Short course radiation & surgery scheduled—questions

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Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Short course radiation & surgery scheduled—questions

Postby Punky44 » Mon Jan 21, 2019 12:55 pm

We just got the call that my mom’s surgery is scheduled for Friday March 22. They said the radiation timing is based around that so working backwards, she will start her short course radiation on Thursday March 14. Then she will do it again on Friday, take a weekend break, and then do it Monday, Tuesday and Wednesday. Then she has Thursday off and surgery Friday. I asked if the “break” in the middle of radiation was okay since I’ve read it should be 5 days straight. They said it’s always based on surgery date and so only the people having surgery on a Monday ever get 5 days straight the week before and all other patients have the weekend break.

Just want to see if anyone has any experience with this timing?
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Gravelyguy
Posts: 382
Joined: Thu Jul 05, 2018 6:03 pm

Re: Short course radiation & surgery scheduled—questions

Postby Gravelyguy » Mon Jan 21, 2019 1:36 pm

Punky,

I had surgery on a Thursday and so had the weekend off mid radiation and had zero issues and all seems well so far.

Dave
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 CEA .9 still NED!
6/11/19 CEA 1.0
12/19/19 CEA 1.0 still NED!
6/17/20 CEA 1.1 still NED!
12/15/20 CEA 1.1still NED!
12/16/21 CEA 1.2 still NED!

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Short course radiation & surgery scheduled—questions

Postby Punky44 » Mon Jan 21, 2019 1:37 pm

I was hoping you would reply since we are going to the same hospital! Glad to hear!
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Gravelyguy
Posts: 382
Joined: Thu Jul 05, 2018 6:03 pm

Re: Short course radiation & surgery scheduled—questions

Postby Gravelyguy » Mon Jan 21, 2019 8:27 pm

I think the radiation your mom is getting and I got is more to, hopefully, reduce the chance of local recurrence and less about reducing the size of the tumor so maybe that makes it less critical?

Dave
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 CEA .9 still NED!
6/11/19 CEA 1.0
12/19/19 CEA 1.0 still NED!
6/17/20 CEA 1.1 still NED!
12/15/20 CEA 1.1still NED!
12/16/21 CEA 1.2 still NED!

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Short course radiation & surgery scheduled—questions

Postby Punky44 » Tue Jan 22, 2019 1:06 am

True, you are probably right—more to “sterilize” the area.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Gravelyguy
Posts: 382
Joined: Thu Jul 05, 2018 6:03 pm

Re: Short course radiation & surgery scheduled—questions

Postby Gravelyguy » Tue Jan 22, 2019 7:18 am

Dr Larson published a study right before my surgery about stage 4 rectal cancer. In it there was a group that did not receive preoperative radiation and a group that did receive it. The group that received radiation had 0 localrecurrences and the group that did not had, I believe, a 20% local recurrence rate. The duration short or long course didn’t matter. What mattered was that you got it.

Needless to say he wants all of us operable stage 4 patients to have radiation and short course seeems to work best for synchronized resections.
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 CEA .9 still NED!
6/11/19 CEA 1.0
12/19/19 CEA 1.0 still NED!
6/17/20 CEA 1.1 still NED!
12/15/20 CEA 1.1still NED!
12/16/21 CEA 1.2 still NED!

Ehut
Posts: 233
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: Short course radiation & surgery scheduled—questions

Postby Ehut » Tue Jan 22, 2019 3:58 pm

I had short course radiation from Mon-Friday the week before my surgery on a Tuesday. No recurrence at any location and it has been almost 7 years.
Dx 12/11 rectal stage IV w/ 6 mets to liver, age 35
4 cycles FOLFOX 12/11 to 2/12
short course radiation 2/12
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
1/17: Added daughter to family!
12/19: Added son to family!
NED for 11+ years and counting!

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Short course radiation & surgery scheduled—questions

Postby Punky44 » Wed Jan 23, 2019 9:59 am

Ehut that’s awesome! Hoping for a similar outcome for my mom!
Last edited by Punky44 on Wed Jan 23, 2019 10:00 am, edited 1 time in total.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Short course radiation & surgery scheduled—questions

Postby Punky44 » Wed Jan 23, 2019 9:59 am

While we are on the subject, did either of you experience side effects or lasting effects of the short course radiation?
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Gravelyguy
Posts: 382
Joined: Thu Jul 05, 2018 6:03 pm

Re: Short course radiation & surgery scheduled—questions

Postby Gravelyguy » Wed Jan 23, 2019 10:12 am

Punky44 wrote:While we are on the subject, did either of you experience side effects or lasting effects of the short course radiation?



If I did, it was masked by the operation. The only thing I remember is being tired but I think that might have something to do with being in Rochester with not much to do and not at home where I had lots to do.

The proton beam radiation is supposed to be much more precise so probably not as damaging to the organs and skin surrounding it.

Dave
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 CEA .9 still NED!
6/11/19 CEA 1.0
12/19/19 CEA 1.0 still NED!
6/17/20 CEA 1.1 still NED!
12/15/20 CEA 1.1still NED!
12/16/21 CEA 1.2 still NED!

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Short course radiation & surgery scheduled—questions

Postby Punky44 » Wed Jan 23, 2019 5:47 pm

Wow that’s awesome Dave.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.


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