Just told I have a mass in rectum

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Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: Just told I have a mass in rectum

Postby Lee » Thu Sep 21, 2017 2:02 pm

KathyLynn wrote:So all tests are done and the doctors had their board meeting. They told me this morning that it is a 1 B stage. T 2. M 0. After seeing oncologist/radiologist, I was told today that they can remove the tumor without any treatment. Wow, now I'm excited. But, should I have a second opinion? I was getting ready for CT scan for radiation to start. I'm so confused now. Suggestions

Thanks All


Sounds like they found your early, that is good news. Since you are dealing with rectal cancer, you really want a Board Certified Colon Rectal surgeon doing the surgery. Radiation, surgery, no chemo. Sounds pretty good to me.

Are you near a major hospital or cancer center? Since you are diagnosed so early (stage I), it's not as important for a 2nd opinion, butt I do believe in them. Your choice.

Congratulations,

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 - 16 years and counting!

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Thu Sep 21, 2017 5:08 pm

It is far up, not sure of the exact location. But the doctors said it was in a good area of the rectum . I was told that I would need rad/chemo for 6 weeks. Then this morning, the tumor board said the doctors would rather remove the tumor first then have rad/chemo if needed. My head is spinning. They said the tumor can be removed without the dissection.
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: Just told I have a mass in rectum

Postby Lee » Thu Sep 21, 2017 6:27 pm

KathyLynn wrote:It is far up, not sure of the exact location. But the doctors said it was in a good area of the rectum . I was told that I would need rad/chemo for 6 weeks. Then this morning, the tumor board said the doctors would rather remove the tumor first then have rad/chemo if needed. My head is spinning. They said the tumor can be removed without the dissection.


Okay, now I am going to say, GET A 2ND OPINION. When dealing with rectal cancer, radiation is the standard of care prior to surgery. I believe that also applies with stage I diagnoses. Unless if the tumor is so far up there,it's in that grey area of being in the rectum and the colon together. Again, 2nd opinion would apply there.

Please find out if your surgeon is a BOARD CERTIFIED COLON RECTAL surgeon vs a "general surgeon".

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 - 16 years and counting!

User avatar
JJH
Posts: 408
Joined: Mon Apr 24, 2017 7:26 am

Re: Just told I have a mass in rectum

Postby JJH » Fri Sep 22, 2017 12:19 am

KathyLynn wrote:...They said the tumor can be removed without the dissection.

Can you find out the name of the surgical procedure that they are proposing? If it is not a resection, then what is it?

There are several different procedures available and it would be important to know which one they have in mind. Is it a local excision? If so, what kind? A different hospital might propose a different procedure. In any event, it is very important to have a Board Certified colorectal surgeon for this type of surgery, especially for a tumor as large as 5 cm.

https://www.texasoncology.com/types-of-cancer/rectal-cancer/stage-i-rectal-cancer
https://www.texasoncology.com/types-of-cancer/rectal-cancer/surgery-for-rectal-cancer

Trans-anal resection or trans-anal endoscopic microsurgery: In some cases it may be possible to remove the cancer through the anus without making an incision in the abdomen. Techniques for removing the cancer in this way include trans-anal resection and trans-anal endoscopic microsurgery (TEM). The operations involve cutting through all layers of the rectum to remove invasive cancer as well as some surrounding normal rectal tissue. This procedure can be used to remove some Stage I rectal cancers that are relatively small and not too far from the anus. If the cancer is found to have certain high-risk features, more extensive surgery may be recommended. These local treatments of rectal cancer offer the advantage of quicker recovery after surgery, but may be linked with a higher risk of cancer recurrence than more extensive types of surgery.
1 Nash GM, Weiser MR, Guillem JG et al. Long-term survival after transanal excision of T1 rectal cancer. Diseases of the Colon & Rectum. 2009;52:577-82.

https://www.texasoncology.com/types-of-cancer/rectal-cancer/stage-i-rectal-cancer
"The darkest hour is just before the dawn" - Thomas Fuller (1650)
●●●

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Tue Sep 26, 2017 9:09 am

So now they have decided to go with radiation/chemo first, then surgery. There is a very fine margin of T2 or T3
The location is 8 cm from the verge. Still N O. M O. Not sure on what surgery I will have. I’m sure I’ll know soon

KathyLynn
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Sun Oct 01, 2017 3:51 pm

So, again, I’m confused. I will have a CT scan on Tuesday and a second opinion on Wednesday with an oncologist. They’re a few Doctors on the board that think I will be over treated if I have chemo/Rad before surgery. I know I have posted quite a few treatments that I thought I was having. Butt, second opinion is what I think I should have. As far as I understand. It is Stage 1. T2, possible early T 3 with NO MO. Anyone had surgery then treatment ? I’m really confused. I just don’t know what to do. And I want to get moving on this ASAP!

Any suggestions?

Thanks All
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

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susie0915
Posts: 945
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Just told I have a mass in rectum

Postby susie0915 » Sun Oct 01, 2017 4:45 pm

I was T3N0M0 which is stage 2A. I was treated with chemo/rad, surgery, then chemo. My tumor was 4-5 cm from anal verge. I had a pretty good response
to chemo/rad. Scar tissue remaining and NED on pet scan. After surgery the pathology report did show minimal residual cancer cells so clean up chemo was
recommended. At T3N0M0, I think that is pretty standard treatment for rectal cancer. I'm not quite sure if the tumor is T2.

I thought most rectal cancers do chemo/rad as it lessens the chance for recurrence.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 PET scan NED
9/15 LAR
0/24 nodes
10/15 blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 C 4mm lung nod
10/17 pel/abd CT NED
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, CT pel/abd/lung NED
11/18 CEA .6
5/19 CT NED, CEA <.5
10/19 Clear colonscopy
11/19 CEA <.5

Beckster
Posts: 438
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: Just told I have a mass in rectum

Postby Beckster » Sun Oct 01, 2017 5:05 pm

KathyLynn wrote:So, again, I’m confused. I will have a CT scan on Tuesday and a second opinion on Wednesday with an oncologist. They’re a few Doctors on the board that think I will be over treated if I have chemo/Rad before surgery. I know I have posted quite a few treatments that I thought I was having. Butt, second opinion is what I think I should have. As far as I understand. It is Stage 1. T2, possible early T 3 with NO MO. Anyone had surgery then treatment ? I’m really confused. I just don’t know what to do. And I want to get moving on this ASAP!

Any suggestions?

Thanks All


A friend of mine had your dx. They did surgery first and than chemo/rad. He was between stage I (T2) and II (T3). However, 2 years after surgery and chem/rad, he had a recurrence. He feels that he would have had better results if he did the chemo/rad first. Rectal cancer has a higher chance of recurrence, so ask your surgeons if you have a better chance of no recurrence doing rad/chemo first. I am sure that you will make the right decision.
57/F
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Type: Adenocarcinoma
Tumor size:3.5 cm x 2.5 x 0.7 cm
Grade: G3
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic
1/2/17 to 6/9/17- Xeloda
6/17,12/17,6/18,12/18,6/19,12/19,12/20,12/21 CT Scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8 12/17-2.8, 3/18-3.1, 6/18-3.0, 9/18 2.8, 12/18 2.5 3/19 3.1 6/19 3.1 9/19 2.6 12/19 2.8 6/20 3.0 12/20 2.7 6/21 2.9,[color=#000000]12/21 2.7[/color]
Clear Colonoscopy 10/17, 11/19,11/21 :D

tarheelmom
Posts: 168
Joined: Mon Mar 07, 2016 5:55 pm

Re: Just told I have a mass in rectum

Postby tarheelmom » Sun Oct 01, 2017 5:07 pm

Hi KathyLynn,

I was a T2N0M0, 3 cm from the AV. No chemo/rad - just surgery. My surgeon did mention that if it had been T3N0M0, then he would have recommended chemo (no radiation) pre-surgery. His rationale was that he was trying to avoid a permanent colostomy since the tumor was so low and that radiated tissue would make the surgery more difficult and increase the potential for either a colostomy and/or LARS (low anterior resection syndrome). I think there is someone on this group who had chemo but not radiation pre-surgery, and I think it was called the PROSPECT trial. Good luck.
52 y at dx, mom to 4
DX: RC on 2/22/2016
Stage I, T2N0M0, 0/32 LN
23 mm x 7 mm moderately differentiated invasive adenocarcinoma
3 cm from anal verge
4/12/16: ULAR, TME, & temp ileostomy
6/14/16: ileo reversal

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

Re: Just told I have a mass in rectum

Postby Basil » Sun Oct 01, 2017 7:38 pm

That's me. I had six rounds of chemo, path complete response at LAR and remaining treatment was cancelled. I think PROSPECT is a stage iii trial but I would ask about it.
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)

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Mon Oct 02, 2017 4:49 pm

Thanks, I really appreciate all the posts. Makes me feel prepared for my appointment. I’ll keep you posted after Wednesday.

KathyLynn
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Wed Oct 04, 2017 8:03 pm

Looks like I will have a short round of Radiation then LAR
Anyone had this treatment for Stage 1 or possible Early Stage 2? NO. MO. As far as I know. They said they will Stage after the surgery because of the close margin of Stage. Also. The tumor is a 2cm. Not a 5 cm as they had thought from the MRI. Anyone have this treatment then surgery? I was told if Stage 1 no other treatment will be needed after surgery. Out of all the doctors I have talked to, none want to mention survival rate. Is this how it works?

Thanks
KathyLynn
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

benben
Posts: 324
Joined: Fri Apr 28, 2017 3:18 pm
Location: Washington State

Re: Just told I have a mass in rectum

Postby benben » Wed Oct 04, 2017 10:26 pm

KathyLynn wrote:Looks like I will have a short round of Radiation then LAR
Anyone had this treatment for Stage 1 or possible Early Stage 2? NO. MO. As far as I know. They said they will Stage after the surgery because of the close margin of Stage. Also. The tumor is a 2cm. Not a 5 cm as they had thought from the MRI. Anyone have this treatment then surgery? I was told if Stage 1 no other treatment will be needed after surgery. Out of all the doctors I have talked to, none want to mention survival rate. Is this how it works?

Thanks
KathyLynn



I had tumor 15cm from AV. So at the convergence of rectum/sigmoid colon.
It was 6.2 x 4.8 cm in size. T3 n1 (the pre surgery MRI noticed 10 nodes that were swollen - only 1 was infectious) .
The tumor stretched into the colon rather than rectum. So being up that high they decided no RAD.
They did remove about 2 inches of my rectum. 1.5 inch clean margins. Surgery was done by certified colon/rectum surgeon.

I received zero chemo/radiation prior to resection.
I received robotic assisted ULAR. Then adjuvant chemo - I have 2 sessions to go.

My ONC talked of survival rate. Given my age/health and pathology he mentioned my odds of survival without recurrence in 5 years was around 85-90%.
Those sounded like pretty good odds to me. Hoping that's the case. Have you met with your Oncologist yet? I'd be surprised if they didn't want to discuss percentages.

best of luck on your treatment. Sounds like they caught you pretty early on - and that means your odds are pretty high in the 5 year survival without recurrence.
----------------------
3/29/17 diagnosed CRC - 44 y/o Male
4/17/17 ULAR - Straight anastomosis - no ostomy.
Path: low grade T3n1m0 - moderate diff.
KRAS - NO, MLH1/PMS2/MSH6/MSH2 - Normal.
5/3 med port install
5/22 folfox - first treatment.
3rd treat, delayed - low ANC - reduced to 90% OXI
zarxio all treats
Treat 7 - 75% OXI
Treats 8-12 - NO OXI, Luke & 5FU
10/20/17 CT- NED
3/18 Scope - Clean
11/8 PORT OUT!
7/22 CT - NED (5 years!)

KathyLynn
Posts: 68
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Just told I have a mass in rectum

Postby KathyLynn » Fri Nov 03, 2017 9:49 am

Hi All,
It’s been awhile since I’ve been on. So this is another update.....
I had a second opinion, had more tests and was then told that it is T2 NO MO.
I’ll have surgery LAR later this month, don’t know why they waited this long
Doctor said if all goes well with surgery, no surprises I guess, I’ll just have surgery. And will have tests for quite awhile after.
I’m so ready for this surgery

I’ll be in touch after surgery
Thanks again!
KathyLynn
8/2017. RC
11/27/2017. Robotic LAR. No chemo/rad
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor.
Lymphovascular and perineural invasion: not identified.
1/13/2018. T2N0M0 with isolated tumor cell (ITC)
7/2018. CEA 2.0. 10/18: 2.0. 1/19: 2.3 11/19. 2.1
11/19 CT NED
06/21 CT NED CEA 1.3

Pemba
Posts: 84
Joined: Thu Aug 24, 2017 7:52 am

Re: Just told I have a mass in rectum

Postby Pemba » Fri Nov 03, 2017 11:48 am

Congratulations on catching it early, hope you can celebrate that and focus on the positive, even though the situation sucks !
Age: 26
2017: 15mm Tubulovillous adenoma- Low grade dysplasi.
Next scopy: original 2020 probably 2018-19


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