how these numbers are determined

PureSerenity

When my doc told me we were gonna do 30 treatments, he said that was his "ballpark" number. that being said, how do they determine these numbers???  I have 4 left, and i do not think i can emotionally or physically take 1 more day!!! so will these last 4 really make a difference??? I just dont think i can do this anymore!!! Any advice???

NYinTX

PureSerenity - some reading material FYI

Peer-Reviewed Original Research Articles
1.	Song S, Hong JC, McDonnell SE, Koong AC, Minsky BD, Chang DT, Liauw SL. Combined Modality Therapy for Rectal Cancer: The Relative Value of Posttreatment Versus Pretreatment CEA as a Prognostic Marker for Disease Recurrence. Ann Surg Oncol 19(8):2471-6, 2012. PMID: 22327251.
2.	Tonlaar N, Song S, Hong JC, Minsky BD, Chang DT, Polite BN, Liauw SL. Combined-modality Therapy for Rectal Cancer: Analysis of Potential Differences in Disease Presentation, Treatment Adherence, and Treatment Outcome According to Race. Am J Clin Oncol. e-Pub 2012. PMID: 23211225.
3.	Guillem JG, Ruby JA, Leibold T, Akhurst TJ, Yeung HW, Gollub MJ, Ginsberg MS, Shia J, Suriawinata AA, Riedel ER, Mazumdar M, Saltz LB, Minsky BD, Nash GM, Paty PB, Temple LK, Weiser MR, Larson SM. Neither FDG-PET Nor CT Is Able to Distinguish Between a Pathological Complete Response and an Incomplete Response After Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Prospective Study. Ann Surg, 2012. PMID: 23187748.
4.	Ilson DH, Minsky BD, Ku GY, Rusch V, Rizk N, Shah M, Kelsen DP, Capanu M, Tang L, Campbell J, Bains M. Phase 2 trial of induction and concurrent chemoradiotherapy with weekly irinotecan and cisplatin followed by surgery for esophageal cancer. Cancer 118(11):2820-7, 2012. PMID: 21990000.
5.	Goodman KA, Khalid N, Kachnic LA, Minsky BD, Crozier C, Owen JB, Devlin PM, Thomas CR. Quality Research in Radiation Oncology Analysis of Clinical Performance Measures in the Management of Gastric Cancer. Int J Radiat Oncol Biol Phys, 2012. PMID: 23040221.
6.	Golden DW, Novak CJ, Minsky BD, Liauw SL. Radiation dose >=54 Gy and CA 19--9 response are associated with improved survival for unresectable, non-metastatic pancreatic cancer treated with chemoradiation. Radiat Oncol 7(1):156, 2012. PMID: 22974515.
7.	Leibold T, Akhurst TJ, Chessin DB, Yeung HW, Macapinlac H, Shia J, Minsky BD, Saltz LB, Riedel E, Mazumdar M, Paty PB, Weiser MR, Wong WD, Larson SM, Guillem JG. Evaluation of � F-FDG-PET for early detection of suboptimal response of rectal cancer to preoperative chemoradiotherapy: a prospective analysis. Ann Surg Oncol 18(10):2783-9, 2011. PMID: 21476107.
8.	Kachnic LA, Winter K, Wasserman T, Kelsen D, Ginsberg R, Pisansky TM, Martenson J, Komaki R, Okawara G, Rosenthal SA, Willett CG, Minsky BD. Longitudinal Quality-of-Life Analysis of RTOG 94-05 (Int 0123):A Phase III Trial of Definitive Chemoradiotherapy for Esophageal Cancer. Gastrointest Cancer Res 4(2):45-52, 2011. PMID: 21673875.
9.	Valentini V, van Stiphout RG, Lammering G, Gambacorta MA, Barba MC, Bebenek M, Bonnetain F, Bosset JF, Bujko K, Cionini L, Gerard JP, R�del C, Sainato A, Sauer R, Minsky BD, Collette L, Lambin P. Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials. J Clin Oncol 29(23):3163-72, 2011. PMID: 21747092.
10.	Edelson DP, Retzer E, Weidman EK, Woodruff J, Davis AM, Minsky BD, Meadow W, Hoek TL, Meltzer DO. Patient acuity rating: quantifying clinical judgment regarding inpatient stability. J Hosp Med 6(8):475-9, 2011. PMID: 21853529.
11.	Marsland T, Arena F, Yeilding A, Glod� M, Ellis L, Yu J, Henderson C, Wagman L, Piver S, Minsky B, Rosen S, Poplack D, Potters L, Crawford D, Hoskins W. Perspective on.the new PSA screening recommendations. Oncology (Williston Park) 25(12):1183, 1187-8, 1190, 2011. PMID: 22229211.
12.	Shia J, McManus M, Guillem JG, Leibold T, Zhou Q, Tang LH, Riedel ER, Weiser MR, Paty PB, Temple LK, Nash G, Kolosov K, Minsky BD, Wong WD, Klimstra DS. Significance of acellular mucin pools in rectal carcinoma after neoadjuvant chemoradiotherapy. Am J Surg Pathol 35(1):127-34, 2011. PMID: 21164296.
13.	Wright JL, Gollub MJ, Weiser MR, Saltz LB, Wong WD, Paty PB, Temple LK, Guillem JG, Minsky BD, Goodman KA. Surgery and high-dose-rate intraoperative radiation therapy for recurrent squamous-cell carcinoma of the anal canal. Dis Colon Rectum 54(9):1090-7, 2011. PMID: 21825888.
14.	Van Cutsem E, Dicato M, Geva R, Arber N, Bang Y, Benson A, Cervantes A, Diaz-Rubio E, Ducreux M, Glynne-Jones R, Grothey A, Haller D, Haustermans K, Kerr D, Nordlinger B, Marshall J, Minsky BD, Kang YK, Labianca R, Lordick F, Ohtsu A, Pavlidis N, Roth A, Rougier P, Schmoll HJ, Sobrero A, Tabernero J, Van de Velde C, Zalcberg J. The diagnosis and management of gastric cancer: expert discussion and recommendations from the 12th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2010. Ann Oncol 22 Suppl 5:v1-9, 2011. PMID: 21633049.
15.	Cunnigham D, Atkin W, Lenz HJ, Lynch HT, Minsky BD, Nordlinger B, Starling N. Colorectal Cancer. Lancet 375:1030-1047, 2010.
16.	Van Cutsem E, Dicato M, Arber N, Berlin J, Cervantes A, Ciardiello F, De Gramont A, Diaz-Rubio E, Ducreux M, Geva R, Glimelius B, Glynne Jones R, Grothey A, Gruenberger T, Haller D, Haustermans K, Labianca R, Lenz HJ, Minsky B, Nordlinger B, Ohtsu A, Pavlidis N, Rougier P, Schmiegel W, Van de Velde C, Schmoll HJ, Sobrero A, Tabernero J. Molecular markers and biological targeted therapies in metastatic colorectal cancer: expert opinion and recommendations derived from the 11th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2009. Ann Oncol 21 Suppl 6:vi1-10, 2010. PMID: 20534623.
17.	Washington MK, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE, Vauthey JN. Protocol for the examination of specimens from patients with carcinoma of the distal extrahepatic bile ducts. Arch Pathol Lab Med 134:e8-e13, 2010.
18.	Washington MK, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE, Vauthey JN. Protocol for the examination of specimens from patients with carcinoma of the intrahepatic bile ducts. Arch Pathol Lab Med 134:e14-e18, 2010.
19.	Washington MK, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE, Vauthey JN. Protocol for the examination of specimens from patients with carcinoma of the perihilar bile ducts. Arch Pathol Lab Med 134:e19-e24, 2010.
20.	Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the appendix. Arch Pathol Lab Med 134:171-175, 2010.
21.	Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the colon and rectum. Arch Pathol Lab Med 134:176-180, 2010.
22.	Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the small intestine and ampulla. Arch Pathol Lab med 134:181-186, 2010.
23.	Washington MK, Tang LH, Berlin J, Branton PA, Burgart LJ, Carter DK,Compton CC, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE. Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the stomach. Arch Pathol Lab Med 134:187-191, 2010.
24.	Wright JL, Patil SM, Temple LK, Minsky BD, Saltz LB, Goodman KA. Squamous cell carcinoma of the anal canal: patterns and predictors of failure and implications for intensity-modulated radiation treatment planning. Int J Radiat Oncol Biol Phys 78(4):1064-72, 2010. PMID: 20350793.
25.	Valentini V, Aristei C, Glimelius B, Minsky BD, Beets-Tan R, Borras JM, Haustermans K, Maingon P, Overgaard J, Pahlman L, Quirke P, Schmoll HJ, Sebag-Montefiore D, Taylor I, Van Cutsem E, Van de Velde C, Cellini N, Latini P, Scientific Committee. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2). Radiother Oncol 92(2):148-63, 2009. PMID: 19595467.
26.	Sarkaria IS, Rizk NP, Bains MS, Tang LH, Ilson DH, Minsky B, Rusch VW. Post-treatment endoscopic biopsy is a poor-predictor of pathologic response in patients undergoing chemoradiation therapy for esophageal cancer. Ann Surg 249(5):764-7, 2009. PMID: 19387328.
27.	Washington MK, Berlin J, Branton PA, Burgart LJ, Carter DK, Fitzgibbons PL, Frankel WL, Jessup JM, Kakar S, Minsky B, Nakhleh RE, Compton CC. Protocol for the examination of specimens from patients with primary carcinomas of the colon and rectum. Arch Pathol Lab Med 133:1539-1551, 2009.
28.	Schwartz GK, Winter K, Minsky BD, Crane C, Thomson PJ, Anne P, Gross H, Willett C, Kelsen D. Randomized phase II trial evaluating two paclitaxel and cisplatin-containing chemoradiation regimens as adjuvant therapy in resected gastric cancer (RTOG-0114). J Clin Oncol 27(12):1956-62, 2009. PMID: 19273696.
29.	Weiser MR, Quah HM, Shia J, Guillem JG, Paty PB, Temple LK, Goodman KA, Minsky BD, Wong WD. Sphincter preservation in low rectal cancer is facilitated by preoperative chemoradiation and intersphincteric dissection. Ann Surg 249(2):236-42, 2009. PMID: 19212176.
30.	Valentini V, Cellini F, Minsky BD, Mattiucci GC, Balducci M, D'Agostino G, D'Angelo E, Dinapoli N, Nicolotti N, Valentini C, La Torre G. Survival after radiotherapy in gastric cancer: systematic review and meta-analysis. Radiother Oncol 92(2):176-83, 2009. PMID: 19586672.
31.	Duffy A, Kortmansky J, Schwartz GK, Capanu M, Puleio S, Minsky B, Saltz L, Kelsen DP, O�Reilly. A phase I study of erlotinib in combination with gemcitibine and radiation in locally advanced pancreatic adenocarcinoma. Ann Oncol 19:86-91, 2008.
32.	Guillem JG, D�az-Gonz�lez JA, Minsky BD, Valentini V, Jeong SY, Rodriguez-Bigas MA, Coco C, Leon R, Hernandez-Lizoain JL, Aristu JJ, Riedel ER, Nitti D, Wong WD, Pucciarelli S. cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted. J Clin Oncol 26(3):368-73, 2008. PMID: 18202411.
33.	Quah HM, Chou JF, Gonen M, Shia J, Schrag D, Saltz LB, Goodman KA, Minsky BD, Wong WD, Weiser MR. Pathologic stage is most prognostic of disease-free survival in locally advanced rectal cancer patients after preoperative chemoradiation. Cancer 113(1):57-64, 2008. PMID: 18442099.
34.	Ajani JA, Winter K, Komaki R, Kelsen DP, Minsky BD, Liao Z, Bradley J, Fromm M, Hornback D, Willett CG. Phase II randomized trial of two nonoperative regimens of induction chemotherapy followed by chemoradiation in patients with localized carcinoma of the esophagus: RTOG 0113. J Clin Oncol 26(28):4551-6, 2008. PMID: 18574157.
35.	Nahas CS, Akhurst T, Yeung H, Leibold T, Riedel E, Markowitz AJ, Minsky BD, Paty PB, Weiser MR, Temple LK, Wong WD, Larson SM, Guillem JG. Positron emission tomography detection of distant metastatic or synchronous disease in patients with locally advanced rectal cancer receiving preoperative chemoradiation. Ann Surg Oncol 15(3):704-11, 2008. PMID: 17882490.
36.	Lin AY, Wong WD, Shia J, Minsky BD, Temple LK, Guillem JG, Paty PB, Weiser MR. Predictive clinicopathologic factors for limited response of T3 rectal cancer to combined modality therapy. Int J Colorectal Dis 23(3):243-9, 2008. PMID: 18046561.
37.	Leibold T, Shia J, Ruo L, Minsky BD, Akhurst T, Gollub MJ, Ginsberg MS, Larson S, Riedel E, Wong WD, Guillem JG. Prognostic implications of the distribution of lymph node metastases in rectal cancer after neoadjuvant chemoradiotherapy. J Clin Oncol 26(13):2106-11, 2008. PMID: 18362367.
38.	Valentini V, Coco C, Minsky BD, Gambacorta MA, Cosimelli M, Bellavita R, Morganti AG, La Torre G, Trodella L, Genovesi D, Portaluri M, Maurizi-Enrici R, Barbera F, Maranzano E, Lupattelli M. Randomized, multicenter, phase IIb study of preoperative chemoradiotherapy in T3 mid-distal rectal cancer: raltitrexed + oxaliplatin + radiotherapy versus cisplatin + 5-fluorouracil + radiotherapy. Int J Radiat Oncol Biol Phys 70(2):403-12, 2008. PMID: 17919844.
39.	Ku GY, Minsky BD, Rusch VW, Bains M, Kelsen DP, Ilson DH. Small-cell carcinoma of the esophagus and gastroesophageal junction: review of the Memorial Sloan-Kettering experience. Ann Oncol 19(3):533-7, 2008. PMID: 17947223.
40.	Roohipour R, Patil S, Goodman KA, Minsky BD, Wong WD, Guillem JG, Paty PB, Weiser MR, Neuman HB, Shia J, Schrag D, Temple LK. Squamous-cell carcinoma of the anal canal: predictors of treatment outcome. Dis Colon Rectum 51(2):147-53, 2008. PMID: 18180997.
41.	Van Cutsem E, Dicato M, Haustermans K, Arber N, Bosset JF, Cunningham D, De Gramont A, Diaz-Rubio E, Ducreux M, Goldberg R, Glynne-Jones R, Haller D, Kang YK, Kerr D, Labianca R, Minsky BD, Moore M, Nordlinger B, Rougier P, Scheithauer W, Schmoll HJ, Sobrero A, Tabernero J, Tempero M, Van de Velde C, Zalcberg J. The diagnosis and management of rectal cancer: expert discussion and recommendations derived from the 9th World Congress on Gastrointestinal Cancer, Barcelona, 2007. Ann Oncol 19 Suppl 6:vi1-8, 2008. PMID: 18539618.
42.	Guillem JG, Chessin DB, Shia J, Suriawinata A, Riedel E, Moore HG, Minsky BD, Wong WD. A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation. Ann Surg 245(1):88-93, 2007. PMID: 17197970.
43.	Rizk NP, Venkatraman E, Bains MS, Park B, Flores R, Tang L, Ilson DH, Minsky BD, Rusch VW, American Joint Committee on Cancer. American Joint Committee on Cancer staging system does not accurately predict survival in patients receiving multimodality therapy for esophageal adenocarcinoma. J Clin Oncol 25(5):507-12, 2007. PMID: 17290058.
44.	Neuman HB, Schrag D, Cabral C, Weiser MR, Paty PB, Guillem JG, Minsky BD, Wong WD, Temple LK. Can differences in bowel function after surgery for rectal cancer be identified by the European Organization for Research and Treatment of Cancer quality of life instrument? Ann Surg Oncol 14(5):1727-34, 2007. PMID: 17265117.
45.	Anderson SE, Minsky BD, Bains M, Hummer A, Kelsen D, Ilson DH. Combined modality chemoradiation in elderly oesophageal cancer patients. Br J Cancer 96(12):1823-7, 2007. PMID: 17533399.
46.	Kelsen DP, Winter KA, Gunderson LL, Mortimer J, Estes NC, Haller DG, Ajani JA, Kocha W, Minsky BD, Roth JA, Willett CG, Radiation Therapy Oncology Group, USA Intergroup. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol 25(24):3719-25, 2007. PMID: 17704421.
47.	Rizk NP, Seshan VE, Bains MS, Ilson DH, Minsky BD, Tang L, Rusch VW. Prognostic factors after combined modality treatment of squamous cell carcinoma of the esophagus. J Thorac Oncol 2(12):1117-23, 2007. PMID: 18090585.
48.	Nahas CS, Shia J, Joseph R, Schrag D, Minsky BD, Weiser MR, Guillem JG, Paty PB, Klimstra DS, Tang LH, Wong WD, Temple LK. Squamous-cell carcinoma of the rectum: a rare but curable tumor. Dis Colon Rectum 50(9):1393-400, 2007. PMID: 17661147.
49.	Verslype E, Van Cutsem E, Dicato M, Cascinu S, Cunningham D, Diaz-Rubio E, Glimelius B, Haller D, Haustermans K, Heinemann V, Hoff P, Johnston PG, Kerr D, Labianca R, Louvet C, Minsky B, Moore M, Nordlinger B, Pedrazzoli S, Roth A, Rothenberg M, Rougier P, Schmoll HJ, Tabernero H, Tempero M, van de Velde C, Van Laethem JL, Zalcberg J. The management of pancreatic cancer. Current expert opinion and recommendations derived from the 8th World Congress on Gastrointestinal Cancer, Barcelona, 2006. Ann Oncolo 18:vii1-vii10, 2007.
50.	Stipa F, Chessin DB, Shia J, Paty PB, Weiser M, Temple LK, Minsky BD, Wong WD, Guillem JG. A pathologic complete response of rectal cancer to preoperative combined-modality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography. Ann Surg Oncol 13(8):1047-53, 2006. PMID: 16865595.
51.	Ajani J, Bekaii-Saab T, D'Amico TA, Fuchs C, Gibson MK, Goldberg M, Hayman JA, Ilson DH, Javle M, Kelley S, Kurtz RC, Locker GY, Meropol NJ, Minsky BD, Orringer MB, Osarogiagbon RU, Posey JA, Roth J, Sasson AR, Swisher SG, Wood DE, Yen Y. Esophageal Cancer Clinical Practice Guidelines. J Natl Compr Canc Netw 4(4):328-47, 2006. PMID: 16569387.
52.	Ajani J, Bekaii-Saab T, D'Amico TA, Fuchs C, Gibson MK, Goldberg M, Hayman JA, Ilson DH, Javle M, Kelley S, Kurtz RC, Locker GY, Meropol NJ, Minsky BD, Orringer MB, Osarogiagbon RU, Posey JA, Roth J, Sasson AR, Swisher SG, Wood DE, Yen Y. Gastric Cancer Clinical Practice Guidelines. J Natl Compr Canc Netw 4(4):350-66, 2006. PMID: 16569388.
53.	Nissan A, Stojadinovic A, Shia J, Hoos A, Guillem JG, Klimstra D, Cohen AM, Minsky BD, Paty PB, Wong WD. Predictors of recurrence in patients with T2 and early T3, N0 adenocarcinoma of the rectum treated by surgery alone. J Clin Oncol 24(25):4078-84, 2006. PMID: 16943525.
54.	Ballas LK, Elkin EB, Schrag D,Minsky BD, Bach PB. Radiation therapy facilities in the United States. Int J Radiat Oncol Biol Phys 66(4):1204-11, 2006. PMID: 17145535.
55.	Melton GB, Paty PB, Boland PJ, Healey JH, Savatta SG, Casas-Ganem JE, Guillem JG, Weiser MR, Cohen AM, Minsky BD, Wong WD, Temple LK. Sacral resection for recurrent rectal cancer: analysis of morbidity and treatment results. Dis Colon Rectum 49(8):1099-107, 2006. PMID: 16779712.
56.	Rengan R, Paty PB, Wong WD, Guillem JG, Weiser M, Temple L, Saltz L, Minsky BD. Ten-year results of preoperative radiation followed by sphincter preservation for rectal cancer: increased local failure rate in nonresponders. Clin Colorectal Cancer 5(6):413-21, 2006. PMID: 16635280.
57.	Jessup JM, Stewart A, Greene FL, Minsky BD. Adjuvant chemotherapy for stage III colon cancer: implications of race/ethnicity, age, and differentiation. JAMA 294(21):2703-11, 2005. PMID: 16333005.
58.	Katz MS, Minsky BD, Saltz LB, Riedel E, Chessin DB, Guillem JG. Association of statin use with a pathologic complete response to neoadjuvant chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys 62(5):1363-70, 2005. PMID: 16029794.
59.	Guillem JG, Chessin DB, Shia J, Moore HG, Mazumdar M, Bernard B, Paty PB, Saltz L, Minsky BD, Weiser MR, Temple LK, Cohen AM, Wong WD. Clinical examination following preoperative chemoradiation for rectal cancer is not a reliable surrogate end point. J Clin Oncol 23(15):3475-9, 2005. PMID: 15908656.
60.	Desch CE, Benson AB, Somerfield MR, Flynn PJ, Krause C, Loprinzi CL, Minsky BD, Pfister DG, Virgo KS, Petrelli NJ, American Society of Clinical Oncology. Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol 23(33):8512-9, 2005. PMID: 16260687.
61.	Chessin DB, Enker W, Cohen AM, Paty PB, Weiser MR, Saltz L, Minsky BD, Wong WD, Guillem JG. Complications after preoperative combined modality therapy and radical resection of locally advanced rectal cancer: a 14-year experience from a specialty service. J Am Coll Surg 200(6):876-82, 2005. PMID: 15922198.
62.	Rengan R, Paty P, Wong WD, Guillem J, Weiser M, Temple L, Saltz L, Minsky BD. Distal cT2N0 rectal cancer: is there an alternative to abdominoperineal resection? J Clin Oncol 23(22):4905-12, 2005. PMID: 16051945.
63.	Guillem JG, Chessin DB, Cohen AM, Shia J, Mazumdar M, Enker W, Paty PB, Weiser MR, Klimstra D, Saltz L, Minsky BD, Wong WD. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer. Ann Surg 241(5):829-36, 2005. PMID: 15849519.
64.	Suntharalingam M, Moughan J, Coia LR, Krasna MJ, Kachnic L, Haller DG, Willet CG, John MJ, Minsky BD, Owen JB. Outcome results of the 1996-1999 patterns of care survey of the national practice for patients receiving radiation therapy for carcinoma of the esophagus. J Clin Oncol 23(10):2325-31, 2005. PMID: 15800323.
65.	Chessin DB, Hartley J, Cohen AM, Mazumdar M, Cordeiro P, Disa J, Mehrara B, Minsky BD, Paty P, Weiser M, Wong WD, Guillem JG. Rectus flap reconstruction decreases perineal wound complications after pelvic chemoradiation and surgery: a cohort study. Ann Surg Oncol 12(2):104-10, 2005. PMID: 15827789.
66.	Weiser MR, Landmann RG, Wong WD, Shia J, Guillem JG, Temple LK, Minsky BD, Cohen AM, Paty PB. Surgical salvage of recurrent rectal cancer after transanal excision. Dis Colon Rectum 48(6):1169-75, 2005. PMID: 15793645.
67.	Bentrem DJ, Okabe S, Wong WD, Guillem JG, Weiser MR, Temple LK, Ben-Porat LS, Minsky BD, Cohen AM, Paty PB. T1 adenocarcinoma of the rectum: transanal excision or radical surgery? Ann Surg 242(4):472-7, 2005. PMID: 16192807.
68.	Temple LK, Bacik J, Savatta SG, Gottesman L, Paty PB, Weiser MR, Guillem JG, Minsky BD, Kalman M, Thaler HT, Schrag D, Wong WD. The development of a validated instrument to evaluate bowel function after sphincter-preserving surgery for rectal cancer. Dis Colon Rectum 48(7):1353-65, 2005. PMID: 15868235.
69.	Valentini V, Glimelius B, Minsky BD, Van Cutsem E, Bartelink H, Beets-Tan RG, Gerard JP, Kosmidis P, Pahlman L, Picciocchi A, Quirke P, Tepper J, Tonato M, Van de Velde CJ, Cellini N, Latini P. The multidisciplinary rectal cancer treatment: main convergences, controversial aspects and investigational areas which support the need for an European Consensus. Radiother Oncol 76(3):241-50, 2005. PMID: 16165238.
70.	Vecchio FM, Valentini V, Minsky BD, Padula GD, Venkatraman ES, Balducci M, Miccich� F, Ricci R, Morganti AG, Gambacorta MA, Maurizi F, Coco C. The relationship of pathologic tumor regression grade (TRG) and outcomes after preopera

mp327

PureSerenity

I was in that exact situation near the end of my treatment.  I had only 3 more to go, but was ready to bail out, as I didn't think I could take anymore pain.  However, I learned that the last few treatments, perhaps 5, are the "coning down" phase, which means the treatment area is targeted only to the tumor.  This is pretty standard procedure and it's likely that your protocol is the same.  The last few are called "boosts" and they CAN make a difference.  I know it's very rough for you right now, believe me, I do.  However, to make the treatment as effective as possible, you must get those last 4 treatments.  You CAN do this!  Take plenty of pain medication and if it's not doing the job, ask for more or something different.  Some people, including me, found relief soaking in the tub a few times a day.  Others say that ice applied to the burned area helps.  You'll just have to see what works for you.  Domeboro has also been recommended.  Do a Google and check that out.  Hang in there, you'll get through this, then the healing can begin! 

eihtak

PureSerenity....

You're so close. We've been there and know how awful this point is, but you can finish. In the end I was on a regular schedule of oxycontin twice a day with oxycodone in between. I didn't need it for too long after but sure helped at the end. Don't be afraid to ask your doc for something to help. I believe those last few treatments are important in most cases. I will have you in my thoughts and prayers as you finish up and move forward in healing!!

LaCh

eihtak said:

PureSerenity....

You're so close. We've been there and know how awful this point is, but you can finish. In the end I was on a regular schedule of oxycontin twice a day with oxycodone in between. I didn't need it for too long after but sure helped at the end. Don't be afraid to ask your doc for something to help. I believe those last few treatments are important in most cases. I will have you in my thoughts and prayers as you finish up and move forward in healing!!

the finish line

The finish line is in sight. Take narcotic painkillers, do whatever you need to do. I'm no supporter of this treatment and had, and still have, grave doubts about it and I was in the same boat, about to bail a few days before the end. It seems --statistically--that the full dosage of grays (the measure of radiation you receive) does make a difference in the outcome. To come this far and quit now will undermine the treatments you've already endured. So you'll start to heal four days sooner.  That's good, but you don't want to be asking yourself if you'd have had a different outcome a year or so down the road if you don't get a cure or do have a remission.  I'm not saying that you will. No one can know that. But you just don't want to open the door for regret.  Stumble to the finish line, fall across the finish line, do whatever you need to do but just get it done.  I know that it's not a warm and fuzzy response but you can find those elsewhere.  By the end, I had third degree burns externally and a tear internally and wanted only one thing. Sudden death which meant immediate relief. But you just put one foot in front of the other and do it.  Then you're done and the external healing is relatively rapid and seems to be so for the vast majority. People do this. You can do it too.