Colon rectal cancer found during routine colonoscopy

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Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Wed Apr 04, 2018 12:34 pm

o stoma mia
thank you so much....Im on it! A friend who's been through this also suggested that i ask for a meeting with all three...oncologist, radiation oncologist, and surgeon together. What is your thinking about that?
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

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O Stoma Mia
Posts: 1261
Joined: Sat Jun 22, 2013 6:29 am

Re: Colon rectal cancer found during routine colonoscopy

Postby O Stoma Mia » Wed Apr 04, 2018 12:44 pm

Lotus wrote:o stoma mia
thank you so much....Im on it! A friend who's been through this also suggested that i ask for a meeting with all three...oncologist, radiation oncologist, and surgeon together. What is your thinking about that?

Yes, I think I would agree, if you could manage to convene such a meeting.

Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Wed Apr 04, 2018 12:58 pm

I just asked oncologist if we could arrange for such a meeting with all three....he said "if you don't need radiation, then there wouldn't be any need to meet one." He said lets hope for that. do you know who makes the determination if and when radiation is needed? Who makes the determination regarding exact size and location of mass?
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

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O Stoma Mia
Posts: 1261
Joined: Sat Jun 22, 2013 6:29 am

Re: Colon rectal cancer found during routine colonoscopy

Postby O Stoma Mia » Wed Apr 04, 2018 1:39 pm

Lotus wrote:... I went in for a routine colonoscopy last week and expected the results to be normal...

Do you have a printed copy of the colonoscopy results, and a printed copy of the biopsy report from the pathologist? Is there additional information in these reports that you haven't mentioned so far?

Also, what kind of doctor did your colonoscopy? What are his qualifications?

Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Wed Apr 04, 2018 4:43 pm

O stoma mia


I went to a practice advertises:
As the largest and most experienced gastroenterology practice in South Carolina, we provide the latest diagnostic testing and treatment. We evaluate and manage patients with GI problems such as GERD, Peptic Ulcer disease, Gallbladder disease, IBS, Inflammatory Bowel diseases (ulcerative colitis, Crohn's disease), Liver diseases, Pancreatic disease, Diverticulitis, difficulty swallowing and Colonoscopy for Cancer Screening.

The doctor who did my colonoscopy is a gastroenterologist. He began his college career with Bachelor of Science in Biology. He then received his doctorate of medicine from a -School of Medicine. He completed his internship, residency, and fellowship in gastroenterology and hepatology).
He is board certified in both internal medicine and gastroenterology. He is a member of the American College of Gastroenterology, South Carolina Gastroenterology Association, South Carolina Medical Association, and the American Society for Gastroenterology Endoscopy.

On health grades, he ranks very high across the board.

Yes i have a copy of the colonoscopy report
There is a diagram of a colon . It states 13 cm from anal verge 2.5 rectal mass . Also polypectomy by suare ---with the word hot inserted above polypectomy. instruments PCFQ180AL . India Ink rectal . also gave us photos.
Pathology report says
Diagnosis
"rectal mass" colonic adenocarcinoma arising in a background of tubulovillous adenoma
Comment
The biopsy demonstrates at least adenocarcinoma in situ with foci suspicious for superficial invasion. Results were concurred with another doctor, it stated.
Microscopic Description
Microscopic examination has been performed and results are incorporated into the above diagnosis
Specimen recieved
A. Rectal Mass
Macroscopic Description
Received in formalin labeled rectal mass. label matching requisition and specimen consists of multiple tan tissue fragments which in aggregate measure approximately 3 by 3 by .3 cm. The specimen is submitted entirely in one cassette.
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

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O Stoma Mia
Posts: 1261
Joined: Sat Jun 22, 2013 6:29 am

Re: Colon rectal cancer found during routine colonoscopy

Postby O Stoma Mia » Thu Apr 05, 2018 1:15 am

Duplicate post
Last edited by O Stoma Mia on Thu Apr 05, 2018 1:17 am, edited 1 time in total.

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O Stoma Mia
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Re: Colon rectal cancer found during routine colonoscopy

Postby O Stoma Mia » Thu Apr 05, 2018 1:16 am

Thank you for posting your report results. I may have some other comments before your Monday meeting, but I am not an expert in this area.

I think you should try to get the surgeon to explain the significance of everything in the report. For example, what is the significance of the color "tan" in the specimen? Also, be sure to bring the report photos to the meeting, since the color and appearance of the mass may be important, in addition to the other findings.

Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Thu Apr 05, 2018 2:16 am

Thank you!
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

User avatar
O Stoma Mia
Posts: 1261
Joined: Sat Jun 22, 2013 6:29 am

Removing a Large Flat Colon Polyp by EMR without Surgery

Postby O Stoma Mia » Thu Apr 05, 2018 9:04 am

Here is an article that you could read in preparation for your meeting with the surgeon on Monday:

Removing a Large Flat Colon Polyp by EMR without Surgery
http://www.sease.com/polyp/emr.html

Utwo
Posts: 190
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Colon rectal cancer found during routine colonoscopy

Postby Utwo » Thu Apr 05, 2018 10:10 am

Lotus wrote:The doctor found a polyp that he said measured 2.5 cm x 2.5 cm and he said it was 13 cm from the end of my colon.
...
My greatest concern is the radiation and chemo because I’m very sensitive to any type of drug especially at my age.
Sometimes (depending on a location of a tumor) it's possible to remove such polyp during colonoscopy.
However such procedure requires highly skilled full time colonoscopist.

Have you already asked about such option?
Again, you need to talk to GI specialist/colonoscopist rather than to a surgeon about it.
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6

Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Thu Apr 05, 2018 12:00 pm

Utwo
Do you have any idea how I could locate a highly skilled gastroenterologist or colonoscopist who may be able to do such a surgery for me?
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

Utwo
Posts: 190
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Colon rectal cancer found during routine colonoscopy

Postby Utwo » Thu Apr 05, 2018 12:18 pm

Lotus wrote:Utwo
Do you have any idea how I could locate a highly skilled gastroenterologist or colonoscopist who may be able to do such a surgery for me?
My surgeon performed my first colonoscopy and was not confident to remove my sessile polyp.
So she referred me to GI guy who specialized in colonoscopy starting with residence.

I assume that any major hospital /GI department should have such specialist(s).
Could you ask your surgeon or oncologist?
Could you just carefully review a list of doctors in a GI department of your preferred hospital (if you have one in mind)?
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6

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O Stoma Mia
Posts: 1261
Joined: Sat Jun 22, 2013 6:29 am

Re: Colon rectal cancer found during routine colonoscopy

Postby O Stoma Mia » Thu Apr 05, 2018 2:30 pm

I think what you might be interested in is a doctor who specializes in what is called "interventional endoscopy." as opposed to "diagnostic endoscopy."

There are various "interventional endoscopy" units around the country, such as this one at the University of Virginia:

What is Interventional Endoscopy?
Interventional Endoscopy
In addition to diagnostic procedures, UVA Interventional Endoscopy offers advanced endoscopic procedures, such as:
    - Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA)
    - Endoscopic retrograde cholangiopancreatography (ERCP)
    - Advanced polypectomy, including
      Endoscopic mucosal resection (EMR)
      Endoscopic submucosal dissection (ESD)
"UVA Interventional Endoscopy utilizes innovative and specialized endoscopic procedures to achieve its goal of providing advanced patient care of the highest quality. Patients are referred to us from the mid-Atlantic region and from across the country for some of these advanced procedures."

Reference: https://med.virginia.edu/gastroenterology-hepatology/fellowship-education/interventional-gi/

Lotus
Posts: 31
Joined: Thu Mar 29, 2018 10:03 pm

Re: Colon rectal cancer found during routine colonoscopy

Postby Lotus » Sat Apr 07, 2018 10:04 am

I have been down with a respiratory bacterial infection all week....doctor gave me antibiotics yesterday. I have been in bed with temperature and body aches. I also have brain fog and can not think straight so I am hoping this question will make sense.
Can I not assume that the surgeon will refer me to less invasive treatment if that is in fact what can fix my issue?


It’s hard to believe that surgeons don’t work together with GI doctors to decide which least invasive procedure is needed to fix problem
Lotus female age 71
3/21/18 Routine colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan showed no distant metastatic disease identified
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no evidence for lymph node spread.
Stage 1 t2n0
3/22/18 CEA 0.8 range 0.0-3.0
4/16/18 Robotic Assisted LAR
Pathology negative for malignancy

Utwo
Posts: 190
Joined: Mon May 23, 2016 10:14 am
Location: T.O.

Re: Colon rectal cancer found during routine colonoscopy

Postby Utwo » Sat Apr 07, 2018 10:47 am

Lotus wrote:Can I not assume that the surgeon will refer me to less invasive treatment if that is in fact what can fix my issue?

It’s hard to believe that surgeons don’t work together with GI doctors to decide which least invasive procedure is needed to fix problem
Where do you live? Is it US or Canada?
A surgeon may not refer you to another specialist if she is not completely booked.
Nothing personal - strictly business. :(
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6


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