Please help, input needed

[Ulendon]

Got the last of the lab and biopsy results.

CEA was normal (3.2)
MSI testing was done and came back intact.
Biopsy confirmed adenocarcinoma
DNA mismatched repair testing was normal.

Tomorrow morning I see the surgeon who is doing a sigmoidoscopy. To check things out herself I guess.

I don't really have an option to take much time off work. So whatever treatment plan we come up with needs to take that into account.

[Punky44]

Like Jacques mentioned above, there is a short course radiation option that you may be a candidate for (I believe they told my mom she qualified because the cancer had not spread through the fascia?

Anyway, it was 5 days vs 5 weeks and she said it was by far the easiest part of her treatment. She went into surgery the next day.

Not sure if you mentioned this already, but where are you located?

[claudine]

So far my husband has been able to work normally through all the treatments he's had (well, except from recovering from surgery, of course). Radiation made his tired and nauseated for a few hours, and he's in pretty bad shape the afternoon after chemo, but he's got a flexible job so he's been able to rest; and get back to work the next day. How flexible is yours?

[Jacques]

... I don't really have an option to take much time off work. So whatever treatment plan we come up with needs to take that into account.

For your meeting with your surgeon in the morning, you could ask about your overall treatment calendar. Your staging now is set at T3bN2M0, or Stage III-C. For this level of rectal cancer, the treatment plan is relatively fixed once they determine your overall risk level and the type of treatment regimen they want to pursue.

Typically, the overall treatment for a Stage III rectal cancer patient would last about 10 months overall, and for you it would probably look something like this:

November: Diagnosis and staging.
December-January: Long-course chemo/radiation.
February: One month of rest/recuperation
March: Laparoscopic LAR surgery, ileostomy surgery followed by rest & recuperation
April -July: Four months of first-line adjuvant chemotherapy.
August: Rest and recuperation followed by ileostomy reversal surgery
September: Start of the 5-year surveillance period

However, it would probably be the oncologist (not the surgeon) who would finalize your overall treatment plan. And this is where you might want to seek a second opinion to confirm that the final overall treatment plan is in fact the best one for you. (You could get a second opinion about this at UCSF, for example, but this would require that you have all of your Kaiser medical records consolidated and organized and ready to submit to them. BTW, the people at UCSF know your surgeon. Her name is listed in the directory there.)

For now, you can ask the surgeon what she thinks., but eventually you will have to have a proper medical team headed by an oncologist.

When is Kaiser going to assign an oncologist to your case?

[Ulendon]

I had the ultrasound yesterday because of the fibroid they found in my uterus and this morning went to the surgery consult. It's looks like the treatment plan is just as you described Jacques.

When I got home I returned the calls from the OBGYN who wants to do an endometrial biopsy. Apparently my endometrium is too thick. I'm not really clear on it but it sounds like endometrial cancer can go hand in hand with other cancers?

It's confusing because I mentioned to the surgeon that I had had the internal ultrasound yesterday and she didn't seem interested.

And oncologist appointment scheduled for next Wednesday.

[Ulendon]

Thanks so much for this, for some reason putting dates to it (accurate or not) helps!

"November: Diagnosis and staging.
December-January: Long-course chemo/radiation.
February: One month of rest/recuperation
March: Laparoscopic LAR surgery, ileostomy surgery followed by rest & recuperation
April -July: Four months of first-line adjuvant chemotherapy.
August: Rest and recuperation followed by ileostomy reversal surgery
September: Start of the 5-year surveillance period"

[Ulendon]

Saw the oncologist yesterday afternoon and he said it would be 28 sessions of radiation along with Xeloda. Seeing the radiation doctor tomorrow morning.

[Jacques]

Saw the oncologist yesterday afternoon and he said it would be 28 sessions of radiation along with Xeloda. Seeing the radiation doctor tommorow morning.

For your radiation treatments, will you be able to do them locally, or will you have to go to the main Kaiser hospital every day?

If you're going to be taking Xeloda, you can do some preparatory reading now on self care tips and the prevention of hand foot syndrome:

How to tackle Xeloda side effects
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=61932&p=490294#p490294

[Ulendon]

The closest radiation center is 45 minutes away. So I am going to have to drive there and back every morning before going to work. I have an appointment there tomorrow morning and hopefully will know more after that.

[Jacques]

The closest radiation center is 45 minutes away. So I am going to have to drive there and back every morning before going to work. I have an appointment there tomorrow morning and hopefully will know more after that.

You might want to go to a medical supply store to see if you can find some sort of cushion to use in the car. It might help with the 45 minute commute.

Also, look for some sort of bidet or spray-gun attachment so that you can use water instead of toilet paper for cleaning.

[Carboxo]

Hang in there, breathe and get your best friend, family, loved ones there to help you. You don’t have to do this alone.

[boxhill]

Make sure you discuss/inform yourself about vaginal dilators and their use BEFORE starting radiation. Read the threads here on women and radiation. Judging by the experience of most other women, do not depend on your doctors to fully inform you on vaginal stenosis, preserving fertility, early onset menopause, etc.

[Ulendon]

Came to the appointment at the radiation therapy center and the earliest appointment they had available for the mapping was after Xmas so I'm hanging around till 2pm to get it done today. I don't want to wait! It looks like the earliest I can start actual treatment will be December 26.

Currently sitting in the parking lot drinking a grand Chai latte to fill up my bladder.

[juliej]

Currently sitting in the parking lot drinking a grand Chai latte to fill up my bladder.

That's an excellent way to fill your bladder! I love Chai lattes.

Be calm, take a deep breath, you can do this!

Juliej

[Ulendon]

Radiation/chemo completed and robot assisted LAR surgery date set for April first

I've been watching lots of surgery videos and trying to figure out the stoma thing. I'm a bit concerned about what the heck I am supposed to eat. No fruits and veggies!?! I'm not a vegetarian but I don't eat a ton of meat, mostly seafood. I really need to loose weight so have been eating a fruit and veggie rich diet. Not sure what to do while I have the ileostomy.