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To do radiation or colorectal surgery?
In May my father was diagnosed with a 5cm Adenocarcinoma located 4.3 cm to the top of the anorectal junction /sphincter complex, no loss of nuclear expression of MMR proteins, no evidence of deficient mismatch repair. Staged at T3x N+.
Was treated with 6 treatments of FOLFOX. Follow-up MRI indicated, "at least moderately diminished since prior, though on several of the other sequences the appearance of the rectum appears relatively similar", "Regardless, this is felt to reflect some degree of treatment response". Surgery was recommended, due to surgical oncologist having to reschedule consult after latest MRI and due to "great response" to chemo treatment, they added in a 7th chemo treatment. Had to wait 4 weeks post treatment to do surgery. Surgery was scheduled, then canceled due to surgeon no longer at hospital. Waited another 2 weeks for new surgical oncologist who is now saying due to location would have high probability of lifelong colostomy, this new doctor would recommend radiation treatment instead, though they do not have a large number of information/results with this treatment protocol.
I understand that everyone has a different experience, but has anyone experience such a huge swing in recommendation? Or has anyone had radiation prior to surgery? I really appreciate any information that anyone has to give.
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Suggest another opinion....can you get to Mayo Clinic?
Any metastasis?
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2 ReactionsThe latest MRI noted “no metastatic disease in the pelvis. Previous 7mm IMA chain lymph node measures 5mm.”
I am going to look into 2nd opinion tomorrow for sure.
@nuubp: Was the distinct tumor shrinkage specifically from the Folfox chemo treatment? How many Folfox infusions did it take to get this result on MRI? I will appreciate your reply.
Folfox was the only treatment that he was receiving prior to the second MRI results. I will say there was a lapse/gap in treatment between the 3rd and 4th treatments during the 6 done in total prior to the mri. This was due to the hospital being hacked. Not sure if this altered the results/response.
@neubp: thank you for sharing your husband’s experience with Folfox chemotherapy infusions. I have heard many successes using Folfox, sometime combined with a “nib” chemo. As a NET patient I know that “treatment options” will always be a decision to keep tumor progression in check, so I appreciate all info on the various treatments available. I’m finishing up my 4th PRRT treatment soon and hoping for resolved tumors.
Good thoughts for you as your husband goes through this journey!
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3 ReactionsSending good thoughts your way!
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1 ReactionSince it hasn’t spread, I would look into proton radiation.
Mine was anal cancer wrapped on my sphincter. Surgery could not be done without destroying it. Regular radiation spreads to surrounding tissue-destroying it, Proton radiation goes just to the tumor. Painless and I still have control of those muscles.
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1 ReactionI too recommend looking into proton radiation, which I had prior to surgery for a very similar tumor to your dad's. For tumors that are low down and may cause a challenge for reversing an ostomy, radiation, either conventional or proton, can shrink the tumor to make surgery more feasible or eradicate it altogether. Radiation before surgery is a very common step for rectal cancer and so may be a promising pathway for your dad.
Rich
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1 Reaction@neubp, checking in. How are you and your father doing? Did you get a second opinion? Did you move forward with radiation?
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