Can Stages go backwards post surgery?

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ocstacy
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Can Stages go backwards post surgery?

Postby ocstacy » Fri Nov 24, 2017 1:49 am

Silly question. Do the Stages go backward after an operation? If you started with Stage 3 and had surgery on the tumor and they got most of it, does it go back to Stage 1 or none? Please share cause I'm clueless. We see the surgeon next Monday, I guess I can ask him.

Happy Thanksgiving to all!!! :D
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

Aqx99
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Location: Pfafftown, NC

Re: Can Stages go backwards post surgery?

Postby Aqx99 » Fri Nov 24, 2017 2:33 am

ocstacy wrote:Silly question. Do the Stages go backward after an operation? If you started with Stage 3 and had surgery on the tumor and they got most of it, does it go back to Stage 1 or none? Please share cause I'm clueless. We see the surgeon next Monday, I guess I can ask him.

Happy Thanksgiving to all!!! :D


From what I have read, the stage of the cancer always remains the same because that dictates the treatment plan. It can be downstaged if their staging was wrong before surgery, like if they thought lymph nodes were involved and it ends up they were not or the tumor is not as invasive as they thought.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Dx, Age 39
2/21/17 CEA 0.9
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Dx w/ovarian cancer
9/6/17 CA 125 11.1
11/27/17 CEA 2.6
12/5/17 CT NED
12/13/17 CEA 2.9
1/11/18 CA 125 8.6
1/23/18 Reversal
3/21/18 CT enlarged thymus
4/6/18 PET NED
7/10/18 CT NED
7/11/18 CEA 2.6
9/18 Bilateral Prophylactic Mastectomy

NHMike
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Re: Can Stages go backwards post surgery?

Postby NHMike » Fri Nov 24, 2017 7:27 am

I asked my surgeon and she said that it's still 3 even though everything is 0 right now. It might make a slight difference for mop-up chemo though. I'll find out myself this Thursday.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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Robino1
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Re: Can Stages go backwards post surgery?

Postby Robino1 » Fri Nov 24, 2017 9:20 am

I do believe that the only time it is staged differently from first diagnosis is if there was a mistake in that diagnosis. Once you have a stage whatever cancer, you will always have that stage.

You will be considered a survivor of that stage of cancer if/when you go into NEDville. Mine will always be a part of my history.
At 54 2014 1st colonoscopy colon cancer detect
Colon resect margins clear. No chemo Stage II
2017
Distend abd, pain in intestines.
CT scan seeding & Ascites
Lap diag - cancer on the omentum
CEA 217; 219
FOLFOX started 6/17
CEA 202
8/29/17 CT melting of tumor.
Latest CT scan shows 2 new tumors and return of ascites.
CEA: (2017)9/30 -109; 10/12 -99.1; 11/4 -90.7; 11/30 -70.7; 12/14 -83.4; (2018)1/4 -73.3; 2/1-84.2; 89.2; 89.8; 88.5; 81.8: 93.5; 107; 119
BRAF V600e

AbbyDoo
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Location: So.Ca.

Re: Can Stages go backwards post surgery?

Postby AbbyDoo » Fri Nov 24, 2017 1:41 pm

Preliminary staging before treatment to come up with a game plan.
I know after chemo radiation and surgery I was downgraded to stage 2 from 3C.
I was really hoping to do xeloda for mop up chemo butt since I was originally 3C oncologist had me do the folfox,oxiplaton cocktail.
Hope your mom is doing well and enjoyed turkey day
53 yrs old
4/30/15 colonoscopy Mass found
5/21/15 staged 3 C rectal cancer
7/3/15 finished xeloda and radiation 28 rounds
9/30/15 LAR
10/29/15 picc line installed
11/2/15 start chemo 5 fu Oxaliplatin
3/7/16 Finish Chemo
4/29/16 Ileostomy Reversal.
7/13/16 colonoscopy clear.
CRC survivors know there Sh%t

Zig2017
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Re: Can Stages go backwards post surgery?

Postby Zig2017 » Sat Nov 25, 2017 8:29 am

Hi from what I understand you are still at original stage as others have said. When they have done surgery and correctly staged you, you are still considered 3. And yes they will decide after surgery best course of action to take for your particular stage, if they got everything, etc. I wish you all the best for treatment and a speedy recovery!
Hubby stage 3C June 2017
MSS BRAF Mutation
18 LN positive
Adenosquamous CC
12 FOLFOX
Right Hemicolectomy
11/08/17 numerous nodules and lymph nodes throughout chest and abdomen. Stage IV.
11/2017 moved care to Sloan clinical trial for BRAF mutation
1/30/18 off clinical trial
2/2/18 one dose of Irinotecan
2/5/18 Hospitalization and hospice
2/16/18 came home from hospital and went home to his Lord at 1:10 pm

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CaliforniaBagMan
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Re: Can Stages go backwards post surgery?

Postby CaliforniaBagMan » Sat Nov 25, 2017 8:19 pm

You definitely can be backstaged after surgery as more precise information is learned through the surgery.

I was diagnosed IIIB, then backstaged to II after surgery. Even though I had T4 tissue invasion.
CT guided biopsy on mass - still NED !!!
CT scan finds new 2x3cm mass on 10/09
APR surgery 11/07; NED thereafter
Folfox/radiation 9/07-10/07
DX Stage III rectal cancer 7/07

weisssoccermom
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Re: Can Stages go backwards post surgery?

Postby weisssoccermom » Sat Nov 25, 2017 11:30 pm

Respectfully AbbyDoo...you are not DOWNSTAGED, particularly after some form of neoadjuvant treatment ....including radiation.
Your tumor may have shrunk but the patient is ALWAYS considered the stage that he/she was staged prior to ANY neoadjuvant treatment. Think about it....the sole purpose of any form of neoadjuvant treatment is to shrink or eradicate the tumor. IF the treatment does its job.....great but you are NOT downstaged.

Take me, for example.
I was clinically staged as a stage IIA. After chemoradiation, there was no visible tumor present. When I had my excision, there were no cancer cells. That doesn't make me a stage 0. I was staged as a stage IIA and that will remain on my record FOREVER. My surgeon actually felt that when she looked at the original scans and EUS that I was more likely a very very late stage I BUTT....my stage still remained as a stage IIA.

Unless an actual mistake was made which was confirmed by scans, surgical pathology report, etc. a patient is NOT downstaged.
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!
Perform random acts of kindness

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susie0915
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Re: Can Stages go backwards post surgery?

Postby susie0915 » Sun Nov 26, 2017 9:45 am

I was also staged a 2A at diagnosis. After chemo/radiation all that was left was scar tissue. My pathology from surgery did state very minimal residual cancer cells, bit was never downstaged. Treatment continued as planned with adjuvant therapy after surgery.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 PET scan NED
9/15 LAR
0/24 nodes
10/15 blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 C 4mm lung nod
10/17 pel/abd CT NED
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, CT pel/abd/lung NED
11/18 CEA .6
5/19 CT NED, CEA <.5
10/19 Clear colonscopy
11/19 CEA <.5

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Atoq
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Re: Can Stages go backwards post surgery?

Postby Atoq » Sun Nov 26, 2017 10:29 am

Hi! From what I read they talk about ”restaging” after neoadjuvant therapy, meaning that you evaluate the size and regression of the tumor and then it can affect the type of surgery you get and if the sphincter can be saved. But the original stage is the one used in research to pool samples together and see the effects of treatment on survival. The new stage can also push you towards a “sit and wait” strategy, if you have total regression. So both stages are kept, the old and the new one, having different meanings.

I copy a link to a paper about restaging:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785617/

Claudia
1972, 2 kids
Dx rectal cancer 10.2017
T3N2aMX (met left lung 8 mm)
Lynch neg
CEA 1.8
Neoadjuvant chemoradio Xeloda + 25x2 Gy
05.12.17 laparotomic surg. for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle lung biopsy
07.05.18 CAT scan, lung met 11 mm
04.06.18 ileo reversal
26.06.18 wedge VATS
24.08.18, 31.02.19 CAT scan
12.09.18, 06.02.19 scope, CEA 1.6
19.11.18 scope
20.08.19 CAT, eco
13.09.19 scope, CEA 1.2
18.03.20 CAT, eco, scope, NED
29.11.20 CAT, NED
2023 NED

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ocstacy
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Re: Can Stages go backwards post surgery?

Postby ocstacy » Sun Nov 26, 2017 1:26 pm

was really hoping to do xeloda for mop up chemo butt since I was originally 3C oncologist had me do the folfox,oxiplaton cocktail.
Hope your mom is doing well and enjoyed turkey day


Thank you! Cooked the whole entire Thanksgiving meal on my own this year with my dear husband. Took 6 hours BUTT all worth it. Mom enjoyed herself. She will be starting Chemo soon again. Hope everyone's was enjoyable too! :D
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

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ocstacy
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Re: Can Stages go backwards post surgery?

Postby ocstacy » Thu Nov 30, 2017 2:14 am

I asked my surgeon and she said that it's still 3 even though everything is 0 right now. It might make a slight difference for mop-up chemo though. I'll find out myself this Thursday.


It was confirmed by mom's surgeon that is considered "Remission" even though they got all of the cancer (tumor) but she still has a few cell residuals. So you always go based off your first stage. She had a Near Path. Result, not complete. So, they do want to do the mop up chemo with Xeloda. My mom did well w/ Xeloda except she had the horrible hand and foot rash. Radiation gave her more pain towards the end, glad she is done with that part. She has to gain back the 8 pd she lost before she starts Chemo. Thank you for all the support and best wishes to you all too. 26 more Days until Xmas!! Yikes! :roll:
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.


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