thankful for all the information - it's helpful going forward, and there's a lot I don't know!!! Thank you for the references and your input, I really appreciate the help.
After meeting with oncologist, I checked on MYChart and it looks like he just ordered the tumor profiling. When we first met him, his take was there is only one stage IV, but your situation is an early stage IV and my aim is for cure. He explained the protocol would be 12 chemo treatments of FOLFLOX 6. The tumor profiling will be something he looks at once he sees scans that aren't favorable. Although I have nothing to compare to since he's the only oncologist I've had, he seems to not want to dwell on some of the negative stuff upfront, I on the other hand like as much information as possible. I have not had a CEA test, thought I did but that was a C reactive protein test (CRP), which is different, and that was in the normal range.
The oncologist seemed very hesitant about the oxy treatment with my liver, I think having metastases in the liver, delaying treatment is not great, even with the good scan results - I know he's concerned that if the liver gets too vulnerable I might not be able to treat at all, he mentioned seeing a liver doctor for some insight into what's going on. He has me scheduled for a reduced dose oxy with slower infusion in two weeks if the liver enzymes are okay. I am older than you Rock_Robster, so maybe age is a factor? though I don't have any other health issues. My scan does show the liver has mild hepatic steatosis, which I believe is mild fatty liver? probably from the chemo treatment. I think the liver surgeon will be able to give me his thoughts -and I meet with him next Thursday. He originally explained to me that one in four liver resections result in cure (no occurrence), my situation I may see recurrence. I'm not sure who I would seek out for a second opinion, should I be looking at major cancer hospitals, (I live in-between Boston and NYC), I don't think my insurance will cover that.
As far as the rectal resection/stoma, that's a tough one I haven't wrapped my head around yet, I know if it's life saving, and I'm faced with that decision I probably will go with the permanent bag, though I can't imagine a life like that, I need to talk to others who have that experience. If the chemoradiation shrinks the rectal tumor away from the AV enough, and he gets the margins he needs, he says it will be temporary, though I have read about LARS and I might not ever get the normal bowel function back.
2/22 - Dx with stage 4 rectal cancer 4cm on/1cm from AV - age 60
T4, poorly diff., EMVI + mesolectal nodes suspicious, extramesorectal nodes neg. MSS
3/22 - CT/MRI 2 liver mets 2.1 cm and 1 smaller close to hepatic vein
Tiny <4mm lung nodules noted.
3/22 Infusion - plan 6 treat. Folflox 6, liver res., chemoradiation, rectal surgery 6 more cycles Folfox
5/5 - CT/MRI, lung nodules no change, liver lesions red. to 1.1 and .9cm, rectal tumor/suspicious lymph node red..