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Fun and Footsore at ASCO

When I finally got on the big bus yesterday from my hotel to the Orange County Convention Center where the ASCO meeting is being held, I realized how excited I was, how much this annual event is looked forward to by doctors and patients alike.

Will there be a blockbuster new drug this year for colorectal cancer?  A big biomarker like KRAS was last year?  New directions in surgery? Radiation?

What’ll be in those “Late-breaking Abstracts” that no one sees until the meeting actually begins?

But even more than the abstracts, presentations, speeches, and posters that highlight research in cancer and patient care, is the chance to meet old friends and make new ones.  Nancy Roach, the C3 Board Chair, reminded me this morning of the New Orleans meeting that she and I did on a shoestring and the little French Quarter guesthouse with water that was only hot sporadically and the ceiling that fell on Nancy’s bed.

I’ve got a very nice, if not elegant, suite this year with a microwave if I had time to microwave anything, two TV’s, and a wide and comfy bed.   Best of all is the WiFi connection that keeps me in touch with my email, my blog, and my new forays into Twittering.

Yesterday was all about plunging in.  Picked up my nametag, without which I can’t get anywhere at all.  Found the Advocate Lounge, which will save my feet and life many times before Tuesday.  Got a nifty bag to carry my stuff … and there is lots of stuff to carry.

Two sessions on Friday focused on:

  • Advanced concepts in clinical trial design with four excellent speakers who looked at ways to develop clinical trials that were faster, more innovative, and focused on patient variations.
  • Controversial issues in rectal cancer management looked at whether tumors in the upper part of the rectum always need radiotherapy, when — if ever — is local excision right for early rectal cancer, and if adjuvant chemotherapy is necessary for stage II and III rectal cancer.

Got back on the bus at 6:00, which is the end of the ASCO day, and headed to a dinner with the FOCUS patient advocates training program.  FOCUS is run by the Research Advocacy Network and provides training before ASCO and support during the meeting for patient advocates.  It also funds registration and meeting costs so advocates can be here at ASCO.

Lots of old friends and some new ones at dinner including another woman who is just beginning her struggles with Lynch syndrome (hereditary nonpolyposis colon cancer) which has been part of my own life for the past twenty-five years . ..  much longer if I think back to my mother’s first colon cancer diagnosis when I was thirteen.

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2 Comments

  1. mike said:

    Hello, I am wondering if there is a link to or where I can find more information on the session you mentioned above: Controversial issues in rectal cancer management looked at whether tumors in the upper part of the rectum always need radiotherapy, when — if ever — is local excision right for early rectal cancer, and if adjuvant chemotherapy is necessary for stage II and III rectal cancer.

    I am stage IIIa rectal cancer patient who is trying to determine if chemoradiation as part of my treatment is something I want to do.

  2. Kate Murphy said:

    The presentations are online as part of the ASCO virtual meeting. However, the cost of accessing the virtual meeting is quite high for non-ASCO members.

    We assume that your stage IIIa rectal cancer has been diagnosed using ultrasound or MRI to locate potentially cancerous lymph nodes. This stage is normally treated with chemoradiation before surgery to reduce tumor size and possibly avoid a colostomy.

    However, it can also be managed with chemoradiation after, surgery when more is known about the tumor stage from pathology. A stage I cancer where tumor does not extend through the muscular wall and there is no lymph node involvement might be followed only with observation.

    However, that doesn’t seem to be the case with your tumor. Almost all doctors would do chemoradiation either before or after surgery to reduce the risk that the cancer will return in the rectum or close by for stage IIIa rectal cancer, and that is what is recommended by the National Comprehensive Cancer Network Treatment Guidelines.

    The ASCO presentation considered controversies that probably don’t affect you:

    One was whether a “high” rectal cancer needed radiotherapy because it might actually be in the colon. The recommendation during the ASCO session was that distance from the anus should be measured with a straight proctoscope, not a flexible one, and if the distance was more than 12 centimeters, do surgery rather than chemoradiation.

    The second was whether surgery through the anus that removed just the tumor was sufficient for very early, small rectal tumors. The conclusion from the speaker was that it was not — potentially cancerous lymph nodes might be left behind, even at this early stage.

    We at C3 would urge you to be sure that your surgeon is a trained and experienced colorectal surgeon. Rectal surgery is complex. The tumors are deep in the pelvis where they are hard or impossible to see. You can find a colorectal surgeon in your community who is a member of the American Society of Colon and Rectal surgeons here.

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