My wife and I met with my surgical oncologist today. The first thing he mentioned was that all five biopsy samples came back from the pathologist clear. That's right! No evidence of local recurrence! Including the four samples from December, that makes nine samples in a little over two months showing only a build up of granulation tissue.
Still, the radiologist remains concerned about the build up of tissue on the outside of the anastomosis. So, we will likely schedule another CT scan in a month. With the results of that CT scan, we will be able to confirm that either the soft tissue found in the MRI but not in the earlier CT scan is now visible or that it is still not visible. If it is still invisible, that would be even more evidence that there is no local recurrence.
There are still some next steps to be considered, including a needle biopsy into the outside of the anastomosis, possibly guided by a CT scan. Or, we could do another sigmoidoscopy in another four months. Or both.
But I have no symptoms, such as abdominal pain, which would indicate that any local recurrence is underway.
We talked about a number of issues, including an explanation why local recurrence is most often associated with the anastomosis. Evidently, the cells of the two ends of the bowel are considered immunologically immature immediately after the surgery. In other words, the tissue doesn't have the natural cancer-fighting properties of normal, healthy tissue. It takes some time for that tissue to mature so that it defends itself.
Oncologists aren't likely to tell me unequivocally that I'm cancer free. But today's news is about as good as it gets.