Surgeon says stage II Oncologist stage III

[star68]

Hi everyone, My mother has colon cancer, when we saw the surgeon he told us stage II but when we have visited the oncologist to decide what treatment will suit her best he told us that she is stage III. In between surgeon and oncologist appointment she had a PET scan. Could it that with the PET scan they could be more exact about the stage of cancer? other ways what could be the explanation for the different diagnosis? I should have asked the oncologist but there were so many questions to ask that we didn't think to ask him about cancer stages. Thank you.

[Lee]

The difference between stage II and stage III is lymph node involvement. Stage II, no lymph nodes involved. Stage III, lymph nodes are involved. Since your mom had a Pet scan, I suspected a few lymph nodes lite up for cancer. Thus the upgrade to stage III.

Lee

[CLD]

This happened to my DH too...pathology and surgeon say stage 3, oncologist says 4. For DH, it ultimately allowed for more frequent scans. Perhaps sitting down with your pathology report and discussing it with onc will clear it up (quite honestly, though, I still don't understand my DH upgrade). Sometimes, I believe, there is controversary about whether or not Stage 2 needs chemo...maybe this has something to do with it, or perhaps thereare other features that lead the dr to feel stage 3 better represents your moms situation.

[jhocno197]

Our oncologist went off on my husband's first surgeon for staging him.

I would think the PET showed node involvement, too.

[BrownBagger]

It's not uncommon for them to disagree, I think. The only sure-fire way to know the stage is through surgery. If they remove lymph nodes containing cancer cells, then it's definitely Stage 3. If the lymph nodes are all clear, it's considered Stage 2 until some new information comes along (or doesn't). A PET scan is an imperfect diagnostic tool. It can provide hints and additional information, but no definitive answers, since other things (like inflammation) can light up a PET.

[Beckster]

Star68,

I had surgery in November and was diagnosed through pathology as stage 2A. Because I had a couple of "high risk" features, he recommended post surgery chemo. The oncologist is treating me as stage III even though surgical pathology diagnosed me as stage 2. He started me with Capeox (oxi and Xeloda) but I had an anaphylactic reaction during the first infusion. Now I am on Xeloda monotherapy, 2 weeks on and 1 week off. If there is no lymph node involvement, it is stage 2 but if there are high risk features, they will treat as stage 3. Maybe this is the discrepancy between the two doctors.

Good Luck!

[star68]

Thank you every one for clarifying my question.

[michelle c]

Does your mother have colon or rectal cancer? Has she had surgery? With colon cancer - lymph nodes are removed during surgery (resection) and if there are local lymph node involvement (test positive) with other organs clear, she will be staged stage III. I have never had a pet scan. Rectal cancer is staged slightly differently.

[BeansMama]

Like others said my guess is they found some lymph node involvement. It may have been too small for the surgeon to see but was found by pathology.

Get a copy of her pathology report and see what it says.

I will add you and your mother to my prayer list.