Most of my time this past Thursday was spent at Memorial Sloan Kettering in New York—a truly remarkable place. I met with Dr. Leonard Saltz and a few members of his team who explained that their pathologists analyzed my tumor specimen and arrived at a very different diagnosis. They identified several high-risk factors, including extensive tumor budding, small vessel lymphovascular invasion, perineural invasion, and pT4a stage. In contrast, pathologists at my community hospital had identified no high-risk factors (pT3N0), which is why my oncologist recommended surveillance and no further treatment.
Given the presence of multiple high-risk factors, Dr. Saltz recommends that I begin chemotherapy without delay. Specifically, he recommends adjuvant treatment for six months (Xeloda 5000 mg for two weeks followed by a one-week rest period). We’re working out the details, and I expect treatment will begin shortly. I’ll update my signature soon.
I believe everyone confronting cancer should get a second opinion—carefully choosing a doctor who specializes in their type of cancer and is associated with an NCI-designated cancer center. The goal is to prevent diagnostic and staging errors and to obtain accurate and complete information to determine the best course of treatment. In an earlier post, Beckster said that she knows Stage II folks who “had a second pathology done on their tumor and the results changed.” Beckster, you can now add me to that list!
DX: CC, 7-9-18 @ age 61, male
Severe anemia (4.5 g/dl), 5-11-18; colonoscopy, 6-29-18
Laparoscopic-assisted right hemicolectomy, 7-16-18
G2, moderately differentiated adenocarcinoma in cecum, 4.2 x 3.7 x 0.7 cm
Stage IIB, T4aN0M0
0/24 lymph nodes, LVI present, PNI present, surgical margins clear, MSS
CEA: 3.0 (pre-op, 7-10-18); 0.7 (post-op, 8-8-18)
TX: Xeloda (Capecitabine) monotherapy