My mother was just diagnosed with colon cancer.. The report is over my head.

[rcreese]

My mother was just diagnosed with colon cancer.. The report is over my head.

Here is the report. Any help is appreciated. I know its not good. I just went thru this with my biological mother in 2015. Hers was the lungs. She passed away within a month of being diagnosed.
Just any thoughts.. Bad or Good. I need to be informed. We will see an Oncologist in the next two weeks. I just kinda wanted to know what we are up against .
Oh and she is 78 years old today. How well does older people respond to treatment ? Thanks in advance .



Tissue Submitted
Right colon

Gross Description
The specimen is received in formalin in one container labeled with the
patient's name, and "right
colon". The specimen consists of a portion of bowel measuring 15.0 x 11.0
x 6.8 cm in greatest dimensions. Two staple margins are identified. The
proximal staple margin is identified, and there is an appendix present.
The ileocecal valve is identified. The serosal surface is pink-tan, and a
darker area is appreciated that is tan-brown to black measuring 2.8 cm.
The specimen is opened along its length revealing white-tan-pink colonic
mucosa and an area of ulceration with an exophytic mass that measures 6.1 x
4.3 x 2.2 cm in greatest dimensions. This mass is within 0.6 cm of the
ileocecal valve, within 3.5 cm of the proximal margin, within 6.7 cm of the
distal margin, and within 1.3 cm of the radial margin. The staple margins
are shaved and submitted. The mass is sampled and submitted. Normal
mucosa is sampled and submitted. The appendix present measures 3.4 x 0.6 x
0.4 cm in greatest dimensions. The serosal surface is pink-tan and
otherwise unremarkable. The appendix is cross sectioned revealing pink-tan
cut surfaces that are otherwise unremarkable. No fecalith is identified.
Representative sections are submitted as per the summary of sections.

SUMMARY OF SECTIONS:
A Proximal margin
B Distal margin
C-G Representative sections of the tumor
H-I Presumed normal colonic mucosa
J-K Representative sections of the appendix
L-V Lymph nodes, 11c
(Cassettes L and M contain one bisected lymph node
each,
cassettes N-V contain multiple single lymph
nodes).

DOS/ab

DIAGNOSIS
Right colon:

Procedure - Right hemicolectomy.
Tumor site - Right colon.
Tumor size - 6.1 cm in greatest dimension.
Macroscopic tumor perforation is not identified.
Histologic type - Adenocarcinoma with mucinous component.
Histologic grade - Low grade.
Microscopic tumor extension - Tumor invades through the muscularis
propria into the subserosal adipose tissue.
All margins uninvolved by invasive carcinoma.






Distance of invasive carcinoma from closest margin - 1.3 cm from
radial
margin.
No history of prior treatment.
Lymph-vascular invasion is present.
Perineural invasion is not identified.
Tumor deposits are present (2) - The largest measuring 0.6 cm.
Seven of twenty-four lymph nodes are positive for metastatic neoplasm
(7/24).
Immunostains on the neoplasm are pending.
Appendix - No pathologic changes

Pathologic staging - pT3 pN2

[bitchslapped]

As a former caregiver I'm going to tell you that your first responsibility is to respect & protect the privacy of your family member's medical information. I hope you immediately edit this public post by removing your mother's name & birth date. Otherwise I hope a moderator deletes the post.
We hesitate to act as oncologists or radiologists in interpreting the medical reports of others. You can go to the American Cancer Society's website & review the staging that the pathologist provided on your mother's report to gain a better understanding. In the meantime, remain calm & steady for your mother. Keep in mind, this is all about her. This site has a wealth of information if you use the search box to help educate yourself in preparation for your mother's oncologist meeting. We have several "sticky threads" @ the top of the forum w/a lot of info/resources to help people self educate.
Once you meet w/the oncologist, I'm sure others w/b happy to assist w/questions you may have. At that point, you should have enough info to create a "signature" if you choose, which is very helpful to people in answering questions.

Best Wishes
BS

[BrownBagger]

I hope you immediately edit this public post by removing your mother's name & birth date.

I edited that stuff out. Thanks BS for the heads-up.

[jhocno197]

Margins sound good, but definitely sounds like chemo will be happening.

[rcreese]

Sorry I did not catch her name in it.

[CLD]

A T3 N2b diagnosis is the same as my husband who also had a tumor deposit. It sounds like your mom is stage 3c. Note there is no M category, indicating no distant metastasis are evident to the pathologist. A PET scan may indicate further involvement (lymph nodes, for example). The chemo is a six month regimine. My husband is now 20 months post school and is doing well. There are many people on here with a worse diagnosis who are also doing well. It is good that the tumor grade is *low*. Why was the appendix removed? You might want to find out if a C.E.A. (blood test that measures something to do with the tumor was done). Lab ranges vary, but Are typically 0-5 or 0-7 . Good luck to you.

[Swirdfish]

I would confirm with your oncologist your M category. I know that on my clinical staging they also left it out, because they hadn't scanned my lungs. Even if there is no spread they should still indicate a M0. Make sure your staging is complete.

[rcreese]

Hopeful we can see an oncologist at some point this week . I came here because all of this is over my head . Heck I do not even understand what most of this means . I am
Googling and trying to take a crash course in cancer reports .
I realize this is all about my mother . Since Iam an only child and she is 78 years old every thing falls on me . My dad passed away in December . Thank you all for the input . You guys are helping me form my question list for the oncologist . A littl back ground . Mother started having stomach issues in Feb. The dr started looking at her stomach first . They went down in it twice in the spring . Found nouthing . As the summer rocked on we had zero change in her stomach issues . However her blood work was off . Iron low and weight loss .
She also had what she called sludge in her poop . Dr ordered a ct scan . It showed a mass on her right colon . No other areas .. The next week she had a colonoscopy. Confirmed large mass on colon . Long story short we had it removed Tuesday . Got the report Thursday . I am also very interested in learning about treatment effects in people her age . Like questions I should ask . Thank you again for all y'all help ..

[bitchslapped]

Here is the "sticky thread" I previously mentioned:
viewtopic.php?f=1&t=53238
Scroll down until you find the Stand of Care link from NCCN. It's a good place to start for beginners & also contains a list of questions to ask the doc.

Also our "Sticky thread" of terminology & abbreviations may be useful:
viewtopic.php?f=1&t=5366

At the top right of the board here is a link for Michael's Mission which also has resource information.

Your mother's age w/b a consideration for the oncologist to determine course of treatment depending on any underlying medical conditions she may have, overall health & living situation. Dose adjustments can be made in chemotherapy while remaining effective if she chooses to go that route.
In the U.S. FOLFOX tends to be the first line of treatment, depending on repsonse, FOLFIRI 2nd line treatment whereas in some other countries it is the reverse.
I would caution if your mom chooses chemotherapy all throw rugs should be removed in the house (trip hazard chemo or not). Chemo has a lot of side effects, particularly Oxaliplatin (peripheral neuropathy).

Spend some time on here reading, using the search box. You'll learn a lot from patients & caregivers alike. Get a notebook; keep all records in it, bloodwork, scans, reports, etc.

I would really encourage you to carefully review the NCCN standard of care guideline link provided above in prep for consult w/the oncologist & really listen to what he/she says to absorb it all. If you reside in the U.S. you will want to brush up on what Medicare will pay for as far as bloodwork, tumor testing, CT scans & PET scans. I would want tumor testing, CEA baseline through bloodwork (though not a reliable baseline marker for some individuals), a PET scan (tho I believe Medicare limits those) AND read, read, read here on this site. Use that search box.

Best Wishes
BS

[rcreese]

Thank you so much .

[WriterGirl1969]

My mother was just diagnosed with colon cancer.. The report is over my head.
Here is the report. Any help is appreciated. I know its not good. I just went thru this with my biological mother in 2015. Hers was the lungs. She passed away within a month of being diagnosed.
Just any thoughts.. Bad or Good. I need to be informed. We will see an Oncologist in the next two weeks. I just kinda wanted to know what we are up against .
Oh and she is 78 years old today. How well does older people respond to treatment ? Thanks in advance .

Hi Rcreese. So sorry that you had to be here, but glad that you found this group. It is filled with amazing people. As someone already noted, people will steer away from medical advice - that's for your doctors - but we can try to make the jargon a little easier to understand.

From my research, all of that initial information (pink and tan, etc.) is a description of the biopsy sample. The Diagnosis is the part that reviews what was found. My diagnosis said Adenocarcinoma also. You can find more information about that and about the "grade" on some of the links people provided to you. It looks to me from what you have noted, that the tumor was removed with "clear margins." This basically means they took a small bit out on either end of the tumor, and found that the cancer cells had not spread out into that tissue. The "extension" of the tumor talks about how deeply into the colon wall the tumor had penetrated. This will determine the "T" value. For example, my tumor had invaded the muscle of the colon wall, but not perforated out into my abdomen, so I'm a "T3" also. Worse than a T2, better than a T4. The information about the lymph-vascular talks about whether cancer cells are found in the lymphatic system. They start to treat your cancer more aggressively when this is positive because your lymph system carries stuff through your body, so they will want to try to ensure those cells don't get to other organs.

That's about the extent of my understanding. Hopefully this helps you to prep your questions for your doctor visits. There's a really excellent book that also lists some things to ask, and goes through a lot of information about how cancer cells work vs. normal cells. Someone here pointed me to it when I was newly diagnosed, and I've found it very helpful. Here's the link:

https://www.amazon.com/Chemotherapy-Sur ... ving+cheom

Colon cancer is generally a slower developing cancer than others. Of course everyone is different, but try not to compare it to other cancers or timelines, as it is not a direct comparison. Also, everyone reacts differently to treatment. Your doctor(s) will hopefully gear treatment around your mother's personal situation and choices. It's great that she has you. As an only child myself, I can identify with the situation you are in. Just remember that ultimately, your mother (and probably you) are the ones with the control. Doctors guide you with best knowledge. Stay informed (as you're doing) and be your own advocates. Do what's right for your family.

Hope this helps. Deep breaths, and keep us posted.
Hugs and Prayers,
--Tracy

[lauragb]

I am sending you a private message. We may live close to one another.

Laura

[dianetavegia]

I recently read that chemo is not being suggested for Stage III for anyone over 70 tho if the person is in perfect health and very active, etc., it's not ruled out. It happened to be included in a paper someone had shared and it caught my eye because I'm 66 in December and hubby is 69 and he has 3 pre cancerous polyps every time he has a colonoscopy with his next one coming up this fall.

Your mom should heal fine. I was Stage III for 3 years before a met and then surgery for that and cancer free for 4 1/2 years since that, so pushing 8 years since my original diagnosis.

[Maggie Nell]

Hello rcreese,

As a former histopathology/medical secretary to a pathologist, I can tell you that the anatomical descriptions
and instructions for the tissues to be sampled are supposed to be over your head. It is technical jargon (in-house)
from the histopathology technician for the pathologist who examined the tissues, under a microscope, to
form a primary diagnosis.

Immunostains were still pending on the neoplasm (cancer) which may/may not alter the primary pathologic staging of pT3 pN2
and the finding of those immunostains will be sent to the oncologist.

This 78-year old female has just undergone a right hemicolectomy that will take 8-12 weeks of recovery for someone of
her age. There will be restrictions on how much she can lift, what she can do in terms of housework/exercise, simple
showering, getting in/out of bed/bath/vehicles and these are the immediate concerns for you as a support person.

Whether or not this woman wants to proceed with treatments that this "seven of twenty-four lymph nodes are positive
for metastatic neoplasm (7/24)" indicates will be the focus of the oncologist's discussion with her, will very much
be informed by her own resistance or acceptance, at the age of 78, to the inevitability of "peoples gotta die sumtime" and
whether or not she perceives herself as having had a "good innings".

I think there's a saying in this forum about not borrowing trouble - if you can help it.

[DarknessEmbraced]

I'm so sorry to hear you and your Mom are going through this!*hugs* After surgery I shared my pathology report on here and received help in interpreting it. I would also write out questions to ask her oncologist.