The Colon Club

Well, my path report was uploaded to my chart, and after reviewing it, it appears I’ve been upstaged from stage 2A to stage 3C. Even more concerning the tumor was identified as “Adenocarcinoma with Signet Cell Features”. I know signet cell is not good news. Any words of advice? I see my surgeon Thursday. Any questions I should ask?

Hello,

Sorry to hear about your upstaging. Don't panic and don't feel discouraged. I have seen many signet cell cancer survivors in this group.

Have you had any chemo and radiation before your surgery? With rectal cancer, neo adjuvant chemo radiation is normally the protocol.

I assume you did, since there was a big gap between your diagnoses and surgery.

Also what were the characteristics of your tumor on the pathology report from your biopsies before surgery? If the description is completely different, i would consider having another pathologist, perhaps another pathogy company examine the removed tumor. Also any suspicious lymph nodes noted on the CT scan report that they didn't pay attention to?

This whole thing sounds a little awkward to me. Mistakes happen all the time, even in medical field. Yours might be one of them. Hopefully.

Good luck

Hi, thanks for your reply! I realize I need to make time to make a signature. I did do 28 days of radiation and Xeloda. The path report from my colonoscopy indicates the tumor had signet ring features, but I think everyone wanted to wait to confirm this during surgery (especially since my understanding is that it doesn’t change the course of treatment). I had a PET, MRI, and CT without contrast (for radiation planning), and they all indicated no adenopathy and no metastasis to other organs. So the positive nodes were definitely a surprise. Does anyone know what the functional difference is between SRCC and A w/SRF?

It is not uncommon to be up staged. This group is awesome and will be a ton of support.

In addition to all this, I’ve had a low grade fever the past two days and generally feel like crap (had surgery on 10/17). I contacted my surgeon, and he wants to stick with the Thursday appointment. I wasn’t able to speak with anything directly but his nurse left a message just as the office was closing (so frustrating), saying that the surgeon has “new orders” for me. My fear is that he suspects stage IV based on the path report. Ugh, I’m just generally freaking out. I appreciate you all listening.

Hi ,
I really don’t think that is the case . Trust me all my mum’s mets were identified through scans . If you were dealing with a rheumatologist you would have not made that leap . It’s just really hard because it’s cancer . Fear is never far from the surface but things are still looking good for you . I doubt they would provide information that way .
Stay strong ,
Stu

I am sorry to read of your upstage, but one thing I have noticed here is that with a higher staging will come with a more aggressive treatment plan and a better post treatment surveillance plan to seek out any reoccurrence.

This may sound scary to you, but it should reassure you that you are dealing with your cancer diagnosis with the best treatments and the most active surveillance program to keep up your future good health. Lower staged patients are sometimes not scanned as much and many do more worrying than knowing that things are on track and going well. Never be afraid of knowledge.

It is better to know, plan, and execute your treatment plan and have planned scans to ensure all is going well in the years to come.

Best wishes,
WS

Sorry, one more question. . . I felt really good the first five or so days after surgery, but since then I’ve been feeling progressively worse-low grade fever, aches, chills, fatigue. I was pretty active and fit before surgery, and rarely got sick. It could be I’m just not used to feeling this way, but it’s definitely not helping my mental state. Have others experienced this? I see my doctor tomorrow, but so far he seems to minimize everything.

Do you think you could have an infection of some sort? You shouldn't be feeling sick a week out so maybe something else is going on. I had a catheter in for a few weeks after one of my surgeries which causes a UTI which gave me the same symptoms.

Your doctor shouldn’t minimize this. I was always told after surgery to watch for the very symptoms you describe. It could be an infection.

I'm so very sorry that you were upstaged following surgery!*hugs* I would tell your doctor the symptoms you are having. Good luck and hope you feel better soon!*hugs*

Hi Jlschueler,

How are you feeling? Just checking on you. Did your fever go away? Hoping you are doing and feeling better.