Stage 2/3 Rectal Cancer Scan Question/Results

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MassMike
Posts: 4
Joined: Sun Nov 19, 2017 11:04 am

Stage 2/3 Rectal Cancer Scan Question/Results

Postby MassMike » Sun Nov 19, 2017 11:13 am

Hello everyone,

My mother was diagnosed with Stage 2/3 rectal cancer in August. She completed her neoadjuvant chemoradiation regimen in October and has surgery scheduled for 12/12. On her initial scans, there were some findings but the doctors did not find them suspicious as my mother was a smoker for 35 years before quitting 6 years ago, and she had bronchitis/pneumonia constantly when she was younger. The radiologist said that since there were lung nodules found, although not suspicious there should be follow up scans in 3 months. It’s been 3 months and my mother’s doctors have said that since surgery is scheduled, the tumor shrunk noticeably, and nothing would change there is no need to do scans at this time and they would follow up with scans after surgery. Is this normal to just go ahead and follow through with surgery without scans? I’m going to post the reports that were on my mothers scans and if anyone has any knowledge of anything regarding them I would appreciate any insight you may have. Thank you so much:)

FINDINGS:
3 x 7 mm nodule along the right minor fissure image 48 may represent an incidental intrapulmonary lymph node. 4 mm micro nodules right upper lobe image 30 and left apex image 12. additional scattered less than 4 mm micro nodules. No suspicious lung
nodules or consolidative changes. Central airways are patent. No pleural effusions.

Hepatobiliary: Subcentimeter hypodense focus medial aspect of left lobe, too small to characterize, likely simple cysts. Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation.

Lee
Posts: 5293
Joined: Sun Apr 16, 2006 4:09 pm

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby Lee » Sun Nov 19, 2017 3:34 pm

Hi Mike and welcome. Sorry for the reason you are here.

I'm a bit confused. How many scans has your mother had? One or more? Or are they comparing it to a scan prior to her diagnoses?

I had a CAT scan just prior to my surgery, I believe that is normal procedure so am a bit confused with her Dr. saying after surgery? And if it was recommend to do follow up scan in 3 months, I do believe there should be follow up scan.

What kind of Dr. is treating her? Oncologist?

Has her Dr. mentioned anything about a PET scan?

Good luck,

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!

MassMike
Posts: 4
Joined: Sun Nov 19, 2017 11:04 am

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby MassMike » Sun Nov 19, 2017 3:42 pm

Lee wrote:Hi Mike and welcome. Sorry for the reason you are here.

I'm a bit confused. How many scans has your mother had? One or more? Or are they comparing it to a scan prior to her diagnoses?

I had a CAT scan just prior to my surgery, I believe that is normal procedure so am a bit confused with her Dr. saying after surgery? And if it was recommend to do follow up scan in 3 months, I do believe there should be follow up scan.

What kind of Dr. is treating her? Oncologist?

Has her Dr. mentioned anything about a PET scan?

Good luck,

Lee


My mother had scans when she was first diagnosed to see if it’s spread, and nothing since then. Her oncologist said that it isn’t necessary to do scans at this time because they’re going to go ahead with surgery regardless and evaluate everything after, and her surgeon agreed. Her doctors are excellent and I trust them, it just seemed odd.

NHMike
Posts: 689
Joined: Fri Jul 21, 2017 3:43 am

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby NHMike » Sun Nov 19, 2017 3:53 pm

Hello Mike,

I had similar concerns - could the cancer spread in-between chemo/radiation therapy and surgery or after surgery but before adjuvant chemotherapy. I talked it over with my oncologist and he said that he could order scans but that it could potentially delay the surgery if something were found. I suspect that you could get scans if you pushed the right doctor to get them. But what difference would that make for treatment? Would you cancel the surgery to go after the mets?

michael (in NH)
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

heiders33
Posts: 43
Joined: Sat Nov 04, 2017 11:08 am

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby heiders33 » Sun Nov 19, 2017 4:04 pm

I did not have any scans done prior to my surgery. My surgeon said he did not need them - he did a physical exam to see what my response was to chemo/radiation. I haven’t had a scan since DX and won’t get another one until post-adjuvant chemo. So I don’t think it’s necessarily standard procedure, unless my surgeon is just crazy!
35 year-old female
May 2017: Dx at T3N2M0
June-July 2017: 28 days of chemo/radiation
September 2017: LAR surgery with loop ileostomy
October 2017: started six rounds of mop-up XELOX

MassMike
Posts: 4
Joined: Sun Nov 19, 2017 11:04 am

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby MassMike » Sun Nov 19, 2017 4:07 pm

NHMike wrote:Hello Mike,

I had similar concerns - could the cancer spread in-between chemo/radiation therapy and surgery or after surgery but before adjuvant chemotherapy. I talked it over with my oncologist and he said that he could order scans but that it could potentially delay the surgery if something were found. I suspect that you could get scans if you pushed the right doctor to get them. But what difference would that make for treatment? Would you cancel the surgery to go after the mets?

michael (in NH)

I’ve been following your story for a while, hence my name. I’m in Massachusetts, mothers being treated at Lahey Clinic in Burlington. We were considering MGH or Dana Farber, but they were both still quite far and Lahey has been excellent.

Lee
Posts: 5293
Joined: Sun Apr 16, 2006 4:09 pm

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby Lee » Sun Nov 19, 2017 4:09 pm

NHMike wrote:Hello Mike,
. . . he said that he could order scans but that it could potentially delay the surgery if something were found. . .
michael (in NH)


Okay, I see that procedures are changing. When I was diagnosed, I was scanned at diagnoses. Did radiation and was scanned again just prior to surgery. Standard protocol in those days. When I had to change Oncologist, new Oncologist wanted a PET/CAT scan as that was standard procedure for new patients.

Thanks for teaching me something new today,

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!

User avatar
susie0915
Posts: 551
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby susie0915 » Sun Nov 19, 2017 6:49 pm

I did have a pet scan after chemo/radiation. I also had a ct scan at diagnosis. My next ct scan wasn't until a month after I finished treatment. Idk maybe there are different protocols doctors follow.
58 yr old mother of 3 Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks of chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. 3 1/2 weeks in hospital,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc thinks scar tissue
monitored for autoimmune disorder/interstitial lung disease
7/17 no change lung nodule
10/17 Clear CT
11/17 CEA<.5

Aqx99
Posts: 279
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Stage 2/3 Rectal Cancer Scan Question/Results

Postby Aqx99 » Sun Nov 19, 2017 6:55 pm

I was scanned at diagnosis, scanned again after chemoradiation and will be scanned again when chemo is over, before my reversal surgery. I don't think it is unreasonable to ask for another scan. I have 2 nodules in my lungs that we are watching, which so far have been unchanged.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL (Siemens Chemiluminescent Method)
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/ temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ precursor ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL (Roche ECLIA Method)
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL (Roche ECLIA Method)
1/23/18 Reversal


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