Moms Rectal Cancer Surgery Pathology

Please feel free to read, share your thoughts, your stories and connect with others!
MassMike
Posts: 17
Joined: Sun Nov 19, 2017 11:04 am

Moms Rectal Cancer Surgery Pathology

Postby MassMike » Fri Dec 22, 2017 11:50 am

Hello,

My mother had her LAR surgery last week for her rectal cancer. The doctor was absolutely esctatic with how the surgery went and said it couldn’t have gone better. Her original staging was T3 N0/1, some lymph nodes looked enlarged on her MRI but they couldn’t tell if it was cancer or just enlarged lymph nodes. Her pathology just got posted on her portal, and I’m confused as to what all of it means. Does anywhere here indicate clear margins? He called and said that the margins were clear but I just want to read it for myself, haha. The medical terminology is so confusing. I’ll post her pathology below and if anyone has any insight on if this pathology is great, good, bad, etc please let me know :)

INVASIVE CARCINOMA

LEVEL OF INVASION OF MUSCULARIS PROPRIA: 1 (INNER 1/3)
(level 1: inner 1/3, 2: mid 1/3; 3: outer 1/3)

HISTOLOGIC TYPE: ADENOCARCINOMA

HISTOLOGIC GRADE: 2/4

MUCINOUS TUMOR COMPONENT: 0%

PERICOLORECTAL TISSUE: NOT INVOLVED

MACROSCOPIC TUMOR PERFORATION: NOT SEEN

TUMOR SITE: RECTUM

TUMOR SIZE: 1 CM ON SLIDE B5

SPECIMEN TYPE: RECTOSIGMOID

SPECIMEN LENGTH: 20 CM

TUMOR DEPOSIT(S) IN PERICOLIC FAT: NOT PRESENT

MACROSCOPIC INTACTNESS OF MESORECTUM: COMPLETE

TNM STAGE: ypT2, ypN0

TUMOR REGRESSION GRADE (TREATMENT EFFECT): 2
(grade 0, no viable tumor cells; 1, single or small groups; 2, outgrown by fibrosis; 3, minimal tumor kill)

LYMPH NODE(S) INCLUDED IN ALL PARTS: NUMBER INVOLVED : 0
NUMBER EXAMINED: 20

TUMOR BORDER CONFIGURATION: INFILTRATING

INTRATUMORAL LYMPHOCYTIC RESPONSE: NONE

PERITUMORAL LYMPHOCYTIC RESPONSE (CROHN-LIKE RESPONSE): NONE

LYMPHATIC (SMALL VESSEL) INVASION: NOT SEEN

EXTRAMURAL VENOUS INVASION: NOT SEEN

PERINEURAL INVASION: NOT SEEN

MMR BY IHC: NO IMMUNOHISTOCHEMICAL EVIDENCE OF DEFECTIVE DNA MISMATCH REPAIR FUNCTION WAS FOUND IN THIS TUMOR (PERFORMED ON PRIOR SPECIMEN SL17-20219)

DISTANCE OF TUMOR FROM RADIAL MARGIN: 30 MM

DISTANCE OF TUMOR FROM PROXIMAL MARGIN: AT LEAST 15 CM

DISTANCE OF TUMOR FROM DISTAL MARGIN: AT LEAST 3.5 CM

Aqx99
Posts: 403
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Moms Rectal Cancer Surgery Pathology

Postby Aqx99 » Fri Dec 22, 2017 9:52 pm

MassMike wrote:DISTANCE OF TUMOR FROM RADIAL MARGIN: 30 MM

DISTANCE OF TUMOR FROM PROXIMAL MARGIN: AT LEAST 15 CM

DISTANCE OF TUMOR FROM DISTAL MARGIN: AT LEAST 3.5 CM


These right here mean the margins were clear. They all describe the tumor as being a distance away from each margin. That means there was healthy tissue at each margin.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Dx, Age 39
2/21/17 CEA 0.9
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 Dx w/ovarian cancer
9/6/17 CA 125 11.1
11/27/17 CEA 2.6
12/5/17 CT NED
12/13/17 CEA 2.9
1/11/18 CA 125 8.6
1/23/18 Reversal
3/21/18 CT enlarged thymus
4/6/18 PET NED
7/10/18 CT NED
7/11/18 CEA 2.6
9/18 Bilateral Prophylactic Mastectomy

User avatar
O Stoma Mia
Posts: 1709
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: Moms Rectal Cancer Surgery Pathology

Postby O Stoma Mia » Sat Dec 23, 2017 2:08 am

Overall, the result looks good to me. I'll give you my impression, but my view is the view of a layman, not a specialist.

The pathology report gives information on two main areas: (1) how well the previous chemo/radiation sessions went, and (2) how well the surgery itself went.

The report shows that the chemo/radiation sessions killed some, but not all of the cancer cells. Thus, it was a partial response, not a complete pathologic response. Some viable cancer cells still remained in the 'muscularis propria' layer of the colon wall, so the pathologic staging had to be set at ypT2. (It would have been set at ypT0 if there had been a complete pathologic response pCR.) However, all of these remaining live cancer cells were removed by surgery with good margins and good surgical technique, and there was no direct evidence of any cancer cells remaining outside the colon wall or in the lymph nodes of the resected specimen. Thus, the surgery itself apparently went very well, since it appears to have removed the few remaining cancer cells that were still present in the core of the tumor, and no live cancer cells were left behind (as far as they know).

Your report gave details on the Tumor Regression Grade, which was set at G2. You can look at the article cited below to see what the prognostic implications are for a ypT2 tumor at Grade 2.

Thus, I can understand why the surgeon would be ecstatic, since the report showed that he did a very good job in removing the tumor. However, I don't think that the radiation oncologist would be quite so ecstatic, since the radiation sessions did not achieve the expected complete pathologic response
.
Grade 1(complete regression) showed an absence of histologically identifiable residual cancer, with predominant fibrosis extending through the different layers of the rectal wall. Grade 2 (intermediate regression) was characterized by an increase in the number of residual cancer cells, which was still outgrown by fibrosis. Grade 3 (poor regression) showed residual cancer outgrowing fibrosis characterized by a scant presence or the complete absence of regressive changes and by residual cancer cells.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053500/

MassMike
Posts: 17
Joined: Sun Nov 19, 2017 11:04 am

Re: Moms Rectal Cancer Surgery Pathology

Postby MassMike » Sat Dec 23, 2017 10:03 am

O Stoma Mia wrote:Overall, the result looks good to me. I'll give you my impression, but my view is the view of a layman, not a specialist.

The pathology report gives information on two main areas: (1) how well the previous chemo/radiation sessions went, and (2) how well the surgery itself went.

The report shows that the chemo/radiation sessions killed some, but not all of the cancer cells. Thus, it was a partial response, not a complete pathologic response. Some viable cancer cells still remained in the 'muscularis propria' layer of the colon wall, so the pathologic staging had to be set at ypT2. (It would have been set at ypT0 if there had been a complete pathologic response pCR.) However, all of these remaining live cancer cells were removed by surgery with good margins and good surgical technique, and there was no direct evidence of any cancer cells remaining outside the colon wall or in the lymph nodes of the resected specimen. Thus, the surgery itself apparently went very well, since it appears to have removed the few remaining cancer cells that were still present in the core of the tumor, and no live cancer cells were left behind (as far as they know).

Your report gave details on the Tumor Regression Grade, which was set at G2. You can look at the article cited below to see what the prognostic implications are for a ypT2 tumor at Grade 2.

Thus, I can understand why the surgeon would be ecstatic, since the report showed that he did a very good job in removing the tumor. However, I don't think that the radiation oncologist would be quite so ecstatic, since the radiation sessions did not achieve the expected complete pathologic response
.
Grade 1(complete regression) showed an absence of histologically identifiable residual cancer, with predominant fibrosis extending through the different layers of the rectal wall. Grade 2 (intermediate regression) was characterized by an increase in the number of residual cancer cells, which was still outgrown by fibrosis. Grade 3 (poor regression) showed residual cancer outgrowing fibrosis characterized by a scant presence or the complete absence of regressive changes and by residual cancer cells.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053500/


Thanks for your detailed reply! Overall, do you think the chances of survival are good? I don’t understand how the response to chemo radiation can impact survival so much if the surgeon “finished the job” that the radiation onocologist stared, persay. If all the cancer got removed, does the effect of the neoadjuvant chemoradiation matter at this point? That doesn’t make much sense to me.
Mom DX Stage 2/3 Rectal Cancer 8/17
Chemoradiation 9/17-11/17
Surgery w/Temp Colostomy 12/12/17
yP Stage T2N0 0/20 nodes
8 cycles folfox begun 1/15/18
Folfox finished 5/18
Reversal 8/18

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: Moms Rectal Cancer Surgery Pathology

Postby NHMike » Sat Dec 23, 2017 10:25 am

My case is similar in 3 suspicious lymph nodes with no cancer after pathology and a complete response. But you don't know if some cells made it out or if there is some other spread in-between treatments. So I'm on Adjuvant chemo to hopefully clean them up. My surgeon and oncologist were happy with the report as well but I've seen 2s and 3s turn into 4s. I may be a little paranoid but I think that you always worry. The numbers get a lot better if you're NED after 2 years.

My oncologist told me that I'm in the top 10-20 percent of the survival curve (5-year survival rate is 69% for my stage) which sounds nice but I think that every case is individual.

So I think that your mother is in good shape as far as the odds go, but see what your oncologist thinks.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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

Re: Moms Rectal Cancer Surgery Pathology

Postby susie0915 » Sat Dec 23, 2017 11:10 am

NHMike wrote:My case is similar in 3 suspicious lymph nodes with no cancer after pathology and a complete response. But you don't know if some cells made it out or if there is some other spread in-between treatments. So I'm on Adjuvant chemo to hopefully clean them up. My surgeon and oncologist were happy with the report as well but I've seen 2s and 3s turn into 4s. I may be a little paranoid but I think that you always worry. The numbers get a lot better if you're NED after 2 years.

My oncologist told me that I'm in the top 10-20 percent of the survival curve (5-year survival rate is 69% for my stage) which sounds nice but I think that every case is individual.

So I think that your mother is in good shape as far as the odds go, but see what your oncologist thinks.

Yes, my oncologist did say most recurrences happen within 2 years of diagnosis. But even if there is a good response to chemo/radiation and clear margins are achieved with 0 lymph node involvement, there is no guarantee cancer cells did not get into the blood stream. This is why my oncologist recommended adjuvant chemotherapy. My oncologist told me even though chance of recurrence is only 10%, never want to wonder "what if", if there is a recurrence and no chemo was done after surgery.
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

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

Re: Moms Rectal Cancer Surgery Pathology

Postby Basil » Sun Dec 24, 2017 2:24 am

O Stoma Mia wrote:Overall, the result looks good to me. I'll give you my impression, but my view is the view of a layman, not a specialist.

The pathology report gives information on two main areas: (1) how well the previous chemo/radiation sessions went, and (2) how well the surgery itself went.

The report shows that the chemo/radiation sessions killed some, but not all of the cancer cells. Thus, it was a partial response, not a complete pathologic response. Some viable cancer cells still remained in the 'muscularis propria' layer of the colon wall, so the pathologic staging had to be set at ypT2. (It would have been set at ypT0 if there had been a complete pathologic response pCR.) However, all of these remaining live cancer cells were removed by surgery with good margins and good surgical technique, and there was no direct evidence of any cancer cells remaining outside the colon wall or in the lymph nodes of the resected specimen. Thus, the surgery itself apparently went very well, since it appears to have removed the few remaining cancer cells that were still present in the core of the tumor, and no live cancer cells were left behind (as far as they know).

Your report gave details on the Tumor Regression Grade, which was set at G2. You can look at the article cited below to see what the prognostic implications are for a ypT2 tumor at Grade 2.

Thus, I can understand why the surgeon would be ecstatic, since the report showed that he did a very good job in removing the tumor. However, I don't think that the radiation oncologist would be quite so ecstatic, since the radiation sessions did not achieve the expected complete pathologic response
.
Grade 1(complete regression) showed an absence of histologically identifiable residual cancer, with predominant fibrosis extending through the different layers of the rectal wall. Grade 2 (intermediate regression) was characterized by an increase in the number of residual cancer cells, which was still outgrown by fibrosis. Grade 3 (poor regression) showed residual cancer outgrowing fibrosis characterized by a scant presence or the complete absence of regressive changes and by residual cancer cells.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053500/


A path complete response is wonderful but far from expected. Most patients do not have a complete response and it’s unfair to label a good but incomplete resposne as being somehow inferior.
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)

MassMike
Posts: 17
Joined: Sun Nov 19, 2017 11:04 am

Re: Moms Rectal Cancer Surgery Pathology

Postby MassMike » Sun Dec 24, 2017 10:15 am

Basil wrote:
O Stoma Mia wrote:Overall, the result looks good to me. I'll give you my impression, but my view is the view of a layman, not a specialist.

The pathology report gives information on two main areas: (1) how well the previous chemo/radiation sessions went, and (2) how well the surgery itself went.

The report shows that the chemo/radiation sessions killed some, but not all of the cancer cells. Thus, it was a partial response, not a complete pathologic response. Some viable cancer cells still remained in the 'muscularis propria' layer of the colon wall, so the pathologic staging had to be set at ypT2. (It would have been set at ypT0 if there had been a complete pathologic response pCR.) However, all of these remaining live cancer cells were removed by surgery with good margins and good surgical technique, and there was no direct evidence of any cancer cells remaining outside the colon wall or in the lymph nodes of the resected specimen. Thus, the surgery itself apparently went very well, since it appears to have removed the few remaining cancer cells that were still present in the core of the tumor, and no live cancer cells were left behind (as far as they know).

Your report gave details on the Tumor Regression Grade, which was set at G2. You can look at the article cited below to see what the prognostic implications are for a ypT2 tumor at Grade 2.

Thus, I can understand why the surgeon would be ecstatic, since the report showed that he did a very good job in removing the tumor. However, I don't think that the radiation oncologist would be quite so ecstatic, since the radiation sessions did not achieve the expected complete pathologic response
.
Grade 1(complete regression) showed an absence of histologically identifiable residual cancer, with predominant fibrosis extending through the different layers of the rectal wall. Grade 2 (intermediate regression) was characterized by an increase in the number of residual cancer cells, which was still outgrown by fibrosis. Grade 3 (poor regression) showed residual cancer outgrowing fibrosis characterized by a scant presence or the complete absence of regressive changes and by residual cancer cells.
Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053500/


A path complete response is wonderful but far from expected. Most patients do not have a complete response and it’s unfair to label a good but incomplete resposne as being somehow inferior.


That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.
Mom DX Stage 2/3 Rectal Cancer 8/17
Chemoradiation 9/17-11/17
Surgery w/Temp Colostomy 12/12/17
yP Stage T2N0 0/20 nodes
8 cycles folfox begun 1/15/18
Folfox finished 5/18
Reversal 8/18

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: Moms Rectal Cancer Surgery Pathology

Postby NHMike » Sun Dec 24, 2017 10:36 am

MassMike wrote:That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.


I think that's a good perspective.

The job of chemo and radiation, from my perspective, is to shrink the tumor and prevent spread and growth. The shrinking is important so that the surgeon can have more to work with. Obviously controlling spread and growth is important.

So your mother's team sounds like my team though I haven't spoken to either of my radiation guys in quite some time.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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

Re: Moms Rectal Cancer Surgery Pathology

Postby susie0915 » Sun Dec 24, 2017 11:13 am

NHMike wrote:
MassMike wrote:That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.


I think that's a good perspective.

The job of chemo and radiation, from my perspective, is to shrink the tumor and prevent spread and growth. The shrinking is important so that the surgeon can have more to work with. Obviously controlling spread and growth is important.

So your mother's team sounds like my team though I haven't spoken to either of my radiation guys in quite some time.

Yes my doctors told me the chemo/radiation is used to help shrink in order to make surgery easier and a better chance to get clean margins and save the sphincter muscle.
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

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: Moms Rectal Cancer Surgery Pathology

Postby CRguy » Sun Dec 24, 2017 11:01 pm

MassMike wrote:That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.

AND to add some additional real world experience here ......
after neoadjuvant chemoradiation I had pCR confirmed ( at resection pathology )
after a successful surgery ( TME ) and adjuvant chemo with temp ileostomy ..........

BUTT ....... 2-3 years later had a single lung met removed via VATS

= YES pCR is great ...
BUTT it is still NO replacement for aggressive and active follow up AFTER intial chemo / radiation/ resection / surgery / ETC. !

ALWAYS ..... ALWAYS continue with increased vigilance

WORD !

Yes you can quote me on that
Cheers
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

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

Re: Moms Rectal Cancer Surgery Pathology

Postby susie0915 » Mon Dec 25, 2017 9:26 am

CRguy wrote:
MassMike wrote:That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.

AND to add some additional real world experience here ......
after neoadjuvant chemoradiation I had pCR confirmed ( at resection pathology )
after a successful surgery ( TME ) and adjuvant chemo with temp ileostomy ..........

BUTT ....... 2-3 years later had a single lung met removed via VATS

= YES pCR is great ...
BUTT it is still NO replacement for aggressive and active follow up AFTER intial chemo / radiation/ resection / surgery / ETC. !

ALWAYS ..... ALWAYS continue with increased vigilance

WORD !

Yes you can quote me on that
Cheers
CRguy

Definitely. Continued followup after treatments is imperative.
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

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: Moms Rectal Cancer Surgery Pathology

Postby NHMike » Mon Dec 25, 2017 9:34 am

CRguy wrote:
MassMike wrote:That’s what I was thinking as well. Both my mothers radiation oncologist, oncologist, and surgeon said a complete pathological response is seen about 10-20% of the time and not to expect one or be discouraged. He also said as long as the surgeon gets all of it out during surgery, the response to the chemoradiation isn’t as important.

AND to add some additional real world experience here ......
after neoadjuvant chemoradiation I had pCR confirmed ( at resection pathology )
after a successful surgery ( TME ) and adjuvant chemo with temp ileostomy ..........

BUTT ....... 2-3 years later had a single lung met removed via VATS

= YES pCR is great ...
BUTT it is still NO replacement for aggressive and active follow up AFTER intial chemo / radiation/ resection / surgery / ETC. !

ALWAYS ..... ALWAYS continue with increased vigilance

WORD !

Yes you can quote me on that
Cheers
CRguy


Most people think of cancer as the thing that keeps coming back and that’s why so many are scared of it. And rightly so. I’m happy that my team is happy with the results but it doesn’t mean resting on a sure thing. I want solutions in case it breaks out somewhere else. Even if I never need those solutions.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 107 guests