Newly diagnosed rectal cancer

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MeAndMine
Posts: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Thu Aug 29, 2019 12:23 pm

The table is fairly narrow and you have to step up on something to get on it. They put pieces of stuff on it to hold your body and put towels on it. You might ask to see the table or room when you meet the radiation oncologist.


I will have to ask to see it & see if they know where my arms might need to be. Out of all of the things to worry about, I want to know where my arms have to be so I can practice or something to make it easier to lay there with my shoulder acting up.

I just heard from someone who said they had a 5 cm rectal tumor & they only had surgery with no other treatment so they think it's overkill to get chemo and radiation. I don't know. How do you say that to someone? I'm sure he was trying to help. Everyone is different. I was thinking he must have meant 5mm but nope, he said cm.
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: 2324
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Thu Aug 29, 2019 12:42 pm

MeAndMine wrote:
The table is fairly narrow and you have to step up on something to get on it. They put pieces of stuff on it to hold your body and put towels on it. You might ask to see the table or room when you meet the radiation oncologist.


I will have to ask to see it & see if they know where my arms might need to be. Out of all of the things to worry about, I want to know where my arms have to be so I can practice or something to make it easier to lay there with my shoulder acting up.

I just heard from someone who said they had a 5 cm rectal tumor & they only had surgery with no other treatment so they think it's overkill to get chemo and radiation. I don't know. How do you say that to someone? I'm sure he was trying to help. Everyone is different. I was thinking he must have meant 5mm but nope, he said cm.


Low rectal cancer: impact of radiation and chemotherapy on surgical treatment.

INTRODUCTION:

The aim of this study was to evaluate the impact of combined radiotherapy and chemotherapy (leucovorin and 5-fluorouracil) on the treatment of potentially resectable low rectal cancer using the following end points: 1) toxicity of this combined modality regimen; 2) clinical and pathologic response rate and local control; 3) down-staging of the tumor and its influence on the number of sphincter-saving operations; 4) disease-free interval, patterns of relapse, and overall survival.

CONCLUSIONS:

Combined up-front chemoradiotherapy was associated with tolerable and acceptable side effects. A significant number of patients had complete disappearance of their tumors (30.5 percent) within a median follow-up of 36 months. This regimen spared 26.2 percent of patients from surgical treatment and allowed sphincter-saving management in 38.1 percent of patients who may have required abdominoperineal resection. Preliminary results of this trial suggests a reduction in the number of local recurrences and reinforces the concept that infiltrative low rectal cancer may be initially treated by chemoradiotherapy.


https://www.ncbi.nlm.nih.gov/pubmed/9749491

Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the rectum.

OBJECTIVE: In this study, the impact of preoperative chemotherapy and radiation on the histopathology of a subgroup of patients with rectal adenocarcinoma was examined. As well, survival, disease-free survival and pelvic recurrence rates were examined, and compared with a concurrent control group.

CONCLUSIONS: This therapeutic regimen has provided enhanced local control and decreased metastases. Furthermore, the marked degree of tumor downstaging, as seen by a 27% incidence of sterile pathologic specimens and a low rate of positive lymph nodes in this group with initially advanced lesions, strongly suggest that less radical surgery and sphincter preservation may be used with increasing frequency.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234712/

Downstaging of advanced rectal cancer following combined preoperative chemotherapy and high dose radiation

Purpose: To assess the potential downstaging of advanced rectal cancer with combined preoperative chemoradiation.

Conclusions: Concomitant preoperative chemoradiation using low dose continuous infusional 5-FU for advanced rectal cancer is relatively safe with acceptable morbidity. This approach is associated with considerable clinical and pathologic downstaging of cancer. Tumor resectability is improved with potential for improved local control of disease and survival.


https://www.sciencedirect.com/science/a ... 1694905320

These studies are from the mid-1990s so the science on Neo-Adjuvant Chemotherapy and Radiation Therapy has been proven for a long time. I'm surprised that a surgeon would remove the tumor given that it goes against the standard treatment protocol. My surgeon wouldn't remove the tumor without Neo-Adjuvant ChemoRadiation. I doubt that other surgeons would either.
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: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Thu Aug 29, 2019 2:06 pm

These studies are from the mid-1990s so the science on Neo-Adjuvant Chemotherapy and Radiation Therapy has been proven for a long time. I'm surprised that a surgeon would remove the tumor given that it goes against the standard treatment protocol. My surgeon wouldn't remove the tumor without Neo-Adjuvant ChemoRadiation. I doubt that other surgeons would either.


Thank you for the links! And yes, I was thinking the same thing.
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
Jacques
Posts: 536
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Newly diagnosed rectal cancer

Postby Jacques » Fri Aug 30, 2019 3:52 am

MeAndMine wrote:
The table is fairly narrow and you have to step up on something to get on it. They put pieces of stuff on it to hold your body and put towels on it. You might ask to see the table or room when you meet the radiation oncologist.


I will have to ask to see it & see if they know where my arms might need to be. Out of all of the things to worry about, I want to know where my arms have to be so I can practice or something to make it easier to lay there with my shoulder acting up. ...


As was mentioned above, there are all kinds of variations in the way that chemo/rad is implemented. It can depend on the kind of machine used. It can depend on the policy of the hospital. It can depend on the preference of the doctor. It can depend on which country you're in, etc, etc.

In the posts in the link below, some patients were put in a custom-made plastic mold. For some, it was a mold of the lower body only; for others it was a full-body mold. Some patients didn't have a mold at all. It depends. Some rectal cancer patients are placed in the machine face up; other rectal patients are placed in the machine face down. It depends.

For some patients, all 25 radiation sessions use the same amount of radiation each day. For others patients, the total radiation for the 25 days is distributed on an escalating scale where the radiation doses during the first week are rather low but increase each day until the radiation doses are very high during the final week. In any case, the total dose of radiation over all 25 days is the same maximum amount; it's just the distribution from day to day that might change.

For some patients, Xeloda is prescribed on radiation days only. For other patients, Xeloda is given 7 days a week, non stop. It all depends

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=51448

So, if you want to know what will happen in your case, I think you will need to talk to the radiation oncologist to see just what the procedure is in your particular hospital.

MeAndMine
Posts: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Fri Aug 30, 2019 10:56 am

For some patients, Xeloda is prescribed on radiation days only. For other patients, Xeloda is given 7 days a week, non stop. It all depends


Thanks My oncologist said he likes Xeloda 7 days a week during radiation, but if it’s too hard we can change to weekends off. I’m hoping I can get the maximum of everything and hang in there. I’ll ask the radiation oncologist about positioning when I go.
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
Jacques
Posts: 536
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Prevention of Hand Foot Syndrome

Postby Jacques » Fri Aug 30, 2019 1:54 pm

MeAndMine wrote:
For some patients, Xeloda is prescribed on radiation days only. For other patients, Xeloda is given 7 days a week, non stop. It all depends


Thanks My oncologist said he likes Xeloda 7 days a week during radiation, but if it’s too hard we can change to weekends off. I’m hoping I can get the maximum of everything and hang in there. I’ll ask the radiation oncologist about positioning when I go.

MeAndMine -

If you are going to be taking Xeloda nonstop, you might end up having an early onset of Hand Foot Syndrome. It would be good to read whatever you can about possible ways to prevent HFS or at least keep it from getting out of control. There are a number of posts related to Hand Foot Syndrome on this forum.

There are also some articles on the Internet, for example:

https://www.oncologynurseadvisor.com/home/departments/ce-courses/prevention-and-management-of-hand-foot-syndromes/

Rock_Robster
Posts: 381
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Newly diagnosed rectal cancer

Postby Rock_Robster » Fri Aug 30, 2019 8:34 pm

I did 25 treatments of pelvic IMRT on my back, due to recent liver surgery. I was told this way can result in more GI side effects, but less external redness/burning. I took Xeloda on Mon-Fri at 3,000 mg/d, and didn’t have any issues with hand/food syndrome. I also used MooGoo cream prophylactically in a few places. Overall I found this one of the more tolerable parts of treatment, but of course everyone is different.

As to doing the treatment itself, I was strongly encouraged to by my surgeon and rad onc, based on a ‘bulky’ tumour (T3b, 3.5cm) with a few nasty features. I had a complete metabolic response (TRG 3), meaning the tumour was no longer visible on PET but some cancer cells remained, prior to surgery. Surgical margins were clear with 1/27 lymph nodes positive.

Best of luck,
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, resectable
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, TRG 3
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 & stoma reversal

MeAndMine
Posts: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Mon Sep 02, 2019 6:39 am

It seems to take forever, the waiting to get started. I don't get to see the radiology oncologist until the end of this week. I've been having lots more stomach pains & pelvic floor pressure for the last few days. I'm scared to get started but scared to wait. Nothing to do but wait in any case. The oncologist said it would take 2-3 weeks to get things set up to actually start. The pharmacy has been working on getting the Xeloda. So far they just send messages that say they have an issue they are working on.

I had a message from a support & wellness specialist. I don't know what I would ask her or what services she would provide. I feel like I need to be doing something. I've never been one to take any kind of medicine but the way my mind goes these days, I'm sure I need to get started somewhere.

I was thinking about making myself an Amazon wish list so that I would know things I need to have on hand before starting. I think putting it on a list like that where I can actually look up the products is better than having it written on a piece of paper that just says "lotions, chair cushion..." I know it's not much but it's doing something besides waiting. Do any of you have a list that you wouldn't mind sharing on what helped you through the different procedures?
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

Rock_Robster
Posts: 381
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Newly diagnosed rectal cancer

Postby Rock_Robster » Mon Sep 02, 2019 6:50 am

Sure thing! What an excellent idea to get this organised now.

https://www.amazon.com/Bidet-Attachment ... way&sr=8-3

https://www.amazon.com/MooGoo-Skin-Milk ... ay&sr=8-13

https://www.amazon.com/Daily-Pill-Organ ... 9TH&sr=8-3

https://www.stealthbelt.com/stealth-belt-pro (in case you have an ostomy at some point)

Also good to get a cheap but large (~1 L) water bottle with measurements on it, as they’ll want you to drink a standard amount of water before each radiation treatment.
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets, resectable
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, TRG 3
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 & stoma reversal

NHMike
Posts: 2324
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Mon Sep 02, 2019 8:06 am

Rock_Robster wrote:Sure thing! What an excellent idea to get this organised now.

Also good to get a cheap but large (~1 L) water bottle with measurements on it, as they’ll want you to drink a standard amount of water before each radiation treatment.


My radiation center gave me a plastic bottle. I think that it was either 20 or 24 ounces. These days I'd prefer stainless steel but the plastic water bottle did the job.
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: 536
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Newly diagnosed rectal cancer

Postby Jacques » Mon Sep 02, 2019 8:08 am

MeAndMine wrote:... Do any of you have a list that you wouldn't mind sharing on what helped you through the different procedures?


MeAndMine
Posts: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Tue Sep 03, 2019 6:36 am

Thanks everyone! I am determined to be prepared. I've been feeling things the last few days. I know they say it's slow growing but somehow things are getting harder and I've been hurting. I keep thinking that it's going to break through a wall or something because I wasn't feeling these things before.

It didn't help that yesterday I was told that maybe I need to take a good look at myself and why I got cancer. I am told I'm holding on to anger. I didn't think I was angry. I was, however, in the "what's the use" mindset. It was really hard to lose my sister from cancer then have my husband diagnosed with cancer the same week, so I'm sure I was angry but mostly I was just sad, sad, sad. It felt like the harder we tried, the more things happened. Mostly I just try to put one foot in front of the other and not think. Some days are better than others.

My daughter bought me a 28oz water bottle. Looking at the markings, if I fill it all the way to the lid, I think it's 32 ounces. I used to keep 8 water bottles on the counter and would grab one when I walked that way, to make sure I had them all empty by the end of the day. I think I do better if I have it all ready to go in the morning rather than emptying and refilling the same bottle.

I watched a video yesterday where a girl said she set her alarm to go to the bathroom every 2 hours during chemo so that her bladder would not be effected by chemo. Is that something you have done or heard about? Are there any other "tricks" that we should do like that?
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: 2324
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Tue Sep 03, 2019 7:02 am

MeAndMine wrote:Thanks everyone! I am determined to be prepared. I've been feeling things the last few days. I know they say it's slow growing but somehow things are getting harder and I've been hurting. I keep thinking that it's going to break through a wall or something because I wasn't feeling these things before.

It didn't help that yesterday I was told that maybe I need to take a good look at myself and why I got cancer. I am told I'm holding on to anger. I didn't think I was angry. I was, however, in the "what's the use" mindset. It was really hard to lose my sister from cancer then have my husband diagnosed with cancer the same week, so I'm sure I was angry but mostly I was just sad, sad, sad. It felt like the harder we tried, the more things happened. Mostly I just try to put one foot in front of the other and not think. Some days are better than others.

My daughter bought me a 28oz water bottle. Looking at the markings, if I fill it all the way to the lid, I think it's 32 ounces. I used to keep 8 water bottles on the counter and would grab one when I walked that way, to make sure I had them all empty by the end of the day. I think I do better if I have it all ready to go in the morning rather than emptying and refilling the same bottle.

I watched a video yesterday where a girl said she set her alarm to go to the bathroom every 2 hours during chemo so that her bladder would not be effected by chemo. Is that something you have done or heard about? Are there any other "tricks" that we should do like that?


I know how you feel as I was wondering why the surgeon couldn't just cut the thing out and why I had to go through chemo and radiation. The chemo and radiation started to reduce the tumor about two - three weeks in and there was the relief. When I complained about the fullness feeling, the medical staff would only suggest Miralax or other softeners. I had a lot of worry that something would break as well and it was very uncomfortable for quite some time.

I asked my doctor why I got cancer and he said because I turned 50. The risk of cancer doubles every seven years of life as I guess that's the turnover for cells or something like that. Each duplication causes the potential for a mutation. There are mechanisms to fix the mutations but they can break too.

This morning I had alarms at 1 AM, 2 AM, 3 AM, 4 AM and 5 AM but that was for LARS. I think that I woke up three times as I usually sleep through a few of them. I had alarms every two hours when I had the ileostomy because I was worried about it filling up and leaking overnight. But those are different things.

I had my radiation appointments at 8:00 AM so I did not have needing to pee overnight as an issue. After the radiation treatment, I headed straight to the bathroom to let it all out as it is a lot of water.

You go through a lot of emotions through the cancer journey. One of my rituals was updating my will and providing all of my username/passwords to accounts to family members before a surgery. I think that everyone that has gone through this has had the very wide range and type of emotions that I've seen.
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: 147
Joined: Mon Aug 05, 2019 2:40 pm

Re: Newly diagnosed rectal cancer

Postby MeAndMine » Tue Sep 03, 2019 7:17 am

The GI doctor just called to tell me that the MRI shows tumor has passed through the muscle and into lymph nodes. He didn't say much more than that other than he will let the oncologist and surgeon tell me what is next and he will pray for me.
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: 2324
Joined: Fri Jul 21, 2017 3:43 am

Re: Newly diagnosed rectal cancer

Postby NHMike » Tue Sep 03, 2019 7:27 am

MeAndMine wrote:The GI doctor just called to tell me that the MRI shows tumor has passed through the muscle and into lymph nodes. He didn't say much more than that other than he will let the oncologist and surgeon tell me what is next and he will pray for me.


He might be referring to the levator muscles. My surgeon said that there was some evidence that these were affected but I think that they weren't. She said that if they were affected to some degree, then I would have a permanent colostomy as there wouldn't be the muscles to prevent stool from coming out. I also had suspicious lymph nodes in the MRI pathology report - three of them. So my stage was IIIB.

The stage of IIIB or IIIC depends partially on the number of suspicious lymph nodes. It would also help to know which muscle was affected. You might look at your hospital online portal to see if you can get the pathology report there.
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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