Stage 1 with no surgery...any thoughts?

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Andrea1976
Posts: 360
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 09, 2017 7:30 am

I think stage 1 is a wide range. From cancer in the polyp where the invasion to submucosa is minimal and in the polyp not in the colon wall. To the 4 cm rectal tumor t2 cancer. You have to talk to your doctors. If I had a rectal t2 polyp I would had the surgery. In your case with the minimal cancer 2 mm I would not. But there are always risks...in life.
Stage I
pedunculate polyp in descending colon
moderately diff adenocarcinoma 0.6 cm
Tumor confined to the head of the polyp
Stalk margin 2 cm negative for dysplasia and malignancy
Polyp removed during colonoscopy 1/15/16
No lymphovascular involved
No surgery
CEA after polyp removal 0.3
Genetic testing negative for colon and breast cancer
39 year old female. I am not celebrating my 40th but waiting for my big 50 birthday party!!!

Trig
Posts: 6
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Thu Jun 15, 2017 1:08 pm

Thank you everyone for your insight and answers...I appreciate it!! Well I pray and hope my follow up MRI is clean! I'm a little worried though cause from what I understand they won't be doing a catscan or chest X-ray

Andi
Posts: 3
Joined: Thu Jun 15, 2017 9:14 pm
Facebook Username: Andrea.Dow

Re: Stage 1 with no surgery...any thoughts?

Postby Andi » Thu Jun 15, 2017 9:30 pm

I'm guess I'm confused on this one... I just had a large polyp removed that they considered Stage 1 and called precancerous. They removed 4 1/2" of my rectum since the polyp was so large. It did not invade the tissue, that was found first through an ultrasound and then after through biopsy after the resection.
I don't want to worry you, that is not why I ask since that was my first thought when they found this is, is that it would just be cut out through a colonoscopy. Perhaps it had to do with the size of your polyp and the location?

Andrea1976
Posts: 360
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Thu Jun 15, 2017 11:30 pm

Were you told the polyp was stage 1? If yes, than it was not precancerous but malignant. Polyp cancers are early cancers. Most people end up being ok. But few are not. NCCN has guidance recommendations.

Page 37 and that includes follow up testing.

https://www.nccn.org/patients/guideline ... /colon.pdf
Stage I
pedunculate polyp in descending colon
moderately diff adenocarcinoma 0.6 cm
Tumor confined to the head of the polyp
Stalk margin 2 cm negative for dysplasia and malignancy
Polyp removed during colonoscopy 1/15/16
No lymphovascular involved
No surgery
CEA after polyp removal 0.3
Genetic testing negative for colon and breast cancer
39 year old female. I am not celebrating my 40th but waiting for my big 50 birthday party!!!

Trig
Posts: 6
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Fri Jun 16, 2017 7:26 am

As far as I know mine was considered stage 1...but the more I read the more I'm confused!! Mine is more in the rectum,..and from what I understand early budding. Does this make it stage 2? Both oncologists said no to chemo and radiation. And said there was a 10% chance of anything returning and after my first clean follow up the percentage drops. It they also said that if I have the surgery the cancer can still spread anyway!! So frustrating!! I'm so worried

Andrea1976
Posts: 360
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 9:14 am

How old are you? I was only 39 when my polyp was removed. You can't really do much at this point - just hope for the best. My 1st follow up colonoscopy was clear and no new polyp. Please ask your doc what type of polyp you had. Also read the NCCN guidelines / it will help you understand your situation.
Stage I
pedunculate polyp in descending colon
moderately diff adenocarcinoma 0.6 cm
Tumor confined to the head of the polyp
Stalk margin 2 cm negative for dysplasia and malignancy
Polyp removed during colonoscopy 1/15/16
No lymphovascular involved
No surgery
CEA after polyp removal 0.3
Genetic testing negative for colon and breast cancer
39 year old female. I am not celebrating my 40th but waiting for my big 50 birthday party!!!

Andi
Posts: 3
Joined: Thu Jun 15, 2017 9:14 pm
Facebook Username: Andrea.Dow

Re: Stage 1 with no surgery...any thoughts?

Postby Andi » Fri Jun 16, 2017 9:24 am

I'm 48, 47 was it was found in November. I had my resection surgery in January. The only follow up I am required to do is a colonoscopy in January 2018.

Thank you for the information Andrea.
I'm going to take a look at my biopsy sheet when I get home from work this afternoon.

Trig
Posts: 6
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Fri Jun 16, 2017 9:56 am

I am 44...and it was a mushroom type

Andrea1976
Posts: 360
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 10:06 am

Good - that's better than sessil. Based on the size of the cancer. You also only had level 1 haggit - cancer was limited to the head of the polyp. I had my pathology checked in 3 different hospitals and wasn't given budding report. I wonder if it wasn't there since they didn't report it. One report is from cancer center. I am also not having regular CT scans only had MRIs. All we can do is hope for the best. I was lucky because of this my Melanoma stage 0 was diagnosed on a mole that I had 12 years. I am not worried about my Melanoma. But glad it was diagnosed at non invasive stage and removed. Now I have to be monitored for both. My kids are 13 and 15. I am enjoying every day. Heading on cruise with them soon. Interesting part in all this that I have found out truth about a lot of people. I have been very private in all this. And only 2 close friends knew about this. I can say that neither of them stepped in. I didn't need much. Just to "talk". Well, big life lesson...
Stage I
pedunculate polyp in descending colon
moderately diff adenocarcinoma 0.6 cm
Tumor confined to the head of the polyp
Stalk margin 2 cm negative for dysplasia and malignancy
Polyp removed during colonoscopy 1/15/16
No lymphovascular involved
No surgery
CEA after polyp removal 0.3
Genetic testing negative for colon and breast cancer
39 year old female. I am not celebrating my 40th but waiting for my big 50 birthday party!!!

plastikos
Posts: 254
Joined: Wed Jan 14, 2015 6:09 am

Re: Stage 1 with no surgery...any thoughts?

Postby plastikos » Fri Jun 16, 2017 11:24 am

Like what others have said. A very tough and personal decision. I can only say what I would do. I would get surgery since it would in theory nip the cancer in the butt. For good. Keep in mind this is from the perspective of someone who was stage 4 and has had multiple recurrences and surgeries. So 1 surgery for a chance to be cancer free for a lifetime is a walk in the park.
Diagnosed St. IV Colon CA @ 37, male, Kras wild type, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab 12/2016 -> pseudoprogression (?), biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab

Andrea1976
Posts: 360
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 12:22 pm

The problem is that there is no way to be 100% cured even with the surgery. Cancer could had already spread. In fact if you research this forum the people here who progressed to stage 4 from pedunculated t1 polyp had the surgery and clear lymph nodes. The cancer spread by blood.

If there are no risk factors than surgery is not indicated in the case of low risk pedunculated polyp. My cancer center simply refused to operate. I had a hard time with it. Surgical gastro oncologist sat with me during his off hours and basically said that that's what he would had done for his mom or sister. I had to put my life in his hands and hope for the best... it is a colorectal cancer dep in a cancer center.
Stage I
pedunculate polyp in descending colon
moderately diff adenocarcinoma 0.6 cm
Tumor confined to the head of the polyp
Stalk margin 2 cm negative for dysplasia and malignancy
Polyp removed during colonoscopy 1/15/16
No lymphovascular involved
No surgery
CEA after polyp removal 0.3
Genetic testing negative for colon and breast cancer
39 year old female. I am not celebrating my 40th but waiting for my big 50 birthday party!!!

mike1965
Posts: 113
Joined: Mon Jan 25, 2016 11:07 pm

Re: Stage 1 with no surgery...any thoughts?

Postby mike1965 » Tue Jun 27, 2017 1:36 am

It is a tough decision. I had a small polyp but it was flat. My surgeon recommend a wait and see. He would do scan every 3 months and check my labs every month. However the cancer board and other surgeon recommend surgery. I was very confused. I waited 6 months and he did the scans and labs every thing looked good. But I was not comfortable with this approach. I went with another surgeon and had LAR surgery. They found that the cancer had traveled to my fat cells near my lymph nodes so I went from stage 1 to Stage 3a very quickly. I am so glad I listened to the other experts. I then did 6 months of Chemo but I am glad that I had surgery. Personally I needed to know if there was more cancer or not. I could not live with the unknown. In my case all the experts wanted surgery except for my original surgeon. I am glad I listen to them. Each of us has to make a hard decision and be comfortable with that decision. I wish you luck and pray all goes well.
Colonoscopy 09/06/15 Doctor removed polyp
DX - Rectal cancer 09/10/2015 T1M0N0
Surgeon recommended wait and see approach 09/2015
Tumor board recommended LARs Surgery 10/2015
Oncologist and PCP recommended LARs Surgery 11/2015
Seeking 2nd opinion from another Surgeon 01/2016
Having Sigmoidscopy on 02/01/16.
Figured out treatment 02/2016
LARS Surgery 03/2016
Stage 3A T1 N1C M0
Chemo Folfox to begin 04/18/16


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