Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

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mozart13
Posts: 157
Joined: Fri Dec 09, 2016 7:38 pm
Location: Toronto

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby mozart13 » Mon Jan 10, 2022 6:14 pm

thx guys, prs 6 years, that's great.

Jolene congrats on 3 years, was told first 2 years are most critical, you did your chemo after chemo/rad, that makes big difference.

I still remember my chemo post chemo/rad, 6th round, was so brutal, prs and some other member helped me to get through, will never forget that.

MedMad , just stay focused what is in front of you, radiation peak is some where between 16-20 weeks, but works for years after. It's good thing your surgeon is W&W expert. Anxiety, was there, that's normal ,I kept busy doing research, didn't know till last minute what will happen, was dealing with 3 hospitals, 2 were pushing for surgery, was hoping from beginning for WW, but ready to deal with whatever comes through the door. After chemo/rad went back to work to preoccupy my mind.
It is hard to stay focused, some times waiting is toughest one to deal with.
I had scope, MRI and CT right after radiation and 3 months after start of radiation , decision was made than.
Good luck !
55 year at the time of diagnosis, male
Diagnosed with T1,T2 N0 M0 rectal cancer
Total neoadjuvant therapy or TNT (chemoradiation followed by systemic chemotherapy)
Negative since Feb. '17
No surgery
Watch&Wait approach 8)
I don’t come much to the forum , so if this is not updated it means I remain negative!
Wish good luck to all!

MadMed
Posts: 79
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby MadMed » Tue Jan 11, 2022 11:04 am

Thanks for the advice Mozart123. Words to live by and I have so far. One day at a time, hard for someone like me that likes to plan but i've successfully lived by that mantra so far.
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
surgery postponed until after 2/23 sigmoidoscopy

MadMed
Posts: 79
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby MadMed » Wed Jan 12, 2022 4:21 pm

@PRS, Jolene and Mozart123, i promised to report back from Pre-OP. I had a very long and good meeting with the surgeon, we reviewed the MRI which stated "dramatic improvement from treatment" it mentioned one tiny area of hyperintensity that could be intraluminal fluid or remaining cancer. The surgeon then performed a sigmoidoscopy and felt around that area. he felt that It was fluid and didn't feel hard. Very positive news and the conclusion to the day was surgery postponed, we wait 6 weeks to seek how this area evolves and potentially, if all looks clear, get into W&W. I did mention (Thank you Joelene) that it had only been 9 weeks since Radiation, so we'll give it more time. His assessment was near complete response. We'll reassess in 6 weeks.

Thank you for your thoughtful advice, sharing of your experience and support.
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
surgery postponed until after 2/23 sigmoidoscopy

prs
Posts: 193
Joined: Sat Dec 12, 2015 7:09 pm
Location: Central California

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby prs » Wed Jan 12, 2022 4:43 pm

MadMed wrote:@PRS, Jolene and Mozart123, i promised to report back from Pre-OP. I had a very long and good meeting with the surgeon, we reviewed the MRI which stated "dramatic improvement from treatment" it mentioned one tiny area of hyperintensity that could be intraluminal fluid or remaining cancer. The surgeon then performed a sigmoidoscopy and felt around that area. he felt that It was fluid and didn't feel hard. Very positive news and the conclusion to the day was surgery postponed, we wait 6 weeks to seek how this area evolves and potentially, if all looks clear, get into W&W. I did mention (Thank you Joelene) that it had only been 9 weeks since Radiation, so we'll give it more time. His assessment was near complete response. We'll reassess in 6 weeks.

Thank you for your thoughtful advice, sharing of your experience and support.

Great news!!!
Peter, age 65 at dx
DX 4 cm x 4 cm very low rectal adenocarcinoma into the sphincters 01/15
Stage III T3 N1 M0 with two suspicious lymph nodes
26 sessions IMRT radiation with 1,000 mg Xeloda twice per day 03/15 to 04/15
Complete clincal response to the chemoradiation...the tumor shrank completely away 06/15 :D
No surgery...Habr-Gama watch and wait protocol instead
Xelox chemotherapy 07/15-12/15
MRI and rectal exam every three months starting 07/15
MRI and rectal exam every six months starting 07/17
NED

prayingforccr
Posts: 213
Joined: Sun Jun 28, 2020 4:44 pm

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby prayingforccr » Wed Jan 12, 2022 5:53 pm

MadMed wrote:@PRS, Jolene and Mozart123, i promised to report back from Pre-OP. I had a very long and good meeting with the surgeon, we reviewed the MRI which stated "dramatic improvement from treatment" it mentioned one tiny area of hyperintensity that could be intraluminal fluid or remaining cancer. The surgeon then performed a sigmoidoscopy and felt around that area. he felt that It was fluid and didn't feel hard. Very positive news and the conclusion to the day was surgery postponed, we wait 6 weeks to seek how this area evolves and potentially, if all looks clear, get into W&W. I did mention (Thank you Joelene) that it had only been 9 weeks since Radiation, so we'll give it more time. His assessment was near complete response. We'll reassess in 6 weeks.

Thank you for your thoughtful advice, sharing of your experience and support.


Couldn’t be better news, madmed.

SO happy for you!
11/19: colonoscopy
12/19: diagnosed with stage 3 rectal cancer 6+cm tumor
1-3/20: 20 sessions of radiation, mon-fri capecetibine+clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: md anderson gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 Will begin immunotherapy/sbrt at weill cornell and nyu/langone in march

MadMed
Posts: 79
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby MadMed » Wed Jan 12, 2022 7:01 pm

Thank you both!
prayingforccr, I’ve been thinking about you. I hope you are in good spirits, the treatment you have planned is very promising.
I’ll be rooting for you and hoping for the best result. My wife just asked me at dinner if I had heard how you are doing.
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
surgery postponed until after 2/23 sigmoidoscopy

Jolene
Posts: 175
Joined: Wed Jan 23, 2019 10:17 am

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby Jolene » Thu Jan 13, 2022 12:24 pm

MadMed wrote:@PRS, Jolene and Mozart123, i promised to report back from Pre-OP. I had a very long and good meeting with the surgeon, we reviewed the MRI which stated "dramatic improvement from treatment" it mentioned one tiny area of hyperintensity that could be intraluminal fluid or remaining cancer. The surgeon then performed a sigmoidoscopy and felt around that area. he felt that It was fluid and didn't feel hard. Very positive news and the conclusion to the day was surgery postponed, we wait 6 weeks to seek how this area evolves and potentially, if all looks clear, get into W&W. I did mention (Thank you Joelene) that it had only been 9 weeks since Radiation, so we'll give it more time. His assessment was near complete response. We'll reassess in 6 weeks.

Thank you for your thoughtful advice, sharing of your experience and support.


Awesome news Madmed ! So very happy for you !! I remember how nervous I was running up to week 8 to see if I was a WW candidate ! Phew !

The radiation will continue to work its magic going forward.
Dx @ 39 F on WW managmeent
Nov 18 - Dx of a mid-rectal tumour at T3N1M0 (2cm) 7cm from AV
Dec 18 - CRT, 28 sessions + Capecitabine at 3000mg daily
Jan - Mar - Wait and watch in place (12 weeks)
Mar 19 - MRI, PET, sig flex and biopsy ordered to determine being a WW candidate.
Apr 19 - CCR success. Surgery on hold. 6 cycles of Xelox.
Aug 19 - 6 cycles of Xelox completed
Oct 19 - Flex sig, biopsy, PET/MRI
2020 - 2021 - Every 6 months - Full scope, Flex sig, biopsy, PET / MRI / CT
Jan 22 - 3rd year NED on WW

Jolene
Posts: 175
Joined: Wed Jan 23, 2019 10:17 am

Re: Rectal Cancer: Habr-Gama Watch and Wait Strategy to Avoid Surgery

Postby Jolene » Thu Jan 13, 2022 12:43 pm

prs wrote:Congrats on three years Jolene!!!

Yeah, Group Hug!!! :D :D :D :D :D


Hugs back to all !!! :D :D :D
Dx @ 39 F on WW managmeent
Nov 18 - Dx of a mid-rectal tumour at T3N1M0 (2cm) 7cm from AV
Dec 18 - CRT, 28 sessions + Capecitabine at 3000mg daily
Jan - Mar - Wait and watch in place (12 weeks)
Mar 19 - MRI, PET, sig flex and biopsy ordered to determine being a WW candidate.
Apr 19 - CCR success. Surgery on hold. 6 cycles of Xelox.
Aug 19 - 6 cycles of Xelox completed
Oct 19 - Flex sig, biopsy, PET/MRI
2020 - 2021 - Every 6 months - Full scope, Flex sig, biopsy, PET / MRI / CT
Jan 22 - 3rd year NED on WW


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