Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Please feel free to read, share your thoughts, your stories and connect with others!
Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 2:33 pm

Hello,

I'd like to share my mom's colon cancer story and I am seeking advice and help at this helpless/depressed/shocking situation.

My mom had sigmoid colon cancer stage 3 diagnosed 4.5 years ago.
During her first colonoscopy done @ age of 58, sigmoid cancer was found, PET scan was done (PET Scan did not show any metastasis to other organs at that time), then Laparoscopic sigmoidectomy was done right after.

I don't remember exact # of lymph nodes they found. my memory is #6 lymph out of 15... so I think it was STAGE 3B.
Colonoscopy doctor said, cancer in sigmoid colon looks like stage 1 or 2.
Surgeon after laparoscopic sigmoidectomy was done, he said, the colon size wasn't big, surgery went well, no need to worry.
Then when we heard the biopsy result, it was stage 3 which required chemotherapy. (was little bit shocking, but thought it's b/c biopsy result was not available for him at the end of surgery??).

she had 6 months chemotherapy with pump infused every other week in year 2014, 5FU + Leucovorin (I don't remember if there was 3rd med added or not).
After chemo, whole family thought she's been doing alright, eating healthy food etc...

However, end of last year 2017, she complained a little bit of discomfort during bowel movement, feeling like the last part of bowel is not coming out easily.
she explained to colonoscopy doctor last year when she did colonoscopy. doctor said, it could be b/c of surgery done (sigmodectomy).

btw, she's been doing colonoscopy every year, so far 3 times done. very last one done in 2017, they found small polyp then biopsy showed "pre-cancerous cell."

beginning of this year, she had a little bit of pain on abdomen, feeling discomfort, so she had to lay down on the bed and rest, but her bowel movement was improving ironically.

also, she's been following-up with Chemo doctor every couple month and blood check up for last 4.5years.
Her original CEA level before surgery was 2.4ish. It's been pretty stable closer to the original CEA#.
Then, at the end of last year, CEA level went up to 2.8, which surprised my mom little bit.

then, beginning of this year, CEA level went up to 4.8, then Chemo doctor ordered PET SCAN.
btw, until this year, chemo doctor did not order any CT/PET scan for her. I was suspicious why she's not monitoring any. is it because her CEA level is still same as original? also b/c of liver function, renal function blood test within normal range? But I remember (could be incorrect memory) when we first met chemo doctor, before her chemo therapy started, chemo doctor mentioned that she will be monitoring with CT/PET scan every year? or every 3 years? it could be every year for colonoscopy and every 3 years for PET/CT. So last year, I told my mom, since surgery was done more than 3 years ago, reaching 4 years already, we should ask chemo doctor to order CT/PET scan for check-up. Afterwards, my mom told me she asked for it, then chemo doctor said, it's not something she can't order it anytime...I don;t know why she didn't order it last year.

anyway, this year, when CEA level went up to 4.8, and she had vaginal discharge (yellowish color), then chemo doctor ordered PET Scan for her, telling her that it could be ovary cancer which is possible for sigmoid colon cancer it's ovary is located closer. PETscan showed "PELVIC MASS, OVARY MASS"
Then chemo doctor referred her to GYN ONCOLOGIST for further check-up, telling my mom that it could be ovarian cancer, scarred my mom, but I know chemo doctor told her what she was suspecting based on PET SCAN & CEA LEVEL DOUBLED.

We met GYN Oncologist, he wanted to do biopsy, but he said, her uterus is enlarged like a 3 months pregnancy, unable to do biopsy, unable to do complete D&C. He ordered ULTRASOUND. While she was waiting ultrasound appointment, she had a big discharge (like urinating on pants), it was lots of discharge with greenish color. she was shocked, then went to ER right away, asked for ULTRASOUND to be done. Ultrasound also concluded "PELVIC MASS, OVARY MASS".

Then GYN Oncologist scheduled an laparotomy surgery "hysterectomy, saphingo-oophorectomy, removal of ovaries,fallopian tubes, uterus", possible debulking (removing any cancer cells). Right before the surgery, surgeon said "CEA-125 level (which is cancer marker for ovarian cancer) came back normal, so which is a good news. So we all thought that it's not ovarian cancer.

After surgery, surgeon said, "surgery went ok, but unfortunately, it was colon cancer recurrence, cancer cells were growing outside ovaries, located also on bladders, intestines, rectal-sigmoid colon area, all sticking together like a porridge, he spent significant amount of time looking at a different angles to see if he can separate these organs and remove some...but b/c my mom was bleeding a lot (I think it's b/c cancer cell requires a lot of blood vessels, so when cancer cells get cut, bleeding is a lot...)and organs were "frozen", unable to remove any. The only option is to do chemotherapy, which he told mom's chemo doctor to follow-up b/c colon is not his specialty. Chemo doctor is COLON oncologist specialist. GYN oncologist said, he thinks this recurrence possibly caused by cancer cell left out 4.5 years ago located outside, that's why cancer cells were growing outside slowly over time. in order to remove cancer cells, he had to remove entire colon, bladders, instestine, ovaries, uterus, everything....but this means, big surgery and (it's not his specialty area...which he didn't mention this, but I think he wouldn't remove everything? b/c he's GYN doctor?) GYN ONC doctor told us that we should have hope to minimize cancers by chemo therapy, then will see if any surgery can be done if organs can be separated...but the surgery will be very big surgery, with risk...he mentioned surgery name, b/c I haven't heard the vocab, not know...I don't remember exact name of surgery, but only know that it's a big big surgery with lots of risk.

It was very shocking news for everyone including my mom. b/c we always heard that the common area of metastasis from colon is liver and lung, never heard from anyone that ovary is also possible met area. If we heard or if doctors mentioned to us, why they didn't do biopsy to ovary even though PET/CT does not show any mets to ovary, especially if # of lymph nodes were not small amount, and cancer cell was already penetrated.

I asked GYN ONC doctor that what if she had laparotomy, not laparoscopy for sigmoidectomy 4.5years ago. then ovary check could've been done?
well, he said, he looked at the previous surgery report, the surgeon removed everything he had to do, well done. it's just cancer cells left outside of colon started glowing.... but I think it's possible that she could've diagnosed with STAGE 4 at that time 4.5years ago. OR cancer grewed over 4.5 years and spreaded to other organs, so stage 3 became stage 4.

I have to look for her previous surgery/pathology report/ chemo regimen etc...will update the details to get better helps and advices.

My mom just had surgery. Soon, we will be visiting mom's original colon chemo doctor to hear about her plan, then we will also try to visit best colon doctors in LA or wherever the best doctors are...to get second opinion. I am in the middle of seeking a best doctor for this diagnosis. it's not just mets to ovary, it's mets to all the organs in pelvic area, surgery couldn't remove any....

Please if you have any advices, let me know. Thank you so much in advance!!!

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 4:01 pm

So, my specific question to you all is....

I am planning to find out colon cancer oncologist who does surgery, chemo, radiation like GYN ONCOLOGIST. b/c her original chemo doctor does not do surgery, just chemo med infusion, monitoring.

So, when we meet doctors for second opinion, what questions should we ask?
anyone familiar with this diagnosis and metastasis, please give me comments, advices. Thank you!!

dauofcamom
Posts: 34
Joined: Sun Apr 22, 2018 7:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby dauofcamom » Sun Jun 03, 2018 4:06 pm

I don’t have anything to offer other than my sincerest hope that you find the best care and treatment for your mom. My heart goes out to you.
Long Distance Caregiver to 75 year old Mom
3/2018 - colonoscopy, DX malignant cecum mass
4/2018 - right hemi
Stage IIIC - T4bN1aM0
MSI High
5/2018 - Xelox Regime
10/2018 - peri Mets discovered
10/2018 - Start Keytruda every 3 weeks
12/2018 - scan all clear

weisssoccermom
Posts: 5974
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby weisssoccermom » Sun Jun 03, 2018 4:17 pm

Welcome to our forum. I truly am sorry for the reasons you have to be here but welcome nevertheless.
On to some of your questions. First of all, the surgery which I believe you are referring to is called a PELVIC EXENTERATION. Does that sound like the name the doctor stated? You need to understand that most commonly, colorectal cancer DOES spread to the lung/liver but that doesn't mean that it can't or doesn't spread to other places. I've been a member of this board for over 11 years and yes, there have been many females who have had their cancer spread to their ovaries, vaginal area, bladder and their uterus. Let's be honest.....cancer can and does metastasize anywhere.

As for the initial confusion regarding the staging of the cancer, a doctor may think ....even based on a CT, PET or MRI that a particular case 'appears' to be a stage I/II but until that biopsy report comes in and gives the doctors a definitive answer, it's impossible to tell, based solely on a colonoscopy, blood results and/or imaging results what stage a patient is. Just as you believed, it is the pathology report from surgery....the report that states the number of nodes affected...along with the other studies, that gives a firm staging. Based solely on what you said about that....everything was done or said prior to surgery was speculation only.

You state that your mom never had a PET/CT between her original one 4+ years ago and the one done at the beginning of 2018. However, did she have a CT scan alone (without the PET)? Did she have an MRI instead of a CT? Did she just have a PET scan? Not all doctors order a CT/PET.....some order just a CT (and only add the PET IF something shows up on the CT) while others opt for the PET and still others opt for the MRI. As long as she was having SOME form of imaging, her doctor was following the correct protocol for your mother. Usually, in the first 5 years, there is a 'standard of care' for the ordering of imaging studies and a normal CEA, liver and/or kidney test has nothing to do with that decision.

I'd like to make sure you understand (based on what you wrote) that NO surgeon should be determining/ordering the chemotherapy....that is the specialty of the oncologist. So your mom's GYN surgeon was completely correct in stating that he can't/shouldn't be recommending or ordering any type of chemotherapy. Furthermore, the ONLY way that they can know definitively that this cancer in your mom's pelvic region is a met from her colon cancer is from the pathology report. If the surgeon stated that this was a colon cancer recurrence without having any news from pathology (and they can get those results during surgery) then that is just wrong. However, let's assume that pathology has confirmed that yes, indeed, this is a recurrence.

You asked why a doctor wouldn't do a biopsy on the ovary IF they knew that the cancer COULD spread there. Well, honestly, as stated earlier, the cancer can and does spread any and everywhere. Following your line of thinking, should a surgeon do a biopsy on every organ in a person's body? It is just not feasible. No doctor is going to biopsy an ovary, a fallopian tube or the uterus just because. In addition, simply doing a biopsy of (for example) an ovary just because the cancer 'could' metastisize there is infeasible. Where exactly would the surgeon biopsy? Let's assume microscopic cancer cells had been in one very small area of the ovary and the surgeon biopsied a few millimeters away and the biopsy results came back normal. Where exactly, without some very concrete reason would a surgeon biopsy? My friend had rectal cancer that ended up metastasizing to her nose....her NOSE for crying out loud....a super UNCOMMON place for any cancer to spread much less rectal cancer. My point is it is unreasonable for a doctor to start doing biopsies just because cancer could spread somewhere. Colorectal cancer patients don't routinely have biopsies of their liver/lung (and again how would you know WHERE in these organs to biopsy??) just because those two organs are the most commonly known organs for colorectal cancer to spread to.

There is absolutely nothing wrong with seeking a second opinion at any time for a patient undergoing colorectal (or any ) cancer. However, if your mother doesn't want to seek out another doctor, you can't really do anything about it. You can't or shouldn't force or coerce her into doing something she doesn't want to....and that includes the big risky surgery that you recommended. I'll be honest....removing a patient's colon, bladder and all of her female organs IS a big surgery and will require a lot of change for your mom. There was at least one member on this board who had the surgery and said that not only was the surgery brutal but the recovery and the emotional changes were extremely difficult. Please understand that without a bladder, your mother would have to have a urinary catheter and without a colon, particularly with that extensive of a surgery, she would be left with a colostomy. I'm NOT saying that a patient can't live with both of those BUT.....that would be your mom's choice and only she can make that determination. In addition, the removal of all the organs and other organs and some of the muscles can be very difficult. Everything in the pelvic region has a place/purpose and when everything is removed, that area simply isn't just blank and everything else is just fine.

Your family has a lot to think about and your mom needs to know what exactly is going on, the chances that chemo will/will not (I have no idea) shrink this enough to do the surgery....she needs to know what the surgery will entail from a surgical standpoint and from the recovery/post recovery phase. She needs to talk to an oncologist, a surgeon who specializes in this type of surgery and honestly, she needs to talk with a counselor.....all right from the get go. You, her family, needs to be well aware as well what all of this entails and needs to help her make this decision, but make no mistake.....whatever your mom decides to do is HER decision and ultimately, no matter what she decides, her family needs to support her.

Your mom (and you) have a hard road ahead of you and I wish you the best of luck. Personally I would get a second opinion....if for no other reason that for peace of mind. It's also possible that some other doctor may decide to add (this is just a thought) some radiation to the mix in the hopes of shrinking the tumors/masses in her pelvis. It's also possible that another center might recommend a chemo wash of the pelvis in addition to/instead of systemic chemo. Then again, those ideas may not be feasible in your mom's case but the only way you will know is if you get a second opinion.

Best of luck.....please let us know how your mom is doing and fill us in on her decisions.

PS....just read your second post. Understand that you WILL be dealing with many different doctors.

ONCOLOGIST.....a doctor who specializes in chemotherapy and does NOT do surgery.
SURGEON....a doctor who specializes in surgery (there are many many different types of surgeons who can specialize in different areas)
RADIATION ONCOLOGIST (not to be confused with a radiologist who reads X-rays, CT scans, etc.) a doctor who specializes in radiation treatments for patients.

No oncologist should be telling a patient what surgery to have, what surgery is possible, etc. AND no surgeon should be telling any patient whether or not he/she needs chemo or what type of chemo to have. No radiation oncologist should be telling a patient about a surgical choice or chemo either. A surgeon is the doctor who deals ONLY with the surgery. The oncologist is the doctor who deals with the chemotherapy and a radiation oncologist is the doctor that takes care of the patient's radiation treatments.
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

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby MissMolly » Sun Jun 03, 2018 4:26 pm

The clinical name of the big, big, big surgery mentioned by the gynecological surgeon is likely what is called a pelvic exteneration.

It includes resection of most/all of the pelvic organs - a complete hysterectomy and resection of the bladder, rectum, and anus and the creation of two stomas (urostomy and sigmoid colostomy). On the United Ostomy Association of America support forum (uoaa.org), there are 2 members who have undergone this surgery.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

SteveNZ
Posts: 147
Joined: Tue Apr 24, 2018 4:21 pm
Location: New Zealnd

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby SteveNZ » Sun Jun 03, 2018 5:27 pm

Ymperdiem wrote:Hello,

I'd like to share my mom's colon cancer story and I am seeking advice and help at this helpless/depressed/shocking situation.
..............Thank you so much in advance!!!
Hi, I cannot give any advice but know that I care and feel for you. You are in my prayers.
Aged 56 - I feel really young...
Colo-Rectal Cancer T2 N1 M0
March 2018 - Diagnosis
April-May 2018 Radiation+Chemo then a TIA (Minor Stroke). - Stopped Chemo.
August 27th-November 2018 - Surgery and long, long recovery
*Decided to live to 100 as I will get a telegram from Her Majesty the Queen when 100yrs old. I so, so want one.
Am a Salvation Army chap so I complete 'knee drill' (prayer) to the Commander in Chief often. For myself personally this helps me through.

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 5:39 pm

SteveNZ wrote:
Ymperdiem wrote:Hello,

I'd like to share my mom's colon cancer story and I am seeking advice and help at this helpless/depressed/shocking situation.
..............Thank you so much in advance!!!
Hi, I cannot give any advice but know that I care and feel for you. You are in my prayers.


Thank you so much for your prayer!!! Thank you!!

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 5:39 pm

dauofcamom wrote:I don’t have anything to offer other than my sincerest hope that you find the best care and treatment for your mom. My heart goes out to you.



Thank you!!!

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 5:40 pm

MissMolly wrote:The clinical name of the big, big, big surgery mentioned by the gynecological surgeon is likely what is called a pelvic exteneration.

It includes resection of most/all of the pelvic organs - a complete hysterectomy and resection of the bladder, rectum, and anus and the creation of two stomas (urostomy and sigmoid colostomy). On the United Ostomy Association of America support forum (uoaa.org), there are 2 members who have undergone this surgery.
Karen



Yes! it was pelvic exteneration. Thanks for info.

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Sun Jun 03, 2018 5:48 pm

weisssoccermom wrote:Welcome to our forum. I truly am sorry for the reasons you have to be here but welcome nevertheless.
On to some of your questions. First of all, the surgery which I believe you are referring to is called a PELVIC EXENTERATION. Does that sound like the name the doctor stated? You need to understand that most commonly, colorectal cancer DOES spread to the lung/liver but that doesn't mean that it can't or doesn't spread to other places. I've been a member of this board for over 11 years and yes, there have been many females who have had their cancer spread to their ovaries, vaginal area, bladder and their uterus. Let's be honest.....cancer can and does metastasize anywhere.

As for the initial confusion regarding the staging of the cancer, a doctor may think ....even based on a CT, PET or MRI that a particular case 'appears' to be a stage I/II but until that biopsy report comes in and gives the doctors a definitive answer, it's impossible to tell, based solely on a colonoscopy, blood results and/or imaging results what stage a patient is. Just as you believed, it is the pathology report from surgery....the report that states the number of nodes affected...along with the other studies, that gives a firm staging. Based solely on what you said about that....everything was done or said prior to surgery was speculation only.

You state that your mom never had a PET/CT between her original one 4+ years ago and the one done at the beginning of 2018. However, did she have a CT scan alone (without the PET)? Did she have an MRI instead of a CT? Did she just have a PET scan? Not all doctors order a CT/PET.....some order just a CT (and only add the PET IF something shows up on the CT) while others opt for the PET and still others opt for the MRI. As long as she was having SOME form of imaging, her doctor was following the correct protocol for your mother. Usually, in the first 5 years, there is a 'standard of care' for the ordering of imaging studies and a normal CEA, liver and/or kidney test has nothing to do with that decision.

I'd like to make sure you understand (based on what you wrote) that NO surgeon should be determining/ordering the chemotherapy....that is the specialty of the oncologist. So your mom's GYN surgeon was completely correct in stating that he can't/shouldn't be recommending or ordering any type of chemotherapy. Furthermore, the ONLY way that they can know definitively that this cancer in your mom's pelvic region is a met from her colon cancer is from the pathology report. If the surgeon stated that this was a colon cancer recurrence without having any news from pathology (and they can get those results during surgery) then that is just wrong. However, let's assume that pathology has confirmed that yes, indeed, this is a recurrence.

You asked why a doctor wouldn't do a biopsy on the ovary IF they knew that the cancer COULD spread there. Well, honestly, as stated earlier, the cancer can and does spread any and everywhere. Following your line of thinking, should a surgeon do a biopsy on every organ in a person's body? It is just not feasible. No doctor is going to biopsy an ovary, a fallopian tube or the uterus just because. In addition, simply doing a biopsy of (for example) an ovary just because the cancer 'could' metastisize there is infeasible. Where exactly would the surgeon biopsy? Let's assume microscopic cancer cells had been in one very small area of the ovary and the surgeon biopsied a few millimeters away and the biopsy results came back normal. Where exactly, without some very concrete reason would a surgeon biopsy? My friend had rectal cancer that ended up metastasizing to her nose....her NOSE for crying out loud....a super UNCOMMON place for any cancer to spread much less rectal cancer. My point is it is unreasonable for a doctor to start doing biopsies just because cancer could spread somewhere. Colorectal cancer patients don't routinely have biopsies of their liver/lung (and again how would you know WHERE in these organs to biopsy??) just because those two organs are the most commonly known organs for colorectal cancer to spread to.

There is absolutely nothing wrong with seeking a second opinion at any time for a patient undergoing colorectal (or any ) cancer. However, if your mother doesn't want to seek out another doctor, you can't really do anything about it. You can't or shouldn't force or coerce her into doing something she doesn't want to....and that includes the big risky surgery that you recommended. I'll be honest....removing a patient's colon, bladder and all of her female organs IS a big surgery and will require a lot of change for your mom. There was at least one member on this board who had the surgery and said that not only was the surgery brutal but the recovery and the emotional changes were extremely difficult. Please understand that without a bladder, your mother would have to have a urinary catheter and without a colon, particularly with that extensive of a surgery, she would be left with a colostomy. I'm NOT saying that a patient can't live with both of those BUT.....that would be your mom's choice and only she can make that determination. In addition, the removal of all the organs and other organs and some of the muscles can be very difficult. Everything in the pelvic region has a place/purpose and when everything is removed, that area simply isn't just blank and everything else is just fine.

Your family has a lot to think about and your mom needs to know what exactly is going on, the chances that chemo will/will not (I have no idea) shrink this enough to do the surgery....she needs to know what the surgery will entail from a surgical standpoint and from the recovery/post recovery phase. She needs to talk to an oncologist, a surgeon who specializes in this type of surgery and honestly, she needs to talk with a counselor.....all right from the get go. You, her family, needs to be well aware as well what all of this entails and needs to help her make this decision, but make no mistake.....whatever your mom decides to do is HER decision and ultimately, no matter what she decides, her family needs to support her.

Your mom (and you) have a hard road ahead of you and I wish you the best of luck. Personally I would get a second opinion....if for no other reason that for peace of mind. It's also possible that some other doctor may decide to add (this is just a thought) some radiation to the mix in the hopes of shrinking the tumors/masses in her pelvis. It's also possible that another center might recommend a chemo wash of the pelvis in addition to/instead of systemic chemo. Then again, those ideas may not be feasible in your mom's case but the only way you will know is if you get a second opinion.

Best of luck.....please let us know how your mom is doing and fill us in on her decisions.

PS....just read your second post. Understand that you WILL be dealing with many different doctors.

ONCOLOGIST.....a doctor who specializes in chemotherapy and does NOT do surgery.
SURGEON....a doctor who specializes in surgery (there are many many different types of surgeons who can specialize in different areas)
RADIATION ONCOLOGIST (not to be confused with a radiologist who reads X-rays, CT scans, etc.) a doctor who specializes in radiation treatments for patients.

No oncologist should be telling a patient what surgery to have, what surgery is possible, etc. AND no surgeon should be telling any patient whether or not he/she needs chemo or what type of chemo to have. No radiation oncologist should be telling a patient about a surgical choice or chemo either. A surgeon is the doctor who deals ONLY with the surgery. The oncologist is the doctor who deals with the chemotherapy and a radiation oncologist is the doctor that takes care of the patient's radiation treatments.



Thank you so much for you comments! some of your answers are what I knew after questioned on the past what had happened...which I know it's not a major priority concern for us at this time. I think it was natural process for everyone thinking back what had happened, what would've done differently, etc.

yes, as you mentioned the surgery doctor mention was pelvic exteneration.

btw, my mom did not have any CT scan ordered by her chemo doctor during last 4.5 years. also pointless to say this, but what if she had CT scan done in pelvic area at least once, or last year, they could've found out uterus enlarged, mass 8cm glowing in ovary?
Since GYN oncologist (surgeon) couldn't do D&C, I dont' really know what's the reason for enlarged uterus, and ovary mass which contain 8cm mass....according to PET SCAN result. However, per surgeon's comment, inside of colon (through her colonoscopy done every year), inside ovary, inside bladder, all the insides are OK! just outside, cancer cells have spreaded out. I don't really have good background on this disease, but at least inside of organs OK sounded like a little hope, but spreaded widely is not a good sign. I think cancer cell can grow more and penetrate those organs later...if she doesn't have chemo therapy, or chemo does shrink effectively.... but at this point, inside OK comforts us a little bit. And Surgeon mentioned that after chemo shrink cancers, if possible to separate organs, we can have another surgery. honestly, no background if shrinked cancers, less cancers can separate organs from this stage (this current situation surgeon described was "organs frozen, all together by cancer cells like a porridge). Thank you anyways!!! I've learned from your points, it made me clear. Of course, everything is on my mom;s decision which she's trying to be ready to get second opinions and start chemo ASAP....unsure of pelvic exteneration yet, which is not a priority at this time. Thank you!!!

weisssoccermom
Posts: 5974
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby weisssoccermom » Sun Jun 03, 2018 6:52 pm

I'm only guessing here, but even if the chemo shrinks the tumors, they are still likely going to take all of them out. When cancer is found, for example, on the outside of the colon, they remove that section of the colon. You are correct that cancer will almost certainly spread to the interior and/or more of the exterior. It's highly unlikely that a surgeon would even consider trying to 'scrape' the outside of the uterus, ovaries, etc. Why would they? Their first thought would be that your mom could easily live without these organs (same for the bladder) and the second thought (perhaps the first....regardless irrelevant) would be that they just wouldn't take the chance that the tumor cells had remained solely on the surface of the organ. You need to understand that even the PET/CT can't definitely tell you that there aren't some microscopic cancer cells that have gone further into the ovary (as an example). When colorectal cancer starts in the inside of the colon/rectum, it will eventually grow into the colon/rectal wall. It may, at first spread internally, but the cancerous mass will grown inward and oftentimes it can't be detected until a biopsy is done or more likely until the ovary (example) is completely removed and looked at by the pathologist. What the CT/PET might show and what the pathologist will see can be entirely different stories.

To answer your question....it is probable that a CT would have picked up something growing in your mom's pelvic region BUT...I have known members who have had 6 month CT exams ....told that everything was fine and 6 months later they have large masses. So honestly, there is no definitive way to know. Besides, your mom didn't have a CT (I would though, ask the onc why he never ordered a CT, CT/PET or MRI in the 4.5 years that your mom was his patient.) and there's no going back now.

You mom's uterus could be enlarged because of fibroids or something else. My guess would be that even if chemo obliterated all the cancer cells, a surgeon would HIGHLY recommend a pelvic exenteration considering the extent of spread that you had mentioned. The fact that your mom had the standard chemo and the cancer came back indicates that either the cancerous cells were in the pelvis all along, just went dormant and weren't killed by the chemo or that some cells were lurking microscopically in her somewhere else and also weren't killed by the chemo. I would hope that your onc would get a CT/PET, MRI or CT or your mom's ENTIRE body.....chest, abdomen and pelvis (obviously this area has been covered) if not already done. Do you know what part(s) of the body were scanned during the most recent CT?
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

Ymperdiem
Posts: 7
Joined: Sat Jun 02, 2018 11:11 pm

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby Ymperdiem » Mon Jun 04, 2018 10:22 am

weisssoccermom wrote:I'm only guessing here, but even if the chemo shrinks the tumors, they are still likely going to take all of them out. When cancer is found, for example, on the outside of the colon, they remove that section of the colon. You are correct that cancer will almost certainly spread to the interior and/or more of the exterior. It's highly unlikely that a surgeon would even consider trying to 'scrape' the outside of the uterus, ovaries, etc. Why would they? Their first thought would be that your mom could easily live without these organs (same for the bladder) and the second thought (perhaps the first....regardless irrelevant) would be that they just wouldn't take the chance that the tumor cells had remained solely on the surface of the organ. You need to understand that even the PET/CT can't definitely tell you that there aren't some microscopic cancer cells that have gone further into the ovary (as an example). When colorectal cancer starts in the inside of the colon/rectum, it will eventually grow into the colon/rectal wall. It may, at first spread internally, but the cancerous mass will grown inward and oftentimes it can't be detected until a biopsy is done or more likely until the ovary (example) is completely removed and looked at by the pathologist. What the CT/PET might show and what the pathologist will see can be entirely different stories.

To answer your question....it is probable that a CT would have picked up something growing in your mom's pelvic region BUT...I have known members who have had 6 month CT exams ....told that everything was fine and 6 months later they have large masses. So honestly, there is no definitive way to know. Besides, your mom didn't have a CT (I would though, ask the onc why he never ordered a CT, CT/PET or MRI in the 4.5 years that your mom was his patient.) and there's no going back now.

You mom's uterus could be enlarged because of fibroids or something else. My guess would be that even if chemo obliterated all the cancer cells, a surgeon would HIGHLY recommend a pelvic exenteration considering the extent of spread that you had mentioned. The fact that your mom had the standard chemo and the cancer came back indicates that either the cancerous cells were in the pelvis all along, just went dormant and weren't killed by the chemo or that some cells were lurking microscopically in her somewhere else and also weren't killed by the chemo. I would hope that your onc would get a CT/PET, MRI or CT or your mom's ENTIRE body.....chest, abdomen and pelvis (obviously this area has been covered) if not already done. Do you know what part(s) of the body were scanned during the most recent CT?


Hello, my mom only had pet scan. It showed that lung lover all fine. Except pelvic mass and ovary mass. NO CT WAS DONE AT ALL UPTO THIS POINT.

weisssoccermom
Posts: 5974
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby weisssoccermom » Mon Jun 04, 2018 10:26 am

A CT isn't necessary if a PET, MRI or CT/PET was done. Some docs prefer a CT....some prefer a PET. Each test has its own benefits and it's own very different costs. My onc only did a CT UNLESS it showed something and then he would have ordered a PET. He personally wasn't a fan of the MRI. Other docs prefer the PET over the CT and still some prefer the CT/PET. As long as your mom had one of the tests....that is considered appropriate. The PET will show metabolic activity....something a CT will not.
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

User avatar
dianetavegia
Posts: 2724
Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia

Re: Stage 3 Sigmoid colon cancer metastasized to ovary, bladder, intestines, pelvic mass, unable to do surgery!!!

Postby dianetavegia » Thu Jun 07, 2018 9:04 am

The usual follow up for Stage III is CT or other imagining and CEA every 6 months for up to 5 years. I think not scanning was a huge mistake on your doctor's part. The massive spread could have been prevented if he/ she had done scans on a regular basis.

I'm so sorry to hear of your mother's spread. Wishing her some answers soon!
Stage III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

11 years since dx and 7 3/4 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 2 guests