Postby roadrunner » Wed Mar 01, 2023 1:03 pm
In general, I think the literature sets the risk of “skip” pulmonary metastases (lungs but not liver) at a relatively low level in a Stage 3 patient with colon—not rectal—cancer (which goes to the lungs first at roughly 2x the rate of colon cancer). That said, the risk, while comparatively low, is sometimes termed “significant” (this should be thought of in context, so more like 3% than 6% for all colon cancer vs. rectal cancer patients—though you are 3b, which likely increases risk somewhat from the broader context). Location (country), insurance considerations (if applicable), and your team’s protocol can be factors (you didn’t say where you are). Sometimes, however, you need to advocate for yourself to make certain the appropriate monitoring protocol is being followed in your case.
Overall, I would want at least some monitoring of the lungs for Stage 3b colon cancer. Thus, I would ask your team whether you should have it, and if not, why not? If they agree, you should ask what their perspective on the appropriate schedule is.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
CT 3/22: Clear
Chest CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign
CT/MRI 9/11 Clear
11/9/22: Rectal exam/scope Clear (2 yrs.)