"Am I gonna die?" It's one of the first questions that comes to mind when diagnosed with cancer. The answer is almost always some version of "it depends," which, although accurate, just doesn't do a whole lot to address the question.
No one knows the answer for sure, and there are a lot of variables that may change the outcome. But most people still search for numbers somewhere. A study published in the journal Radiology provides some. When researchers examined the medical records of 68 people (mostly men) with stage 2 or stage 3 rectal cancer, they identified specific recurrence and survival rates based on tumor margins in their MRI films. (An MRI uses radio waves and magnets to show a doctor what a slice of you looks like.)
Specifically, the researchers measured the distance of the tumor from the mesorectal fascia and divided the results into three groups: less than one millimeter, one to five millimeters, and more than five millimeters. Millimeters are so tiny it may seem like it wouldn't make much of a difference, but it did.
- When the tumor was less than a millimeter from the fascia, recurrence rates were 33 percent and five-year survival was 39 percent.
- When the tumor was more than one millimeter away, recurrence rates were five to six percent.
- Survival rates were also a lot better. The one to five group had a 70 percent five-year survival rate and the more than five group had a 90 percent five-year survival rate.
What can you do with this information?
Unless you're a medical professional, there's no way you'll be able to look at your own MRI films and figure out how far away the tumor is from the mesorectal fascia. But, you can certainly ask your doctor. If you do, make sure you ask for the measurements before any treatment. Even though each person in this study received chemotherapy before surgery (neoadjuvant chemotherapy), the MRI films were taken before chemo or radiation were administered.
It's important to note that this study does not advocate skipping chemotherapy or altering treatment options based on tumor margins. The medical community is still figuring out the role MRI can (or should) play in colorectal cancer.
Related Articles: Source: Wieder, H. and Rosenberg, R. "Rectal Cancer: MR Imaging before Neoadjuvant Chemotherapy and Radiation Therapy for Prediction of Tumor-Free Circumferential Resection Margins and Long-term Survival." Radiology Published online ahead of print. Accessed 28 Apr. 2007 [http://radiology.rsnajnls.org/cgi/content/abstract/2433060421v1?ct=ct].
