Surgey update

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Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Surgey update

Postby Claudine » Tue Apr 12, 2022 9:21 am

DH had laparoscopic LAR yesterday. Long day, but everything went well; I didn't get to talk to surgeon (except when he called briefly to say he was done and all went fine), but I read surgical report this morning and those are the main points:
1. Bilateral ureters identified and protected
2. Loss of plane at the ileocolic pedical likely 2/2 to previous spine radiation
3. No evidence of metastatic disease
4. No evidence of leak on leak test times two and anastomosis was well perfused without bleeding
5. 1.5cm mucosal margin on tumor with subsequent distal margin

Now we'll be waiting for pathology report of course, and life with ileostomy will begin... Glad this thing is out of him, finally!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

MadMed
Posts: 123
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Surgey update

Postby MadMed » Tue Apr 12, 2022 10:53 am

Hi Claudine,
I am no surgeon, but this reads like great news. Great margin, no spread! Excellent, wishing DH a good recovery and a healthy path forward.
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
NED as of 4/06 CT/MRI/sigmoidoscopy
On W&W 04/06/2022

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beach sunrise
Posts: 647
Joined: Thu Mar 05, 2020 7:14 pm

Re: Surgey update

Postby beach sunrise » Tue Apr 12, 2022 4:26 pm

Here's to a good recovery for him!
This update makes me happy for you all.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

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Peregrine
Posts: 41
Joined: Tue Mar 01, 2022 1:18 am

Re: Surgey update

Postby Peregrine » Tue Apr 12, 2022 11:05 pm

Thanks for the update. It's a very encouraging surgery report! Hopefully the pathology reoport will bring good news, too.

Here's a link to an ostomy handbook. Over the next few weeks it will be very important to treat the ostomy incision with great care while the underlying tissues and muscles are still healing. This is to avoid getting a parastomal hernia. Also, it is important to find a good stoma nurse who is both willing and able to discuss all of the many intricacies of ostomy care.

A Handbook for New Ostomy Patients
http://www.uoavancouver.com/uploads/2/6/8/9/26894454/handbook_for_new_patients_web_8th_printing_2019.pdf

Take care, and best of luck in the future for you and your family.

Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Surgey update

Postby Claudine » Wed Apr 13, 2022 8:53 am

Thanks all! Peregrine, I’ll save the link. We met yesterday with the stoma nurse, she’s very nice and experienced (and recognized me from cross country ski races, small world!).
DH told me he had a leak last night but it wasn’t his pouch, it was the jp drain that is temporary.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

jsbsf
Posts: 92
Joined: Sat Aug 24, 2019 6:01 am
Location: San Francisco

Re: Surgey update

Postby jsbsf » Wed Apr 13, 2022 9:16 am

This is great news!
DH 61
2019 4A t3 n2 m1a
8/23 C-scopy, 5+cm mass. CEA:4.1
8/26 CT ~1cm lvr met?
9/6 PET: lvr spot
9/16 MSS. MRI: 2 live mets: 2.7 & 7mm
9/23 Port
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm (raised concern), pri tmr stable.
CEA: 10/13,12.5;10/27-12/8 btw 4.7 & 3.1
11/5 both lvr mets ~ 2/3 smaller.
12/17 PET: sm lvr met gone, remaining tmrs @10% of orig sz & actvty
Chemo break
2020
MWA 2/5, Lap resection 2/11
CEA: 3/1-5/31 btw 2.1&2.9
3/2 start FOLFOX 7-12
7/23-29 rad
10/2/2020 NED/W&W

Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Surgey update

Postby Claudine » Thu Apr 14, 2022 7:55 pm

3 days post surgery; DH’s intestines are slow to awake, he’s back on IV to prevent dehydration (he kept throwing up yesterday). Plan is to try resuming liquid diet tomorrow. Otherwise he’s doing well, walks a lot around the floor, but he’s a bit bored - I’ll bring him his guitar tomorrow :D
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

roadrunner
Posts: 240
Joined: Sun Jan 12, 2020 8:46 pm

Re: Surgey update

Postby roadrunner » Thu Apr 14, 2022 8:04 pm

He plays guitar? Awesome. I’ve played for many years. It was a great lift during treatment, and has been generally since diagnosis. Was very bummed when on Oxi and my hands would cramp. If he can do that a few days after major surgery he’s already halfway down the road to recovery!
7/19: Rectal cancer: Staged as IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; biopsies negative
TAE 11/20, tumor cells removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT for remaining nodule 1/22
CT 3/22: Clear

User avatar
beach sunrise
Posts: 647
Joined: Thu Mar 05, 2020 7:14 pm

Re: Surgey update

Postby beach sunrise » Thu Apr 14, 2022 8:35 pm

Heck ya, super cool he plays!
My husband has played his whole life.
When I got home from surgery, I swear him playing for me helped more than anything.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Surgey update

Postby Claudine » Thu Apr 14, 2022 9:08 pm

Haha that’s awesome!

And we got great news tonight, the pathology report is on MyChart:

MARGINS
MARGIN STATUS FOR INVASIVE CARCINOMA: All margins negative for invasive carcinoma
DISTANCE FROM INVASIVE CARCINOMA TO RADIAL (CIRCUMFERENTIAL) MARGIN: 1.8 cm
MARGIN STATUS FOR NON-INVASIVE CARCINOMA: All margins negative for high-grade dysplasia/intramucosal carcinoma and low-grade dysplasia.
REGIONAL LYMPH NODES
REGIONAL LYMPH NODE STATUS: Regional lymph nodes present. All regional lymph nodes negative for tumor.
NUMBER OF LYMPH NODES WITH TUMOR: None
NUMBER OF LYMPH NODES EXAMNED: 16

:D :D :D :D :D
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Surgey update

Postby Claudine » Thu Apr 14, 2022 9:33 pm

Interestingly, the tumor had invaded to subserosa (even though the MRI did not show that), so final staging is pT3 pN0, stage 2A. Tumor cells were well differentiated.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

jsbsf
Posts: 92
Joined: Sat Aug 24, 2019 6:01 am
Location: San Francisco

Re: Surgey update

Postby jsbsf » Fri Apr 15, 2022 9:05 am

I hope he is recovering well. It’s a little scary how we have to rely so heavily on the scans. They do give us a lot of information but often tend to miss a lot.
DH 61
2019 4A t3 n2 m1a
8/23 C-scopy, 5+cm mass. CEA:4.1
8/26 CT ~1cm lvr met?
9/6 PET: lvr spot
9/16 MSS. MRI: 2 live mets: 2.7 & 7mm
9/23 Port
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm (raised concern), pri tmr stable.
CEA: 10/13,12.5;10/27-12/8 btw 4.7 & 3.1
11/5 both lvr mets ~ 2/3 smaller.
12/17 PET: sm lvr met gone, remaining tmrs @10% of orig sz & actvty
Chemo break
2020
MWA 2/5, Lap resection 2/11
CEA: 3/1-5/31 btw 2.1&2.9
3/2 start FOLFOX 7-12
7/23-29 rad
10/2/2020 NED/W&W

stu
Posts: 1561
Joined: Sat Aug 17, 2013 5:46 pm

Re: Surgey update

Postby stu » Fri Apr 15, 2022 12:13 pm

It has taken a long time to get this particular primary tumour out but delighted to hear his results and hope he is recovering well .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Claudine
Posts: 680
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Surgey update

Postby Claudine » Fri Apr 15, 2022 8:05 pm

Bowels are finally awake, DH will be released tomorrow. Now to get used to this new (temporary?) life with ileostomy. But he’s really taking it in stride!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Lytic met L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox ; Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
Multiple small lung nodules (03/19) now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
CEA since 03/19: high 81.1, low 3.2, now 66
MRI 2/11/22: rectal adenocarcinoma pT3 pN0 stage 2A
LAR surgery April 11

DarknessEmbraced
Posts: 3686
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Surgey update

Postby DarknessEmbraced » Sat Apr 16, 2022 8:43 am

I'm glad he's doing well. :)
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)


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