Postby boxhill » Tue Sep 24, 2019 12:48 pm
As you may know, I am all in favor of research, but you really have to be careful about assessing what you read and putting it in perspective.
For example, lots of older articles confidently state that right-side tumors have a worse prognosis. Newer ones can state the reverse. The reasons for this seem fairly clear: right-side tumors tend to be found at a later stage, probably because they are more likely to be sessile and thus harder to find AND they take longer to make themselves known with blockages and the like. But they are also more likely to be MSI-H, so now things look much brighter because of immunotherapy. Frequently articles focused on survival stats will make the assertion without delving into the reasons.
You can also find articles that confidently assert that "Stage IV CRC is incurable." It can at best be managed to prolong life. Now we know that outright cures might not be in the majority, but they definitely exist because of advances in treatment. Certainly there are plenty of patients who are in the care of doctors in the back of beyond who are not up on the latest treatments, and may well not treat aggressively because conventional wisdom says it's pointless. (As Stu's mom experienced.)
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED