Sorry to hear of your diagnosis. Really glad to hear though that this forum is of help to you.
This may not be a popular opinion, but my inclination in general would be that if your staging comes back at I or II, you could probably be well-handled by a competent local oncologist, then go to a major hospital for surgery. If it came back at III or IV, then I’d be heading to MSK to make sure the whole plan (chemo, radiation, surgery) is properly integrated.
However my first impression was that given you’re “only” an hour away from MSK, then I’d be inclined to go anyway. However I’m also conscious an hour may be a lot more inconvenient for some people that others, so I won’t try to make a judgement on that.
Rectal cancer can be slightly more complicated, due to the need to work radiation therapy in with the plan, and also an often more complex resection. 5cm is also getting on the lower side, so sphincter-sparing becomes a priority. In this case it’s definitely better to err on the side of a high-volume cancer centre that uses a multidisciplinary team approach.
Just my $0.02 - best of luck for the staging!
Male 37 yr; Melbourne, Australia. BMI 24
10/2018 Dx 3.5 cm RC adenocarcinoma, 12cm from AV
Mod diff (G2), EMVI+, LVI+, PNI-
3 local LN; 4 liver mets, resectable
pT3 pN1a pM1a; 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
12/18 - DVT
3/19 - Liver resection (open); R0
4-5/19 - 25 x pelvic radiation w Xeloda; complete metabolic response (TRG 3)
07/19 - ULAR (robotic), temp ileo. R0; 1/27 LN positive
08/19 - FOLFOX x 2-4