Internal Iliac Node involvement??

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Punky44
Posts: 81
Joined: Mon Oct 01, 2018 4:29 pm

Re: Internal Iliac Node involvement??

Postby Punky44 » Tue Oct 16, 2018 10:10 am

Thank you Beth—yes, I am in the process of finding a surgeon who will remove the distant node at the time of surgery (since my mom has RC, surgery is the last step for us instead of the first.)
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—1 down, 7 to go!

Rikimaroo
Posts: 151
Joined: Tue Dec 20, 2016 8:48 pm

Re: Internal Iliac Node involvement??

Postby Rikimaroo » Mon Oct 22, 2018 9:43 am

From what I understand and at the time, i went to Cleveland Clinic they never said I was stage four. This is what my MRI results showed:

LYMPH NODES
Mesorectal lymph nodes and tumor deposits:
* Suspicious mesorectal lymph nodes/tumor deposits: N+: Short axis 5-9
mm and round shape / irregular contour / heterogeneous signal intensity
* Location of most suspicious node: 3:00, immediately below the level of
the tumor;

Extra-mesorectal lymph nodes:
* Suspicious extra-mesorectal lymph nodes: Yes , left internal iliac
node measuring 1.2 cm in short axis with increased peripheral
irregularity (7:16). Additional ill-defined left internal iliac lymph
node located immediately superior to this (7:20).
* IMA node station: No suspicious adenopathy.

THIS IS AFTER 3 MONTHS OF FOLFOX (CHEMO)
LYMPH NODES
Mesorectal lymph nodes and tumor deposits:
* Suspicious mesorectal lymph nodes/tumor deposits: N0
* Regression of mesorectal adenopathy.

Extra-mesorectal lymph nodes:
* Suspicious extra-mesorectal lymph nodes: No
* Fibrosis of previously identified left internal iliac lymph notes.
* IMA node station: No suspicious lymph nodes.

At each of these points I was classified Stage 3. Once it went to my liver is when I was classified Stage 4. Nodes are a way of transferring cancer to other organs and also the bloodstream so I am not sure if it is stage 4 just because some nodes lit up.

I hope this helps. Let me know if you have any other questions.
Diagnosed at 38 y/o male, 3 kids 7,9,14 - Now 39.
RC T3N1M0
Chemo Rad, CCR - W&W 5/2017
Local Recurrence, discuss options 11/26/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
Port Scheduled for 12/15/2017, folfox/oxapalatin + avastin starts on the 12/20/2017
Blood Clot in Neck 1/16/2018, stop avastin, continue FolFox
TME/Liver Resect 4/3/2018
Biopsy Results 0/8 Lymph nodes clear, margins not clear, CEA now .8,
Chemo Finish 8/15/2018
Reversal October 17th 2018

hawkowl
Posts: 116
Joined: Sun Dec 14, 2014 5:29 am
Location: MN/FL

Re: Internal Iliac Node involvement??

Postby hawkowl » Fri Oct 26, 2018 2:59 pm

Just saw your post...
My oncologist preferred not to commit to stage 3 or 4 (I had several enlarged iliac nodes), and instead preferred to stage me as T3N2MX (I also had some presacral changes that were not biopsied)

As you know, i underwent 8 cycles of FOLFOX followed by 28 days of chemoradiation plus targeted radiation to extraregional nodes. I had a complete clinical response and was given the option of watch and wait (but this was not a good fit for my personality, so I elected to proceed with surgery)

I did end opting for an APR, which was done robotically, and convinced my surgeon that it was worth pursuing robotic iliac node dissection as well. Post up plan was to continue with maintenance xeloda plus Celebrex (basically the ADAPT protocol) but I had persistently low platelets, and since I had a complete pathological response (and a strong family history of myelodysplastic syndrome) we decided to drop the xeloda and continue with Celebrex alone. That was 3 years ago, and scans and CEA have been stable.

My life has been complicated by other complications of chemo, radiation, and my underlying autoimmune disease, but I would choose the same treatment course again with no hesitation. Neuropathy and dysautonomia are no fun, but it could be a lot worse. Please let me know if you have any other questions about my treatment...I am not on this forum much, but I do check in from time to time
Dx 12/2014 T3N2MX (iliac nodes) low rectal
12/2014-4/2015: FOLFOX (8 cycles)
4/2015-6/2015: 28 cycles of chemoradiation with xeloda
8/2015: Robotic APR with iliac node dissection; path showed ypT0,ypN0 (complete pathological response).
11/2015 scans clear, CEA 2.1
11/2015 parastomal hernia repair
3/2016 CEA 1.7
10/2017 CEA remains in normal range (1.4), scans stable.
6/2018 CEA still normal.

Totally disabled due to oxaliplatin induced neuropathy and dysautonomia

Punky44
Posts: 81
Joined: Mon Oct 01, 2018 4:29 pm

Re: Internal Iliac Node involvement??

Postby Punky44 » Fri Oct 26, 2018 4:34 pm

Thank you again hawkowl. I have shared your story with my mom.
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—1 down, 7 to go!


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