Question About Staging

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Deep
Posts: 38
Joined: Thu Nov 01, 2018 6:10 pm

Question About Staging

Postby Deep » Sun Dec 09, 2018 7:13 pm

I just had a CT scan and had it come back as spread to some lymph nodes, but no spread to other organs. I have another procedure on Wednesday of this week to take a look at the cancer in my sigmoid colon to determine how far the cancer has penetrated the layers of the colon. Can I still be stage 4 even though the cancer has yet to spread to my other organs, or am I looking at stage 3 with the spread to a few lymph nodes? Thanks.
11/29/18 Diagnosed T3N1 Rectal Cancer (Age 39, Male, no family history)
01/02/19--02/7/19--- 25 rounds radiation/chemo (Capecitabine 2000 mg)
04/15/19 Surgery, temp ileostomy (Tumor Staged T2)
7/8/19-10/15/19 Chemo (8 Rounds) Folfox
11/12/19- Scan NED

Achilles Torn
Posts: 141
Joined: Fri Dec 16, 2016 2:41 pm

Re: Question About Staging

Postby Achilles Torn » Sun Dec 09, 2018 8:29 pm

I can't answer definitively as everyone has a unique medical profile.

Generally if it has only spread to lymph nodes in proximity to the colon that is stage 3. If it has spread to any other organs or distant lymph nodes that is considered stage 4.


This can be a little tricky depending on how far the nodes are or if there is a tumor deposit in the fat outside the colon.


Not sure if that helps

AT
Diagnosed as 40 yo Male. BC Canada. Sigmoid Colectomy Dec. 2016
Pathology T3N2bM1 19 of 24 Nodes Positive + tumour deposits
PET scan - Para-Aortic and Iliac Lymph node spread. Stage VI.
Moderately differentiated. MSS. KRAS/BRAF Wild.
Mutations: TP53, ERBB4, MLL3, PDCD1LG2, PRKDC, SMAD3
FOLFOX + Bevacizumab Commenced Jan 9/2017 PET Scan July 2017 - on maintenance 5FU/Bev every 2 weeks.
Progression after Covid19 induced break June 2020. Resume Maintenance chemo of Capecitabine and Bev

Punky44
Posts: 498
Joined: Mon Oct 01, 2018 4:29 pm

Re: Question About Staging

Postby Punky44 » Mon Dec 10, 2018 2:41 am

First of all, it’s great news that your CT didn’t show any organ involvement. I am guessing your next scan is an MRI—I asked this exact questions of doctors when my mom was between scans and got this answer: it is possible for an MRI to pick up something the CT can’t, particularly in the pelvic region. BUT the most likely place for this cancer to spread is your liver and lungs and the CT usually does a great job of seeing that so the fact that it saw nothing should be a good sign.

Now in our case, after the CT suggesting we were looking at Stage 3, the MRI showed a suspicious mass not picked up by the CT and this warranted a PET scan and transvaginal ultrasound to investigate and we spent another week worrying if we were really Stage 4. Turns out it was a non cancerous enlarged ovary, aka no big deal and we were back to Stage 3. I don’t want to scare you but I have seen on this board people who have spread to certain lymph nodes in the pelvic region considered “distant” and not “regional” and these would make a person Stage 4, but I will pray for you that your MRI finds nothing of the sort.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4; 3.0; 3.4; 3.1; 3.4; 3.0; 3.1; 2.6
Latest update: 8/21/23 Clear CT with CEA 2.6!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Deep
Posts: 38
Joined: Thu Nov 01, 2018 6:10 pm

Re: Question About Staging

Postby Deep » Mon Dec 10, 2018 12:02 pm

Punky44 wrote:First of all, it’s great news that your CT didn’t show any organ involvement. I am guessing your next scan is an MRI—I asked this exact questions of doctors when my mom was between scans and got this answer: it is possible for an MRI to pick up something the CT can’t, particularly in the pelvic region. BUT the most likely place for this cancer to spread is your liver and lungs and the CT usually does a great job of seeing that so the fact that it saw nothing should be a good sign.

Now in our case, after the CT suggesting we were looking at Stage 3, the MRI showed a suspicious mass not picked up by the CT and this warranted a PET scan and transvaginal ultrasound to investigate and we spent another week worrying if we were really Stage 4. Turns out it was a non cancerous enlarged ovary, aka no big deal and we were back to Stage 3. I don’t want to scare you but I have seen on this board people who have spread to certain lymph nodes in the pelvic region considered “distant” and not “regional” and these would make a person Stage 4, but I will pray for you that your MRI finds nothing of the sort.



I do not know if they are going to schedule an MRI or not. Really, the only appointment I have right now is for a procedure sort of like a sigmoidoscopy, on Wednesday, where they will look to see how far the cancer has penetrated using some sort of ultrasound. A Doctor called me on Friday and said the Surgeon had me scheduled for a Thursday appointment, but they have yet to call me to confirm the appointment time. I am dealing with the VA healthcare system, and it is hard to tell if they are risking me going from stage III to stage IV with these long waits. I want answers now, but have to remain patient as this plays out. It has only been 11 days since they identified the mass, but I had to wait six weeks with the cancer symptoms just to get seen the first time. Has anyone else had to wait so long once the blood starts? Or, is this the norm in the medical world?
11/29/18 Diagnosed T3N1 Rectal Cancer (Age 39, Male, no family history)
01/02/19--02/7/19--- 25 rounds radiation/chemo (Capecitabine 2000 mg)
04/15/19 Surgery, temp ileostomy (Tumor Staged T2)
7/8/19-10/15/19 Chemo (8 Rounds) Folfox
11/12/19- Scan NED


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