neuropathy and dysautonomia

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ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby ocstacy » Thu Jun 29, 2017 12:53 am

We are true Buddhists and we believe in positive thinking. i will pray for each and everyone of you and please do the same for my mom. PCR here we come! :D
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

User avatar
ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby ocstacy » Sun Jul 16, 2017 12:23 am

The surgeon said at first they couldn't find the growth, and eventually did. He said it shrunk that much it was difficult to detect. So it went from 5-6 cm easy to see to barely detectable


This is super amazing. When I worked in the Radiation Oncology department over 15 years ago, Rectal cancer wasn't as common as Breast or Prostate. I would get a rectal diagnosis one in fifty or so just like Testicular. Anyhow, at what week of Radiation did you find that the tumor was actually shrinking to where you could actually go to the bathroom more easily?
My mother is now feeling a little fatigue. I always get so nervous for her. I go through up's and down's. Thank goodness I found St. John Wort herbal. Takes my depression away a little bit.

Thank you,
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

mozart13
Posts: 158
Joined: Fri Dec 09, 2016 7:38 pm
Location: Toronto

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby mozart13 » Mon Jul 17, 2017 9:35 am

Stacy, she will have some swelling during radiation, and BM might become like pencill, thats what happen to me, I was afraid that I will become obstruct, my surgeon warned about that, told me to drink a lots of water, that worked.
Took me about 4 weeks after therapy finished completlly, to get normal size BM.
I kept active, walked twice a day, on top of going for radiation, took xeloda after meal, twice a day, was told by some people on this board not take it on empty stomach.
Kept bladder full just before the radiation, radiation makes it shrink, that helpped, that was hardest part of whole radiation, timming of bladder, usually drank 500 cc of getorade 15 min. before radiation, that gave me energy and filed up bladdrer.
Avoided antioxidants during therapy, and 2 weeks after, was told by radiation guys it counteracts radiation.
Also protein diet is important.

Good luck!
55 year at the time of diagnosis, male
Diagnosed with T1,T2 N0 M0 rectal cancer
Total neoadjuvant therapy or TNT (chemoradiation followed by systemic chemotherapy)
Negative since Feb. '17
No surgery
Watch&Wait approach 8)
I don’t come much to the forum , so if this is not updated it means I remain negative!
Wish good luck to all!

Basil
Posts: 275
Joined: Thu Mar 16, 2017 12:33 pm

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby Basil » Mon Jul 17, 2017 1:16 pm

Oh man this thread made my day. I am stage 3 but did not have any radiation, just FOLFOX. After six cycles I had an 80%+ regression with only "minimal residual disease remaining."

I really like the idea that I have a "wimpy" cancer that's just waiting to roll over and die.
40 y/o male (now 46), kids 11 & 14.
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
1 year scans - clear
2 year scans - clear
3 year scans - clear
4 year scans - clear
5 year scans - clear (considered cured)

AbbyDoo
Posts: 134
Joined: Wed Jun 29, 2016 2:25 am
Location: So.Ca.

Re: Any luck with Neoadjuvant chemo/radiation therapy Stage 3 Rectal Cancer?

Postby AbbyDoo » Tue Jul 18, 2017 2:58 am

My initial staging was 3c with two enlarged lymph nodes. My tumor was 6 cm. Chemo/radiation shrunk it about 40%.
My final staging was stage 2 with no lymph nodes involved.
The last week of radiation can be a little tough fatigue and a sore butt. The good new is that it don't last long. Took me about 2 weeks to feel normal again.
I used an Aloa Vera jell I think the name brand was good earth. And soaking in the tub seemed to help to.
Good Luck
53 yrs old
4/30/15 colonoscopy Mass found
5/21/15 staged 3 C rectal cancer
7/3/15 finished xeloda and radiation 28 rounds
9/30/15 LAR
10/29/15 picc line installed
11/2/15 start chemo 5 fu Oxaliplatin
3/7/16 Finish Chemo
4/29/16 Ileostomy Reversal.
7/13/16 colonoscopy clear.
CRC survivors know there Sh%t


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