I had trans-anal TME surgery about 2.5 weeks ago. Recovery is going well I’d say. Within 3-4 days I was outside walking, and I think I went home on the 7th day after surgery. It’s kind-of a blur.
Partly because of the holidays they didn’t complete the pathology and post surgery report until after I checked out. I finally got it yesterday. My actual staging was kind of a shock. After chemo radiation the tumor had barely regressed at all and I had 7/16 cancerous lymph nodes. T3 N2b.
I guess I had let myself get a little optimistic based on the scans showing one or no suspicious nodes and my falling CEA levels. From what i read, the prognosis for IIIc gets dramatically worse than for milder stage 3. The lack of response to neoadjuvant treatment isn’t good either. I can’t help thinking that if the cancer had gotten to (at least) 7 nodes, it must be in more nodes that are left behind. I don’t know if the pathologist finds the 7th bad node node and can just stop hunting because that will determine staging. The surgeon said he was pretty sure he got more than 16 nodes, but 16 is what they dissected.
On the good side the margins were clean. The surgeon seems really happy with the procedure. My blood stats came quickly back up to mostly normal. I’m finding the ileostomy extremely convenient compared to the discomfort and unpredictability I had before.
The oncologists and surgeon had said they will recommend adjuvant chemo no matter what the final staging was. Now it’s obviously really necessary. The onc at the hospital recommends 8 rounds of FOLFOX. I understand that’s considered the minimum to be effective. He cited the results of the ADORE study. I can read the abstract and conclusion online, but the actual articles about that seem to be paid only.
I know it could be much worse, but I’m a little bit in shock still today.