Update - new to the club

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Readerokie
Posts: 3
Joined: Wed May 13, 2020 6:12 am

Update - new to the club

Postby Readerokie » Sat May 16, 2020 5:30 pm

My husband was released from the hospital after his open partial colectomy. He's healing very quickly, but has been very troubled by the news he's Stage 3b.

Official diagnosis is adenocarcinoma, 9 cm, upper left colon. T3N1aM0. Moderately differentiated.

I'm still a bit hopeful we can preserve some fertility. Does anyone know what regimens to avoid?
5/20 Urgent surgery, blockage.Tumor, upper left colon. 9cc. G2. Adenocarcinoma. Clear margins.
5/20 Dx Stage 3b. T3N1aM0. 1/15 lymph nodes.

Rock_Robster
Posts: 495
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Update - new to the club

Postby Rock_Robster » Sun May 17, 2020 4:49 am

Hi Readerokie,

Sorry to hear your news, but glad you’ve found the group. 3b is clearly intimidating and the treatments objectively unpleasant, but also good to know the stats are still squarely on your side.

Indeed cancer treatment can be rough on fertility. My main advice would be to freeze some sperm before treatment starts, as nothing is guaranteed. This way you can confidently pursue the treatment that confers the best outcomes for your husband, without having to trade-off against fertility concerns. I had 5 weeks of pelvic radiation and 13 cycles of chemo, I am now very lucky to be NED (after stage 4) but my sperm count is currently zero. Thankfully I have 10 sticks of sperm frozen; enough to do artificial insemination and/or IVF if we want to. The radiation is definitely the most damaging, but chemo can still have an impact. In many cases sperm counts can recover from 6-12 months after treatment too.

Best of luck with it,
Rob
Male 38; Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2, May-20=1.9.
11/18 FOLFOX x6
3/19 Liver resection
5/19 25x pelvic VMAT radiation; complete metabolic response
07/19 ULAR (robot), temp ileo, 1/27 LN
08/19 Missed a liver spot
08-11/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resection #2
02/20 Ileostomy reversed
03/20 PET & MRI = NED!

JJH
Posts: 290
Joined: Mon Apr 24, 2017 7:26 am

Re: Update - new to the club

Postby JJH » Sun May 17, 2020 11:10 am

Readerokie wrote:My husband was released from the hospital after his open partial colectomy. He's healing very quickly, but has been very troubled by the news he's Stage 3b.

Official diagnosis is adenocarcinoma, 9 cm, upper left colon. T3N1aM0. Moderately differentiated.

I'm still a bit hopeful we can preserve some fertility. Does anyone know what regimens to avoid?

Hi Readerokie -
You have updated your signature but it is still too short. Your signature should summarize all of the main data items from the pathology report. This is because these are the data items that the oncologist will be looking at in order to plan the best first-line chemotherapy for your DH. Right now, your signature is only one line long and many of the important items are not displayed there. Here are some of the important items that are still not found in your signature. (They should be added to the signature so that all of your future posts have this information available right at the bottom of each post and so that readers do not have to scroll back and forth through your past posts to find these details.)

    Tumor Location : upper left colon?
    Tumor Size: (in cc.) 9cc?
    Tumor grade:
      G1: Well differentiated (low grade)
      G2: Moderately differentiated (intermediate grade) ?
      G3: Poorly differentiated (high grade)
      G4: Undifferentiated (high grade)
    Stage: (Stage III-B ?)
    Lymph node involvement: Number of positive nodes out of total number sampled
    Lymphovascular invasion: present/absent
    Perineural invasion: present/absent
    Primary surgery type: open partial colectomy?
    MSI-status (or dMMR status) - This is needed to determine the best chemotherapy treatments to use (and which ones will likely be ineffective). It should have been tested at the time when the original tumor was being tested for malignancy .
    KRAS/BRAF/NRAS mutation status. (required for Stage IV, but recommended for Stage III-B because of elevated risk profile)
    Baseline CEA value (Very important! Must be taken before start of first treatment intervention )
    Surgical margins: clear or involved


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