IsmailMehdi wrote:Hi Jolene,
You're lucky your surgeon is pro-WW. It seems that surgeons favor cutting for the most part. The odds they cite for local recurrence are usually in the 90+%. But there's trials now for organ preservation that show it's a viable path.
The protocol you are on sounds very good, i hope to be lucky enough to get there.
I am now on FOLFIRINOX, after 6 more sessions, i'll go through chemoradiation and then we'll see where things are.
Did you mean TEM instead of TME. I think TME is when they remove the rectum.
Hi Ismail - Ops.. Yes, it's TEM !! I revised my post. Thanks for highlighting.
Cutting it off is the gold standard because most doctors don't like veering off. It's like that colleague we have who doesn't like changes and experimenting with new methods and techniques. That old "if it's not broken, don't change it" adage. Lol.
I suspect it could also be internal politics and the pressure to keep up their KPI if they have bosses and board of directors above them who frown upon cutting-edge practices unless you are MSK (memorial sloan kettering) who is an advocate for WW.
My surgeon has his own private practice which basically means he is his own boss and I'm guessing that provides a lot of leeway in offering some cutting-edge ideas to patients and also why doctors set up their own practice instead of "working for the group". He presents regularly in conferences even with his own practice so he is quite an active researcher in a sense and often on top of new research papers being published.
As for the odds of local recurrence, it's not 90%+ .. it's more along the line of 30%! This is on the basis of a published paper by Dr Habr-Gama in 2013. Unless he is referring to other statistics but don't take my word for it, you may want to check this paper out on Google Scholar or just Google to see if you can have access to it. > Local Recurrence After Complete Clinical Response and Watch and Wait in Rectal Cancer After Neoadjuvant Chemoradiation: Impact of Salvage Therapy on Local Disease Control
Check out MSK website with follow-up research since > https://www.mskcc.org/news/how-watch-an ... ality-life
Another tip. Dr Habr-Gama use an 8 weeks bench mark to determine her WW candidates. My surgeon modified the framework and had me wait up to 12 weeks for the tumor to completely disappear. He mentioned that there are updated research out there that had patients wait up till 16 weeks and still made the cut for being a WW candidate. If he had follow the 8 weeks benchmark, I would have to undergo surgery then. My tumour was still lurking around at week 8 but was completely gone by week 12. It takes time for the radiation to work.
All the best for your treatment. Please keep us posted !