Solitary lymph node metastasis: treatment options

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skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Tue Aug 31, 2021 9:43 pm

Hi catstaff, I do not remember if he said that bevacizumab would be added. It was a blur :(
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Metastatic lymph node treatment options

Postby rp1954 » Wed Sep 01, 2021 4:43 pm

The major failing of oncologists concerns their (in)ability to totally eliminate distant, metastatic lymph nodes using 2-3 week chemo cycles, with cyclical chemo's kill - regrow - "hardening" cycle unto eventual failure. Palliative is all that can be usually done for distant LN with Folf- -ox -iri +MAb formulas without surgery - usually they buy time, despite whatever spin. Their usual biases are that this is better than the risk(s) of metastatic spread from surgery, and the big waits between surgery and chemo. Their other bias is that "theirs" is bigger and better than any other chemistry.

Then if a metastatic residue exists after surgery, patients usually miss 6-12 weeks between chemo and surgery and things can spread. A fundamental problem for normal chemo is various forms of damage vs chemo intensity, and chemo continuity.

Our plan included four special elements:
a. eliminate dead space (ahem) in the chemo-surgery-chemo cycle to less than 2-3 days (about 1.3 days actual vs 6-12 wks);
b. reduce/eliminate perioperative metastasis;
c. absolute (immuno)chemo continuity where possible (all 24 hrs, x365); AND
d. to increase chemo intensity with superior QoL, so that chemo restart was not a big ugly decision.

They were stuck on solitary nodes/sites and we were aimed for hell or high water, even if multiple sites and circulating CRC cells, as necessary. My wife has never used -iri, -oxi, MABs or cycles.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

User avatar
dianetavegia
Posts: 2731
Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia

Re: Solitary lymph node metastasis: treatment options

Postby dianetavegia » Thu Sep 02, 2021 8:47 am

May I remind you that oncologists are trained to treat cancers with chemo (poisons) and surgeons remove said cancer. Surgery is the gold standard for cure.

A spread four years out is a good sign. I'd suggest the cells were there at your Stage III dx but that your cancer sounds like a very slow growing variety.

I had a solitary, smaller than a dime met on the back of my liver 3 years post my Stage III dx. My oncologist did suggest major surgery with a famous doctor out of Atlanta. I had 80% of my liver removed but no follow up radiation or chemo. That was spring 2012. No lymph nodes were involved but I had 5 out or 17 (I think) positive for microscopic cells in Jan. 2009 at my first dx.

I'm having my colonoscopy next Thursday. It's been 5 years since my last. The only polyp I ever had was the cancerous one in Jan. 2009.

Have faith and get that node removed!
Stage III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

14 years since dx and 11 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Wed Sep 15, 2021 11:54 am

catstaff wrote:Yeah, we were told they only do surgery on lymph nodes if it's a particular node that is "causing a problem." It's a more difficult surgery than one might think.

But why not SBRT? Is this node in a previous radiation field or is the intestine at risk? Radiation was very effective on my DH's retroperitoneal nodes at diagnosis.

But chemo may be very effective as well, and I would agree that there's a substantial chance of other lymph node involvement at some point.



Hi Catstaff, I stand corrected. When I met with radiation oncology team, they told me that this node falls in a previous radiation field and were nervous about proceeding with radiation. I still dont have a treatment plan, I meet with surgeon today
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

Cancercare
Posts: 1
Joined: Thu Sep 16, 2021 4:46 am

Re: Solitary lymph node metastasis: treatment options

Postby Cancercare » Thu Sep 16, 2021 4:59 am

Solitary lymph node (SLN) metastasis is a distinct subset of colon cancer associated with good prognosis. You might want to try Ask-A-Doc, a free service on OncoPower app. They have a panel of US Oncologists help patients manage symptoms or treatment options or virtually any questions absolutely free. It was started by an oncologist.

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Thu Sep 16, 2021 8:44 am

My doctors have arrived at a consensus, a treatment plan.

Surgery to remove metastatic lymph node followed by chemo.
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Solitary lymph node metastasis: treatment options

Postby Dennyp » Thu Sep 16, 2021 8:37 pm

skb wrote:My doctors have arrived at a consensus, a treatment plan.

Surgery to remove metastatic lymph node followed by chemo.


I happy to hear you have a plan, I’m sure it’s a great relief knowing what’s next. Best of luck!
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Fri Sep 17, 2021 9:44 am

Cancercare wrote:Solitary lymph node (SLN) metastasis is a distinct subset of colon cancer associated with good prognosis. You might want to try Ask-A-Doc, a free service on OncoPower app. They have a panel of US Oncologists help patients manage symptoms or treatment options or virtually any questions absolutely free. It was started by an oncologist.

This is very useful information that gives me hope, thank you very much
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Mon Jul 25, 2022 2:26 pm

I am back on the forum , 9 months after an abdominal surgery to remove retroperitoneal lymph node metastasis. This was followed by FOLFIRI (12 rounds- that is 6 months) during which I lost all hair
I suffered foot drop from the surgery due to nerve damage sustained during the surgery . I limp and use a walking stick. I have physiotherapy sessions. Also my bowel control is less than ideal, I often have to rush to the bathroom.

What is interesting is that the surgery took 10 hours and did not find any lymph node that had metastasis. Out of 6 samples taken, two tissue samples had cancer. I doubt if the procedure that made me kind of disabled was necessary at all. Here is the pathology report. I made complaints to the hospital about nerve damages but they say that I have no case and these are normal risks that manifested itself. i also tried getting some lawyer to represent me but no one out of 10 people I called was willing to take the case.

Are all these things common in pelvic surgery? (losing normal mobility, using a walking stick, reduced bowel control)
I felt very healthy before I went into surgery. Now I am a mess. I started working again this month but still suffering from a bit of chemo brain


--------------Surgical pathology report- Oct 1st, 2021-----

A. RIGHT OBTURATORLYMPH NODES X5, EXCISION:
Negative for metastatic carcinoma (0 /5)

B. RIGHT OBTURATOR LYMPH NODE X1, EXCISION:
Negative for metastatic carcinoma (0 /1)

C. RIGHT OBTURATOR LYMPH NODES X2, EXCISION:
Negative for metastatic carcinoma (0 /2)

D. RIGHT OBTURATOR LYMPH NODE, EXCISION:
Fibroadipose and neural connective tissue:
-No lymph nodes identified; negative for carcinoma

E. PET POSITIVE RIGHT OBTURATOR LYMPH NODE, PART 1, EXCISION:
POSITIVE for carcinoma (intravascular):
-Fibroadipose and skeletal connective tissue only
-No lymph nodes identified (See Comment)

F. PET POSITIVE RIGHT OBTURATOR LYMPH NODE, PART 2, EXCISION:
POSITIVE for carcinoma (perineural and soft tissue):
-Fibroadipose, neural and skeletal connective tissue only
-No lymph nodes identified
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Solitary lymph node metastasis: treatment options

Postby Dennyp » Mon Jul 25, 2022 4:15 pm

Wow! I’m sorry to hear that! My oncologist did a biopsy prior to me starting chemo and having surgery I assume your oncologist didn’t order one?
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Mon Jul 25, 2022 5:38 pm

Dennyp,
Thanks for your concern, Dennyp.

A biopsy was done on lymph node which was positive. But when lymph nodes were removed during surgery, they were negative for adenocarcinoma.

Something is off. Either the biopsy was wrong. Or the pathology study of lymph nodes removed during surgery was wrong. If lymph nodes had no cancer, why put me on 6 months of Folfiri??

I had a horrible surgery.
Still cant walk properly after 9 months
Still have some brain fog from chemo

I dont know if the surgery was warranted.
I feel wronged
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Solitary lymph node metastasis: treatment options

Postby Dennyp » Mon Jul 25, 2022 6:01 pm

That’s awful, I understand why you feel that way.
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: Solitary lymph node metastasis: treatment options

Postby rp1954 » Tue Jul 26, 2022 1:48 am

I'm working on a long answer of cumulative experiences.

Could you fill in some of the story gaps running up to surgery and chemo?
What kind of direct conversations and outside consults did you have with various surgeons before surgery.
Did you repeat our stories to them in the search for options?
what kind of uncertainties did you have and their changes/resolution in the run up to surgery?
What serial CEA readings (as well as any CBC, ALP, GTTP, LDH and CA199 panels) did you have in 3-4 months before surgery? (and after)
did you ask for (or they used) substitutions on opiates for surgery; cimetidine for proton pump inhibitors, and celecoxib for post surgical pain?
What kind of conversations and consults did you have with various oncologists before chemo actually started?
How many weeks after surgery before chemo?
what was your view of the hospital and doctors' stature and (special) quality before surgery and did you feel like there was much choice (vs work, timing, distance, big city/medical center access, HMO/insurance)?
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

I_will_fight
Posts: 148
Joined: Mon Jun 29, 2020 3:38 pm

Re: Solitary lymph node metastasis: treatment options

Postby I_will_fight » Tue Jul 26, 2022 5:03 am

skb wrote:Dennyp,
Thanks for your concern, Dennyp.

A biopsy was done on lymph node which was positive. But when lymph nodes were removed during surgery, they were negative for adenocarcinoma.

Something is off. Either the biopsy was wrong. Or the pathology study of lymph nodes removed during surgery was wrong. If lymph nodes had no cancer, why put me on 6 months of Folfiri??

I had a horrible surgery.
Still cant walk properly after 9 months
Still have some brain fog from chemo

I dont know if the surgery was warranted.
I feel wronged



Wow normally getting a pathology that is negative for cancer is good news, but so sorry to hear the surgery and treatment were so horrible.
46 yo male Spain
06/2020 - 6cm T3N0M0 CC splenic flex
3 and 4 mm lung ground glass
lymp 0/37
dMMR MSH6
KRAS mt G13D
V/LNI absent
PNI present
07/20 - hemicol surg, optimistic surgeon.
11/20 - 4 x CAPOX completed.
12/20 - Clear colonoscopy
02/21 - MRI liver lesion unchanged.
11/21 - Clear CT
02/22- Colonoscopy: Sessil polyp 3mm
05/22- Clear CT
06/22- Negative Signatera
12/22- Negative Signatera
01/23- Clear CT
07/23- Clear CT, normal markers.
09/23 - Negative Signatera
01/24 - Clear CT

skb
Posts: 100
Joined: Tue Mar 28, 2017 2:00 pm

Re: Solitary lymph node metastasis: treatment options

Postby skb » Tue Jul 26, 2022 9:42 am

rp,
I have answered your questions to the best of my ability.

rp1954 wrote:I'm working on a long answer of cumulative experiences.

Could you fill in some of the story gaps running up to surgery and chemo?
What kind of direct conversations and outside consults did you have with various surgeons before surgery.
Did you repeat our stories to them in the search for options?
what kind of uncertainties did you have and their changes/resolution in the run up to surgery?
What serial CEA readings (as well as any CBC, ALP, GTTP, LDH and CA199 panels) did you have in 3-4 months before surgery? (and after)
did you ask for (or they used) substitutions on opiates for surgery; cimetidine for proton pump inhibitors, and celecoxib for post surgical pain?
What kind of conversations and consults did you have with various oncologists before chemo actually started?
How many weeks after surgery before chemo?
what was your view of the hospital and doctors' stature and (special) quality before surgery and did you feel like there was much choice (vs work, timing, distance, big city/medical center access, HMO/insurance)?


-------------------------

Question: What kind of direct conversations and outside consults did you have with various surgeons before surgery? Did you repeat our stories to them in the search for options? what kind of uncertainties did you have and their changes/resolution in the run up to surgery?
I had conversation only with the one surgeon who performed my surgery. Now I regret it. During my prior diagnoses, I always sought second opinion at Mayo (which is only an hour's drive from here) but I did not take second opinion this time. I regret it badly now. My surgeon at the University of Minnesota is highly qualified and had great reviews and had known my case for 5 years. I trusted her. Having such a great surgeon close to where I live seemed like a good option. With this one surgeon who performed the surgery on me, I had a list of questions about the procedure and complication rate. She seemed very confident and did not give an impression that this would be a complicated surgery. At the time of surgery, I thought a lymph node had metastasis and removal of it would be simple and straightforward. But the surgery went 10 hours. The surgeon was hunting and pecking for cancerous tissue repeatedly.


Question: What serial CEA readings (as well as any CBC, ALP, GTTP, LDH and CA199 panels) did you have in 3-4 months before surgery? (and after)
CEA- Oct 2020 - < 0.5
CEA- Jan 2021- 2.1
CEA- July 17, 2021- 15.6
CEA- July 22, 2021 (repeat measurement after a week)- 17.1
CT- July 2021- Clear scan, no evidence of metastatic disease
Colonoscopy- Aug 2021- clean- no evidence of disease
PET- August 2021- one hypermetabolic lymph node (right obturator lymph node)
Biopsy- August 2021 -lymph node is positive for metastatic adenocarcinoma
Surgery- Oct 1, 2021- pathology finds lymph nodes have no cancer, some nearby tissue had cancer!
CEA- Oct 6 2021 - 1.6
CEA - Jan 24, 2022- 0.6
CEA - Feb 7, 2022- 0.9
CEA- April 25, 2022- 0.8

CEA measurements until and including Oct 6, 2021 was performed on a Siemens device and since then, on an Abbott device
Other than CEA, only CBC readings were taken before surgery, It was normal.

CT result- April 29, 2022- No evidence of metastatic disease in the chest, abdomen, or pelvis.


Question: did you ask for (or they used) substitutions on opiates for surgery; cimetidine for proton pump inhibitors, and celecoxib for post surgical pain?
I am not sure, I had oxycodon prescribed after surgery, which I used for two weeks. I did not have much pain in the abdomen after the surgery, the pain was neuropathic pain on my foot for which I took Gabapentin for six months following surgery. Now the pain is gone, numbness and lack of dorsal flex (foot drop) persists.

Question: What kind of conversations and consults did you have with various oncologists before chemo actually started?
I only met with the one oncologist who has been treating me for five years. He was the one who prescribed Folfox for me in 2017. He understood my case. His opinion was to try Folfiri for two reasons (i) It is different from Folfox which I already tried in 2017 (ii) hitting the body hard with chemo would reduce chances for recurrences. So he prescribed 12 rounds of Folfiri which I thought was too much. I asked him about it but he was firm in his recommendation. He initially thought that he might add ongoing chemo but after seeing CT and CEA results from April 2022 (which he called excellent), did not prescribe further chemo.

Question: How many weeks after surgery before chemo?
Four weeks. Surgery was on Oct 1, 2021 and Chemo started the first week of November 2021. I was very weak and had had bowel control issues at the time of the start of chemo. But I decided to bite down on my difficulties and start the chemo to improve my chances of living longer. Now it is all a blur.

Question: what was your view of the hospital and doctors' stature and (special) quality before surgery and did you feel like there was much choice (vs work, timing, distance, big city/medical center access, HMO/insurance)?[/quote]
Both the oncologist and the surgeon were very cordial and supportive before and after the procedures. They have fellowships from Johns Hopkins, Cleveland Clinic etc. Both are teaching faculty as well. I had consulted a radiologist too but she said that the new tumor was in the same field as the prior radiation in 2017 and so it is not ideal to radiate there again. These three people met at a tumor board meeting at the hospital with other doctors and decided on my treatment plan. However I have alienated the surgeon now with my repeated communications with her office regarding my post-surgery complications. I also asked her why the lymph nodes removed during surgery had no cancer but the PET and biopsy indicated it. She responded that images are images and do not have 100% accuracy. I took time off work during surgery and six months of chemo. I was able to return to the same job, fortunately. This cancer center is about 15 miles from my residence. So I did not have much travel issues. But I could not drive after the surgery for many months due to 'foot drop'. My wife took me to most appointments. At other times, I used Uber. Now I have learned to drive with my left and right feet, the left foot compensating for right foot's issues. I did not have much trouble with insurance. I could have consulted more surgeons but I felt that time was slipping away and the more I wait for surgery, the more the cancer would spread. I was very upset and had lost my energy to run after more surgeons. I had trouble with Folfiri. I lost all hair, became bald and had frequent bowel issues- sometimes it was diarrhea, sometimes it was constipation. There were some accidents.


My continued walking problems (I use a walking stick now and cant walk fast) and my poor bowel control in the morning (up to 10 am) have me frustrated. These are due to two nerves injured during the surgery. EMG tests say that the nerves were injured but not severed. I am double thinking everything, overanalyzing. Perhaps all my treatments were correct and were the best course of action for me. I know that I have been more fortunate than many cancer patients in the world and I should be grateful for the treatment I received. I am not a very outspoken person. Sometimes I think that this trait has prevented me from being a very good advocate for myself.
3/21/17: Dx T3N0M0-mid rectal 4.5cm
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17 to 12/17: Folfox
8/19 VATS - 1cm lung nodule
7/17/21- Clean CT, CEA 15.6 !
8/24/21- PET , biopsy finds met along obturator lymph nodes
10/1/21- Surgery , 12 rounds of FOLFIRI -ended 4/22
4/15/22, 9/6/22. 1/20/23- Clean scan, normal CEA
10/23- four sub-centimeter lung nodules, all PET negative


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