Post surgical changes. Reoccurrence?

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Basil
Posts: 262
Joined: Thu Mar 16, 2017 12:33 pm

Re: Post surgical changes. Reoccurrence?

Postby Basil » Wed Oct 24, 2018 7:20 pm

Nohogirl wrote:Thank you all for your replies.

The surgeon didn't seem too care much about it. I asked him if this is possibly a reoccurrence, he said it could be or not. To my question if he can do a sigmoidoscopy he answered that it won't tell him anything. He said my husband looks good and he doesn't see any reason to be worried. His cold approach frustrates me. My husband looked good before his diagnoses and to me look is not the best prediction of the illness.
Whats killing me is that when i I read about local reoccurrence in rectal cancer, it says it has a very poor prognosis and is considered terminal :(


My husband didn't have any colostomy bag, when 24 cm of his rectum and colon was removed, his colon was reconnected together. So to make me feel a little relieved i am thinking this was probably to much trauma for his surgery site and will take more time to heal especially he also had radiation prior to it.


To address the middle part of your post - a local recurrence is not necessarily fatal. Small sample size, but I had two friends with local recurrences and they’re both Ned. One is from the 1990s. Distant presentation is more difficult.
40 y/o male, kids 8&11
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

boxhill
Posts: 403
Joined: Fri Apr 06, 2018 11:40 am

Re: Post surgical changes. Reoccurrence?

Postby boxhill » Thu Oct 25, 2018 12:47 pm

I think it is normal not to do PET scans so soon after surgery, because chances are they would light up with a lot of surgical changes and it would be very difficult to determine what was what. Or so I was told.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable

CF_69
Posts: 89
Joined: Sat Dec 22, 2018 9:44 pm

Re: Post surgical changes. Reoccurrence?

Postby CF_69 » Fri Oct 25, 2019 12:18 am

I was just looking over my CT from September, roughly 6 months post surgery.

I just saw my oncologist for the last time (hopefully) two weeks after the scan, and approximately 2 months after I finished 4 cycles of Xeloda.

There is similar wording in my CT report:

“Mild thickening of the rectum circumferentially likely post treatment related but can be reassessed on subsequent studies”

“Presacral thickening compatible with treatment related change”

They just don’t ever want you to relax.

In the summary it says:

“Impressions: post therapeutic change appreciated at the surgical site. No evidence of intrathoracic or intra-abdominal metastatic disease.”

I guess we never really get the definite “YOU ARE FINE” that would be so, so good to hear.
47 year old male
Distal sigmoid near rectosigmoid junction adjacent to upper rectum
Adenocarcinoma
2.8 x 1.8 x 3.5 cm
G2
T3N0M0 after pathology
CEA:
Dec 2018 - 1.9
September 2019 - 2.5
Xeloda / radiation x 25
Laparoscopic LAR April 2019
0 of 12 nodes
Stage 2A
4 cycles of adjuvant Xeloda
MRI on liver for 2mm hypodensity not suspicious.
Clear CT - September 2019

Rock_Robster
Posts: 392
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Post surgical changes. Reoccurrence?

Postby Rock_Robster » Fri Oct 25, 2019 12:31 am

CF_69 wrote:I guess we never really get the definite “YOU ARE FINE” that would be so, so good to hear.

Precisely. Unfortunately as soon as we enter the cancer world, we enter one of uncertainty - where both diagnoses and prognoses are based on statistics - stochastic models of outcomes based on large populations. No prudent oncologist will ever say any outcome is 0% or 100%, and I believe finding a way to live with that uncertainty is a key part of wellbeing during survivorship.

Best wishes for continued healing.

Rob
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets
pT3pN1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response
07/19 - ULAR (robot), temp ileo, 1/27 LN
08/19 - Missed liver spot
08-11/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 5
12/19 - Planned liver resection #2 & (01/20) stoma reversal

Claudine
Posts: 179
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Post surgical changes. Reoccurrence?

Postby Claudine » Fri Oct 25, 2019 9:13 am

Unfortunately as soon as we enter the cancer world, we enter one of uncertainty


Part of the conversation I had with the onc two days ago:
Me: "I know you don't have a crystal ball, but..."
Him: "I wish I did!"
(this regarding possible traveling we want to do in April. Way too far ahead to know where we'll stand then, alas)
Wife of Dx 04/2018 (51 yo). MSS, KRAS mutated G12A
No primary, lytic tumor L4 vertebrae, CEA 10
Radiation 04/2018
Resection small intestine 05/18 (no cancer found - Crohn's)
Xelox * 6, 05/2018 to 10/2018
6.7 cm left adrenal mass 03/14/2019, 4.4 cm 05/21, 4.1 cm 09/16
SBRT L4 02/2019
Folfiri + Avastin
CEA since 03/15: 58, then low of 3.2 now 6.9
Scan 03/14: Multiple small lung nodules
Scan 05/21: shrinking
Scan 09/16: lungs show no abnormalities (YAY!!!)

Rock_Robster
Posts: 392
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Post surgical changes. Reoccurrence?

Postby Rock_Robster » Fri Oct 25, 2019 6:37 pm

Claudine wrote:
Unfortunately as soon as we enter the cancer world, we enter one of uncertainty


Part of the conversation I had with the onc two days ago:
Me: "I know you don't have a crystal ball, but..."
Him: "I wish I did!"
(this regarding possible traveling we want to do in April. Way too far ahead to know where we'll stand then, alas)

Hi Claudine, absolutely right!

Although as my therapist says, uncertainty also leaves lots of room for good outcomes - which I’m happy with. I’d much rather an uncertain outcome with good potential, than a definitely bad one...

She also taught me to make “options” rather than “plans”; as in ‘next week we have the option to go away for the weekend if I’m feeling good’. Now I just need the airlines and hotels to agree with the option mindset :-)
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets
pT3pN1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response
07/19 - ULAR (robot), temp ileo, 1/27 LN
08/19 - Missed liver spot
08-11/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 5
12/19 - Planned liver resection #2 & (01/20) stoma reversal

Claudine
Posts: 179
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Post surgical changes. Reoccurrence?

Postby Claudine » Mon Oct 28, 2019 11:23 am

Although as my therapist says, uncertainty also leaves lots of room for good outcomes - which I’m happy with. I’d much rather an uncertain outcome with good potential, than a definitely bad one...

She also taught me to make “options” rather than “plans”; as in ‘next week we have the option to go away for the weekend if I’m feeling good’. Now I just need the airlines and hotels to agree with the option mindset :-)


Haha yes I like the bit about uncertainty that can have positive outcomes!
I'm looking into travel insurances that have a waiver for pre-existing conditions. Apparently one needs to read the fine prints, since some of them make an exception for cancer (= they don't insure cancer patients...)/
Wife of Dx 04/2018 (51 yo). MSS, KRAS mutated G12A
No primary, lytic tumor L4 vertebrae, CEA 10
Radiation 04/2018
Resection small intestine 05/18 (no cancer found - Crohn's)
Xelox * 6, 05/2018 to 10/2018
6.7 cm left adrenal mass 03/14/2019, 4.4 cm 05/21, 4.1 cm 09/16
SBRT L4 02/2019
Folfiri + Avastin
CEA since 03/15: 58, then low of 3.2 now 6.9
Scan 03/14: Multiple small lung nodules
Scan 05/21: shrinking
Scan 09/16: lungs show no abnormalities (YAY!!!)


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