Postby menreeq » Sun Sep 24, 2017 12:52 am
Badass wrote:FWIW-- the rectum is part of the colon. It is the last section-- so technically your surgeon's office is correct.
Yes, which I think supports the term colorectal carcinoma. The cells are the same. The pathology is the same. The difference in treatment, from what I understand, has more to do with the inherent difficulty of getting clear margins for rectal resection due to the complex anatomy of the pelvis. It's a small area with a lot of important structures, making the surgery more challenging.
When people say pancreatic cancer, everyone assumes adenocarcinoma but there are other types. Same with breast cancer. I wonder -- do the people with invasive lobular carcinoma feel like invasive ductal gets all the attention? No, really, I am wondering if there is an ILC board with a similar rant!
The way I see it, public health should strive for awareness of the top cancers affecting the population of that area/country. CRC is in the top 3. It definitely could get more attention.
As far as the term "rectosigmoid," which is where mine was, it can certainly be a management dilemma. There are many ways to define the border between these two areas, whether it is distance from the anal verge on colonoscopy, CT, MRI, flexible sigmoidoscopy, rigid sigmoidoscopy, site of peritoneal reflection, whatever! I spent way too long reading articles, trying to figure out if I was gonna have neodjuvant chemoradiation or not. I looked at my own CT and MR. I had two opposite opinions from GI docs who scoped me. In the end, the surgeon was the "decider." I think that speaks to whether they feel they can get it all out.
All this to say -- hey, this is the place to rant! Rant away! Don't fret over the clinical indication on Radiology reports -- this is often directly imported into the report based on what a clerk types in. The clerk just reads it off an order or an ICD code. I've had doctors give detailed histories on a requisition and then all I see is "pain." It's annoying.
Stage IIA rectosigmoid CC (T3N0M0)
Dx 6/5/17 @age 41ls
Workup: c-scope, EUS, rectal MRI, CT C/A/P
AdenoCA 5.5cm, WHO Grade 2, 0/22 LN, no distant mets
CEA 1.9 (6/5/17), 0.8 (2/28/18), 1.0 (9/17/18), 1.1 (4/16/19), 1.0 (9/24/19), 1.7 (7/8/20)
No lymphovasc/perineural invasion, clear margins
MSI intact, OncotypeDx RS 7
Lap sig colectomy 6/23/17, no ileo/colostomy
Genetics neg for mutations, 4 VUS
Xeloda monotherapy 8/13/17-1/22/18
PET/CT 3/21/18 NED
CT C/A/P 9/17/18 NED, 3/8/19 NED, 9/19/19 NED, 5/13/20 NED