not sure what this means..about my lymph nodes...

[Traveler001]

I originally went into surgery with the idea that I had Stage I colon cancer. A 3.5 cm mass was reported in the original Colonoscopy. The CT scan showed that there was no lymph activity. Then I went in for surgery a few weeks later. the tumor at that time was measured as only 1.5 x 1.5 x .6 cm. (Does that mean it shrunk?) After the surgical pathology repot came back however, cancer cells were found in 4 out of 21 lymph nodes, so it was termed a Stage III cancer, although, the tumor never grew outside of the wall of the colon to become Stage II...

Currently I am NED awaiting Chemo starting next week. I am wondering, if since the CT scan showed nothing, then does it mean that the lymph nodes were only minorly invaded, or perhaps were recently invaded. In any case, is this a good sign that this was still caught early? Also, does it sound like the tumor was shrinking on its own? Perhaps my body was fighting it off on its own? I dunno... just thinking...

[Hannah]

Hi Traveler,

I'm not sure about the tumor size - I think the size is the overall size including all sides, so 1.5+1.5+.6 = 3.6, very close to the original size you were told. But this is something good for me to read up on and make sure I am telling you the right thing! So I will read up about it, but meanwhile write down that question and be sure to ask your doctor about the different numbers.

If the tumor didn't go out of the colon wall but you have positive lymph nodes, you do have stage III - which isn't unheard of at all. Another way of staging would be T1N4M0 - T1 meaning tumor has spread only to the middle layers of the colon, N4 meaning 4 positive lymph nodes, and M0 meaning zero metastases/spread to other organs. To be sure about the level of the tumor invasiveness, ask your doc to stage you this way - you will probably be T1 but you might be T2. There is a much better explanation about tumor staging at the C3 site:
http://www.fightcolorectalcancer.org/pa ... tm#staging
or the PLWC (People Living With Cancer) site:
http://www.plwc.org/portal/site/PLWC/me ... fmt=cancer

It is definitely good that they got 21 lymph nodes out (minimum is considered to be 12) and that only 4 were positive. I would say that it is cautiously good that the CT scan didn't pick up the nodes - if they were really large and inflamed, it is more likely that they would have been picked up on CT. Definitely not a hard and fast rule - we just don't know enough about how cancer spreads to say - but it's a step in the right direction!

Hannah

[missjv]

i had a tiny pea sized polyp that did not invade colon wall at all. the stalk of the polyp was negative for cancer and patholgy from 2 different labs placed me at low risk. well turns out it did get to my liver some how and i had 3 small mets on right lobe so just because the cancer is small doesn't mean it can't invade as i found out. luckily i had a ct scan because my cea is 1.5 and was 2 at diagnosis so they weren't even going to scan me because they felt it would be a waste of time and i also had no lymphnode involvment i had over 20 nodes removed during liver resection along with the part of my colon where the polyp grew and none of them showed cancer so this stuff is sneaky for sure.

missjv

[suzieh]

I had a very similar story, however The size does not necessarily determine staging. If we could all be so lucky. I am a nurse in a colonoscopy lab and have seen huge obstucting colon tumors be pre cancerous, and as miss jv stated polyps that come back adenocarcinoma. I would not rely totally on CT scan for picking up colon lymph node activity either. I think your pathology will reveal what truly needs to be treated. My CT showed the colon tumor and slight activity in the lymph nodes under the tumor. Pathology confirmed that after surgery and therefore I followed Stage3 Treatment protocol.

I wish you the best of luck.
Suzie Hill
Stage 3 CC, age 37, Dx. Oct. 2005
NED

[ASTEPHENS33]

http://www.nccn.org/patients/patient_gl ... stages.asp - Here's the website from the American Cancer Association about staging. My cancerous polyp also did not grow beyond the wall, but did go to 1 lymph node, so I was stage IIIA

[ray]

My tumor was 2.5 x 4.5 cm, about the size of an egg and partially obstructing. Two prominent enlarged lymph nodes and a suspicious spot on my liver were revealed by CT scans. The liver spot was a benign cyst and 23 of 23 nodes were negative. The enlarged nodes were an immune reaction. The tumor had penetrated the mucosa. Even with such a large tumor that could have been there for 5 years, I was still very fortunate to have been stage II.