O Stoma Mia wrote:Dear Lara -
It looks like it's already Sunday evening there in Phoenix, and you have asked a lot of new questions here that might not receive any answers before you have to head off for your Monday appointments with the oncologist and surgeon. I'll try to address some of the questions here. The rest of them might might have to wait until after your doctors' appointments, since the people here who would have opinions or answers to your questions might not be logging in overnight.
For tomorrow (Monday), here are a few of the priority items to cover:
- Urgency of surgery - You said, "...The report I got shows the mass on the top left corner... The picture of the mass shows it is pretty well filling the colon..." The issue here is whether the mass is so big that it is in danger of causing an obstruction any day now. If so, the surgeon will probably want to remove the tumor right away and forget about doing any neoadjuvant chemo-radiation to shrink the tumor. So, this is one of the questions you should ask. If they decide to do chemo or chemo-radiation first, then they will not be able to do surgery to remove the tumor for another 2 or 3 months from now. If they decide to do surgery right now, then chemotherapy will have to wait for another 6 to 8 weeks.
- Location of primary tumor, and of liver spots - You said, "The report I got shows the mass on the top left corner. The picture of the mass shows it is pretty well filling the colon.... Doctor said that it is in a good place to cut it out and that might be all I need... . It is not clear to me exactly where your tumor is located. What do you mean by, "..top left corner.."? Did they tell you exactly where the primary tumor was located? Could it be near the Hepatic Flexure by any chance? If so, this means that it is close to the liver, and this suggests (to me, at least) that if your up-coming PET-CT scan confirms liver malignancies that are accessible and all on the same liver lobe, then maybe they could do a liver resection at the same time as doing the colon resection, since all of these tumors would be in the same general part of the abdomen (does this make any sense???)
The average colon is about 1.5 m long. Lengths of the various parts are:
* Ascending colon: 25 cm
* Transverse colon: 45 cm
* Descending colon: 15 cm
* Sigmoid colon: 40 cm
* Rectum: 12 cm
* Anal canal: 5 cm
The splenic flexure is thus at around 72 cm from the anal verge, and the hepatic flexure at around 117 cm.
- Choice of surgeon - For colorectal surgery, it is important to have a surgeon who is Board-Certified to do this type of surgery. One thing you could do at this point is to check for certified colorectal surgeons in your area. The link to do that is here: Is My Doctor Board-Certified?. Some of the reasons why this is so important are discussed in this prior post by weisssoccermom: Board-certified colorectal surgeons.
- PET scan - If they are going to do a PET scan, then presumably it would be a PET-CT scan, which would be able to show whether the liver spots and any lymph nodes are likely cancerous. (They are unlikely to give you both a PET scan and an MRI, so it looks like they prefer PET scans at your facility). If they do give you an appointment for a PET scan, then there is a special diet and set of special instructions that you have to follow prior to the scan. Be sure to follow the instructions closely so as not to introduce error factors into the captured images.
They should give you a set of detailed instructions for your PET scan prep. If they don't, then you could have a look at a few of the detailed PET/CT scan preparation guidelines that have been posted on the internet. These will give you an idea of the kinds of things that you should or should not do up to 72 hours before your exam.
Preparing for your PET CT scan
Positron Emission Tomography (PET Scan) - Johns Hopkins
- Hospital packing list - If you are in fact going to have surgery soon then you might want to have a look at some of the threads here related to stays in the hospital for colon-cancer related surgeries:
Things that are helpful to have with you in the hospital...
"take to the hospital" list
If you could take to the hospital what would it be?
There are also some web-sites that have more general information in this area
What to pack for hospital
What to Pack for a Hospital Stay
The 10 Most Important Things to Bring With You to the Hospital
What to Expect for Inpatient Surgery
Good luck on your upcoming appointments. I hope they come up with a good plan for you. Remember to write down or tape-record everything they tell you.
KElizabeth wrote:I strongly suggest finding a board certified colorectal surgeon to do the resection as you will have less chance of complications later...
Find a NCI designated cancer center instead of a small office oncologist. They will be more progressive if times get even tougher. It's an easy google search.
Bti wrote:Thanks everyone! I have requested an appointment with the U of M cancer center. The hospital I am currently working with has me schedule for an appointment with a board certified general & colon rectal surgeon on the 27th. I do think before I make and decisions on course of treatment I want to talk with the U of M Cancer center. I should be getting my pathology reports tomorrow (fingers crossed)
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