Tumor regression number / other results

[CF_69]

I just got my post chemoradiation / pre surgery CT scan and MRI report back. I have not seen the doctor yet. Of course I decided to read it and try to figure out what it means.

CT scan states: “Known rectal mass is no longer visible on CT.”

I interpret this as positive.

The MRI states: “There is some surrounding low signal fibrosis at the superior margin of this residual tumor in particular along the muscularis side. The tumor reduction is on the order of 60%. Because there is residual tumor signal intensity in the setting of tumor volume reduction I will consider this grade 3 progression.”

And at the end of the report:

“Opinion:

There has been tumor regression but residual intermediate tumors signal intensity remains with persistent extension of tumor signal intensity through the muscularis such that there is residual T3 tumor in the mesial rectal fat.

Based on the findings I would consider this grade 3 tumor regression.”

So I have found that there are two scales to measure tumor regression. One where complete response is 0, and the other where complete response is 4.

I’m guessing that my “grade 3 regression” is good.

If anyone can give their opinion on their interpretation of the above, I would greatly appreciate it, recognizing that it is not medical advice.

I have a tentative surgery date near the end of March.

[CRguy]

CT scan states: “Known rectal mass is no longer visible on CT.”
I interpret this as positive. = Yes !

The MRI states: “There is some surrounding low signal fibrosis at the superior margin of this residual tumor in particular along the muscularis side. The tumor reduction is on the order of 60%. Because there is residual tumor signal intensity in the setting of tumor volume reduction I will consider this grade 3 progression.” = PROgression ?

And at the end of the report:
“Opinion:
There has been tumor regression but residual intermediate tumors signal intensity remains with persistent extension of tumor signal intensity through the muscularis such that there is residual T3 tumor in the mesial rectal fat.
Based on the findings I would consider this grade 3 tumor regression.” = REgression ?

If anyone can give their opinion on their interpretation of the above, I would greatly appreciate it, recognizing that it is not medical advice.

I have a tentative surgery date near the end of March.

My comments above in blue FYI ... BUTT I note the PRO / RE gression terminology so I think a talk with the Doc is in order.

" Hey Doc .... Which is it ? "

That aside, your sitrep and mine are pretty much similar.
rectosigmoid tumor, neoadjuvant chemoradiation with Xeloda, questionable MRI "enlarged nodes",
full LAR TME resection which showed pCR = tumor completely nuked back to the last millenium !!! = GOOD news.

I would say you are probably in a good place and when the surgery is done ... my guesstimate is that you may well have the same result I had.

Just sayin' ... NOT a medical opinion ... just a ++++Posi VIBE I am sending your way

Cheers and Harmony on the Journey
CRguy

[CF_69]

Thanks for the reply.

I noticed the “pro”gression . There are many small errors in the report, I think it may be generated from some kind of dictation software, or maybe it’s just a guy that doesn’t care to correct typos.

For sure I will discuss all of this with my doctor when I do meet with him.

[CF_69]

Also about those suspicious nodes, this is the update.

“There are a few small lymph nodes in the mesial rectal fat with short axes of 2 to 3 millimeters. They are smaller than on the prior study. No adenopathy is appreciated.”

Am I correct in interpreting this as non cancerous?

I know the surgeon will take them out and they will be analyzed. Just curious. If I have no cancerous nodes does that make me a stage 2?

When I was originally getting staged, I had 1 CT scan done at the emergency room that only scanned my abdomen. I never saw the report for it, but once the cancer center took over my case, I had the chest scan done.

I was told that I was all clear. My post chemo radiation CT scan did my entire upper body, so this report has my liver, etc on it and it says:

“Millimetric hypodensity within segment 8 unchanged from previous measuring approximately 2 mm in size. This remains too small to characterize. Remainder of the liver is unchanged without definite metastatic disease.”

I’m wondering why none of my doctors ever mentioned this to me at all.

The abdominal CT was done at the end of October, so a little over 4 months ago. I’ll interpret the fact that the “hypodensity” hasn’t changed to be positive news, I’m just really wondering why nobody ever mentioned it.

I’ve been paranoid of every ache and pain I’ve had, and after radiation, I’ve had a lot. I suppose that is a side effect.

I’ve started taking CBD oil and it really does seem to help with my overall physical feeling.

I have about 3 weeks until my surgery. I imagine things are going to start happening rather quickly.

[Cured]

CF, I did the Radiation with Chemo before surgery. Since they told me that they could possibly have sterilized the cancer, I asked “can we skip the surgery then?”
Thank goodness I followed protocol, as my Rectal tumor was “like an iceberg” my surgeon said. Just the tip inside the colon and large on the outer wall.
Surgery is still the best way to get rid of Rectal cancer. All the rest is auxiliary.

Before I started treatment, to refine the stage a Dr. performed Rectal ultrasound* and said it appeared Stage I. As the tumor was found to involve lymph nodes, I was Stage III. My Colorectal Surgeon is so expert, he began by saying that the colonoscopy presented as if I was Stage 2, but he was approaching as if I were Stage 3. (Which is common as the rectum does not have fat surrounding like the colon does, so the nodes get involved more easily).

I pray that your surgery goes well and that God gives you the strength to endure.

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* on a lighter note: I don’t get why UFO fans want to be probed by Aliens.