Postby weisssoccermom » Mon Apr 21, 2014 9:57 am
Good morning and welcome to our site. I am truly sorry that you had to find our 'club' but hoping that you will find a lot of helpful people here.
As to your questions, no a surgeon cannot tell you, with any comfort, that you are a stage I, II, III or IV without some sort of scans....either an MRI, a CT or a PET. Simply put, the staging is based on three components....TNM.
"T" stands for the tumor depth....how far the tumor extended into the rectal wall
"N" stands for the number of LOCAL nodes were affected
"M" represents any distant metastatic disease (either in a distant organ or lymph nodes)
A person could have a small tumor and have one or more positive nodes. Another person could have a large tumor with no local nodes affected. Still another person could have a small tumor, no nodes but a met in the lung. There's so many different 'combinations' that you can't say definitively that you are/aren't a stage I without some diagnostic imaging tests on the rest of your body.
Like you, I also had an excision, however, I had CT scans done routinely to check for any metastatic disease....both before and after my surgery. I am certain that your oncologist will order a baseline CT scan to ascertain what, if anything, is going on in the rest of your body.
Although your surgeon indicated a stage I, that was ONLY based on the "T" part of the overall staging and shouldn't be taken as a definitive answer. You very well may have had a T1 or a T2 tumor and your surgeon may feel that there is nothing else there, but one 'drawback' of the excision is that no nodes (or very very few) are taken so unless you've had an endorectal ultrasound and a CT scan, there is no way that your surgeon, simply from the excision, can tell whether or not any local nodes are/aren't affected.
Finally, depending on the results of all the tests AND the pathology results, you may be recommended to undergo a course of chemoradiation. Later stage I patients who have excisions are routinely followed up with a course of chemoradiation just to be safe. If, for example, your tumor was a T2 and all the other imaging tests prove negative, the 'standard of care' after an excision for a T2 patient is to have the routine 28 days of chemoradiation. I just don't want you to be surprised if that treatment is recommended. Honestly, a surgeon shouldn't be advising you on whether or not you need/don't need chemo or radiation. That is the call for the oncologist and the radiation oncologist. PLEASE make sure that you keep the appointment with an oncologist and hear what he/she has to say.
Good luck. Please keep us posted.
Jaynee
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
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