Newly diagnosed rectal cancer

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MeAndMine
Posts: 149
Joined: Mon Aug 05, 2019 2:40 pm

Newly diagnosed rectal cancer

Postby MeAndMine » Mon Aug 05, 2019 4:26 pm

Hi, I'm home from my colonoscopy earlier today so I have no staging or anything. Doctor found one tumor & one polyp. He removed the polyp & took biopsies & said they would be mailed to me when they came in. The report says:

-Likely malignant tumor in the mid rectum and in the distal rectum. Biopsied. Appears 2-3 cm proximal to anal verge, one longitudinal fold extends from tumor to anal verge at hemorrhoids.
-One 6mm polyp in the descending colon, removed with cold snare. Resected and retrieved.
-Diverticulosis in the sigmoid colon.

I don't see the size of the tumor on the paperwork but he said it was 4cm. I thought he said 5cm once but when I asked again he said 4cm so I'm not sure on that. On the page with the photos it says "rectum mass with longitudinal fold. Mass in rectuam no retroflexion performed.

As you can tell, I have no idea what any of this means or what is next so anything you can tell me will help.

They took blood work to test for hemogram with white blood count and platelets, CEA & CMP. I had a checkup a couple of weeks ago that did blood work but I'm sure it was different stuff. They said everything was good at the checkup except low thyroid & to come back in 6 weeks to re-check.

They also said I need a CT scan of the abdomen and pelvis without contrast but they are supposed to call me about that. He was saying something about chemo/radiation/surgery but he's not a surgeon & didn't know. He also said I have a polyp outside along with skin tags but that he only deals with what is inside so I will need to talk to the surgeon about the one on the outside.

Anything you can think of for me to do while I wait on the CT scan? I haven't eaten anything since I got home from the colonoscopy. I've not been wanting to eat for weeks though. I don't know what to do next.
F 56 non-smoker
8/5/2019 - Colonoscopy - 4-5 cm rectal mass, 2-3 cm proximal to anal verge and 6mm polyp
8/13/2019 - CT - No mets
8/19/2019 - Rectum: Adenocarcinoma arising from tubulovillous adenoma. Descending colon: tubular adenoma
8/23/2019 First visit with surgeon
8/26/2019 First visit with oncologist
8/26/2019 MRI
CEA 8/19/19=3.9, 8/26/19=7.1
9/6/2019 - T3N2a
9/11/2019 - Radiation begins - 5.5 weeks along with oral capecitabine

Soccermom2boys
Posts: 212
Joined: Tue Nov 10, 2015 10:29 pm

Re: Newly diagnosed rectal cancer

Postby Soccermom2boys » Mon Aug 05, 2019 7:17 pm

Hi MeAndMine—welcome to a club of the most wonderful people for the most awful reason. I am four years out from my rectal cancer diagnosis and popped on and saw your message and thought of how I was in a similar situation exactly four years right this week. Everything you have from the dr who did your colonoscopy is right on target for standard operating procedure. It sucks, but truly you are in a waiting pattern right now until you get the biopsy info back and get the CT scan and bloodwork. What you can do is start researching the Colorectal Surgeons and oncologists in your insurance plan (I guess that also depends on what country you reside in?). As you have a distal tumor that means it is pretty low and close to anal verge from what you wrote so you 100% want a board certified colorectal doctor as they are best qualified for the surgery you will need. Another really important piece of advice is to let the surgeon deal with the surgery and the oncologist deal with the treatments for the cancer.

Hang in there, it is toughest at the beginning mentally because where your imagination takes you is scarier than the reality. This really is an awesome place to come to if you are in the CRC club. Keep posting with more information as you get it and ask away—sooo many knowledgeable people willing to help and share on here.
8/3/15 Went in with a hemorrhoid, came out with a tumor
8/12/15 Biopsy from colonoscopy confirms RC (45 yrs old--zero family history!)
9/21 - 10/29/15 chemorad 28 tx (with Xeloda)
12/17/15 APR with perm colostomy
Pathology report stages me as IIIA (T2N1M0)--1/15 LN detects cancer
2/3/16 chemo port inserted
2/8-6/2/16 8 rounds of Folfox

CF_69
Posts: 90
Joined: Sat Dec 22, 2018 9:44 pm

Re: Newly diagnosed rectal cancer

Postby CF_69 » Mon Aug 05, 2019 8:17 pm

I went on a super strict diet and worked out a lot when I found out. There is so much waiting and anxiety going through the initial diagnosis and staging that I wanted to feel like I was at least doing something positive.

I’m not sure where you are, but I’m in Canada and while I got rushed through a ton of scans and appointments, getting into the cancer center just for the initial assessment took about a month.

The waiting sucks. Just try to be positive. Summon your inner warrior. This board is full of information and survivors.

Good luck.
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

NHMike
Posts: 2338
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Mon Aug 05, 2019 8:48 pm

Welcome to the forum where nobody wants to join.

I had a 5 CM tumor about 5 CM from the Anal Verge and was stage 3B. The staging drives the treatment protocol. My diagnosis was two years ago and the protocol was 28 days of radiation and chemotherapy at the same time, six-eight weeks rest, surgery, six-eight weeks rest, and then six months of stronger chemo. The protocols are more varied today so yours may not be exactly the same or the order might be different.

Each of these treatments has its challenges and it may sound tough, but, as my GI doctor said, you just put one step in front of the other and keep going. We can tell you about the challenges and what things are like but doing so all at once might be overwhelming. There is a wealth of experience here and we can help with all kinds of things - you only need ask - even if you want to ask what to expect. It looks like you will be set up with an oncologist and radiation oncologist.

The oncologist manages your chemo treatments. Your radiation oncologist manages your radiation treatments. You will need a surgeon and the usual advice here is to get a board certified surgeon in this specialty area. That is get a surgeon who does your type of surgery on a regular basis instead of a general surgeon. If possible, get a specialist at a high-volume cancer center.

Again, feel free to ask questions. This is likely a scary time and you'll have a lot of things running through your mind. I think that the CT scan will give them a rough idea about the tumor. They may need an MRI to see if there is any local spread to lymph nodes.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

Rock_Robster
Posts: 399
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Newly diagnosed rectal cancer

Postby Rock_Robster » Mon Aug 05, 2019 9:18 pm

Hi MeAndMine,

Firstly, welcome. You’ve got great advice here so far so I won’t attempt to add to this.

My only other comment is that the waiting truly sucks and there is not much you can really do about it - other than distraction. I had a week between my colonoscopy and staging scan results; I was living in the Netherlands so I just went to London for 3 nights and ate, drank and went out as much as I could to keep myself occupied.

Maybe find something nice you (and the family?) like doing and try to immerse yourself in that for a few days!

Best of luck for results,
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

CF_69
Posts: 90
Joined: Sat Dec 22, 2018 9:44 pm

Re: Newly diagnosed rectal cancer

Postby CF_69 » Mon Aug 05, 2019 9:39 pm

This is a good point.

I had what the doctors called suspicious nodes so pre pathology I was treated as though I was T3 N1.

The pathology after surgery found that the nodes were not cancerous, so I was ultimately staged at 2A which does change the adjuvant chemo element of treatment.

My oncologist originally said I didn’t need to do adjuvant chemo but we scheduled an appointment a few weeks later where he recommended 4 cycles of Xeloda as I indicated that I wanted to do the chemo.

I was also fortunate that I did not have a temporary ileostomy, so that saved me a ton of issues and a reversal surgery.

I foolishly believed I would breeze through the treatment and be back to work about 3 months after diagnosis. If I’m lucky I may go back to my full time job in October. 1 year later.

This is a marathon.

Also NHMike has a thread that about his journey that I read from beginning to end when I was diagnosed. It helped me a lot in those early days.
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

MeAndMine
Posts: 149
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Tue Aug 06, 2019 10:15 am

Thank you all so much for your advice. I am not having a good day. I feel hopeless when I try to find doctors in my network & think about what is coming.

I'm waiting on callbacks for referrals & my insurance is not very good. It doesn't work with any of the cancer centers or cancer hospitals. I've also been referred to a cardiologist because my heart keeps racing & blood pressure went up. The first referral was denied by my insurance, the second was approved but out of network & they wouldn't make an appointment until they got something faxed. This morning my husband's cardiologist said he would see me but still waiting on the referral to come through on that one.

I am making sure to find a board certified surgeon. So far I can only find one that my insurance will cover. But I'm jumping the gun since I haven't even gotten the CT referral yet. It's kind of a hurry up & wait situation. I have no idea who to see for oncology, etc. I was hoping to be able to go to a good cancer center but I will have to stay local with regular doctors at different places I think.

I have barely eaten. I think if I eat more I'll feel better but when I eat, my stomach hurts. I've tried to get started making a list of all of my passwords & links for bills, etc. so my husband will have them. I'm a mostly sedentary 57 year old & don't feel like I have the energy to do what I used to do already.

I'm rambling. Just so lost & don't know what to do next. I think all I can do for now is wait. Thanks again for listening.
F 56 non-smoker
8/5/2019 - Colonoscopy - 4-5 cm rectal mass, 2-3 cm proximal to anal verge and 6mm polyp
8/13/2019 - CT - No mets
8/19/2019 - Rectum: Adenocarcinoma arising from tubulovillous adenoma. Descending colon: tubular adenoma
8/23/2019 First visit with surgeon
8/26/2019 First visit with oncologist
8/26/2019 MRI
CEA 8/19/19=3.9, 8/26/19=7.1
9/6/2019 - T3N2a
9/11/2019 - Radiation begins - 5.5 weeks along with oral capecitabine

NHMike
Posts: 2338
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Tue Aug 06, 2019 12:24 pm

I gave my wife and my kids my password lists too.

I dropped 12 or more pounds after diagnosis.

The oncology and radiation can be done locally. I did them locally after getting a second opinion that reiterated what the first guys said. We're here if you want to chat though. We understand a lot of what you're going through.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

User avatar
Jacques
Posts: 566
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Newly diagnosed rectal cancer

Postby Jacques » Tue Aug 06, 2019 1:48 pm

One thing you could do is to read through this NCCN overview of rectal cancer and try to understand some of the basic concepts related to diagnosis, staging, and treatment planning

NCCN Guideline for Rectal Cancer Patients
https://www.nccn.org/patients/guidelines/rectal/index.html

NHMike
Posts: 2338
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Tue Aug 06, 2019 2:12 pm

My thread - if you have a LOT of time. viewtopic.php?f=1&t=58447
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

MeAndMine
Posts: 149
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Wed Aug 07, 2019 7:02 am

Thank you, I've been reading everything I can get my hands on. I am still overwhelmed. I never got a call back for my CT so I haven't even had that done yet. I keep calling. I can't sleep for thinking. I'm in a bad place in my head & can't get out. I've tried to find a chat room or somewhere I can just talk to someone.
F 56 non-smoker
8/5/2019 - Colonoscopy - 4-5 cm rectal mass, 2-3 cm proximal to anal verge and 6mm polyp
8/13/2019 - CT - No mets
8/19/2019 - Rectum: Adenocarcinoma arising from tubulovillous adenoma. Descending colon: tubular adenoma
8/23/2019 First visit with surgeon
8/26/2019 First visit with oncologist
8/26/2019 MRI
CEA 8/19/19=3.9, 8/26/19=7.1
9/6/2019 - T3N2a
9/11/2019 - Radiation begins - 5.5 weeks along with oral capecitabine

User avatar
SilverWedding
Posts: 71
Joined: Sat May 18, 2019 5:54 am
Facebook Username: Cynthia Harding Marshall

Re: Newly diagnosed rectal cancer

Postby SilverWedding » Wed Aug 07, 2019 7:28 am

Hi,

My DH is just a few months ahead of you in getting nearly same news as far as a rectal mass goes. Lots of tests happened over the next few weeks. Everyone here helped me by letting me know that the waiting would happen but would offer necessary insight. Getting doctors was awful as I knew little more than flip and dip through lists. What helped a lot is finding out that our local cancer center uses a multidisciplinary team (oncologist, radiologist, Surgeon, nutritionist, palliative care nurse) all who work with cancer. We were originally just given a surgeon name scribbled on the oncology report and knew no better. I started talking and calling anyone to find out who was not a general surgeon but a colorectal specialist - that’s when I found my state has one (ha - not sure of any others), and he is part of my cancer center’s multidisciplinary team. I canceled surgeon appt and got in with him. He was great because he understood the entire cancer process and wasn’t simply there to do a surgery. I think he was the one that got all the tests rolling.

Also, one huge help is that I started a binder right away. I printed out a calendar and began writing all appts along with phone numbers and contact info. I could’ve done this electronically, but there’s something about writing it out that seemed helpful - and we could just grab the red binder anytime to file receipts and reports and prescriptions and more. That binder has been a huge help, and I took it to all appts.

I didn’t find out till too late how you can go with a well-renowned cancer center far away but have radiation and chemo handled locally. If I could do it again, I would’ve done that. I was under wrong impression that we’d have to travel hours per day. What a shame. If things get worse for us, I’ll want to switch to a major cancer center.

I hope this is helpful.

As for this summer, it was lost to tears and worry and anxiety. I can’t say enough how helpful it was to have that multidisciplinary team all meet simultaneously with us and talk. It was huge. It was good to see everyone in accord. Two disagreed in the clinical staging, so they went with the more severe to be safe. It sounds weird, but I just needed this team to give facts, a plan, and hope. They did.

Also, this board has been a huge help. Honestly - people here are so helpful. I wish I could meet them all and thank them personally.

Here’s something I was told when I insisted they just cut out the tumor. Docs said it took about 10 years to get to this size, so waiting a few more weeks for a successful surgery under optimum conditions was fine.

My husband is through that first stint of daily chemo and radiation. Now we wait 6-8 weeks before surgery. They call it the cool down period. The Xeloda chemo was a pill
Form twice a day (six pills per day), and he didn’t lose hair. And, the anti-nausea pills worked every time.

I hope this is helpful and offers hope.
DH, 56, Sigmoid & rectum
Adenocarcinoma 2cm
 G2: Moderately differentiated
T3N2aM0
Stage IIIb
LN 6/22
5/19 Baseline CEA value - 18.9
Lymphovascular invasion (LVI): present
Perineural invasion (PNI): not identified
Surgical margins: proximal -negative; distal - negative 1.5cm; circumferential - negative 1mm)
MSI status: Waiting‬
Lynch status: ?
KRAS/BRAF: ?
Open Restorative Proctectomy, J-Pouch Coloanal Anastomosis, Loop Ileo w/Appendectomy
Neo-adjuvant Xeloda/radiation
Adjuvant Chemo: to begin 11/19

NHMike
Posts: 2338
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Wed Aug 07, 2019 8:52 am

MeAndMine wrote:Thank you, I've been reading everything I can get my hands on. I am still overwhelmed. I never got a call back for my CT so I haven't even had that done yet. I keep calling. I can't sleep for thinking. I'm in a bad place in my head & can't get out. I've tried to find a chat room or somewhere I can just talk to someone.


You can do private chats on this forum. Sometimes people will offer to talk on the phone. It is very distressing stuff and I'm glad I found this forum two years ago.

Hospitals and medical services can drop the ball or they can be exceptionally busy or understaffed. It can be pretty frustrating trying to get someone and just getting a machine where you have to leave a number.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

MeAndMine
Posts: 149
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Wed Aug 07, 2019 12:28 pm

I appreciate you all so much. Just knowing that someone is listening means so much.

I still cannot get anyone on the phone or anyone to return my call today. Can I ask, is the GI doctor the one who is supposed to schedule the CT or do I need to do it myself somehow? When I call their main number, they send me to scheduling & scheduling sends me to his medical...something, I forgot what her title is.

Yesterday when I called they said they return calls made after 3 the next day but I called well before that so I expected to hear something by the end of the day. Today I get the same recording which also says to not leave multiple messages but I was afraid they couldn't hear me or understand my phone number yesterday or something since they haven't called.

Maybe I'm supposed to do it myself but I have no idea how. When I left after the colonoscopy, they said they would schedule it & let me know. I think that's what they said, I was still a bit out of it.

How was your CT scan scheduled?
F 56 non-smoker
8/5/2019 - Colonoscopy - 4-5 cm rectal mass, 2-3 cm proximal to anal verge and 6mm polyp
8/13/2019 - CT - No mets
8/19/2019 - Rectum: Adenocarcinoma arising from tubulovillous adenoma. Descending colon: tubular adenoma
8/23/2019 First visit with surgeon
8/26/2019 First visit with oncologist
8/26/2019 MRI
CEA 8/19/19=3.9, 8/26/19=7.1
9/6/2019 - T3N2a
9/11/2019 - Radiation begins - 5.5 weeks along with oral capecitabine

NHMike
Posts: 2338
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Wed Aug 07, 2019 12:52 pm

MeAndMine wrote:I appreciate you all so much. Just knowing that someone is listening means so much.

I still cannot get anyone on the phone or anyone to return my call today. Can I ask, is the GI doctor the one who is supposed to schedule the CT or do I need to do it myself somehow? When I call their main number, they send me to scheduling & scheduling sends me to his medical...something, I forgot what her title is.

Yesterday when I called they said they return calls made after 3 the next day but I called well before that so I expected to hear something by the end of the day. Today I get the same recording which also says to not leave multiple messages but I was afraid they couldn't hear me or understand my phone number yesterday or something since they haven't called.

Maybe I'm supposed to do it myself but I have no idea how. When I left after the colonoscopy, they said they would schedule it & let me know. I think that's what they said, I was still a bit out of it.

How was your CT scan scheduled?


My first CT scan was scheduled while I was in the ER. My second was scheduled by my GI Doc. It was easy to get services at my local hospital.

I wanted second opinions at Dana Farber Cancer Institute in Boston though. It took me two weeks just to get to talk to someone to schedule an appointment. My GI doctor's office was calling them to get appointments too. At Dana Farber, it's hard to get the initial appointment because they seem flooded with patients. Once you get by intake, it's easy to get appointments.

Hospitals are like other businesses, some do things well and some don't. Sometimes I will drive over to a place if I can't get them on the phone.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT


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