Need help with lab report

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Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Need help with lab report

Postby Eleda » Thu Jan 17, 2019 7:02 am

My report from my oncologist to my GP
Originally was T3N2MO ( 6LYMPHS AFFECTED)

Clinical stage prior to surgery was T3N1NO (after NACR) 1 lymph still left affected....

Pathology now YpT2 N1A M0( after SURGERY)
can someone explain this to me please???
Thanks ADELE
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

Punky44
Posts: 453
Joined: Mon Oct 01, 2018 4:29 pm

Re: Need help with lab report

Postby Punky44 » Thu Jan 17, 2019 12:40 pm

I could be wrong here so someone feel free to correct me if I am but from my understanding, the pathological staging refers to the staging of what they found when they did surgery—so it sounds like they went in there and removed the tumor that at this point was a T2 (shrunken from a T3 after your radiation) and they removed between 1-3 cancerous nodes (N1) and likely several others that were non cancerous but probably used to be back when you were N2.
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
Latest update: 6/20–Clear CT; 9/22—CEA 2.4

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

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: Need help with lab report

Postby Eleda » Thu Jan 17, 2019 1:00 pm

Thanks punky,
but would you know what the abbreviation or YP is???
I don't see the point of restaging but maybe I'm uneducated in this area, and there may be a likely reason
I'm assuming bthe accurate report is the original one at DX?????
And it was originally moderately differencated at biopsy,,,,
Then poorly
And now moderately again at pathology???
More confusing???
As if it's not difficult enough to study lol
Thanks Adele
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

SurvivorsSpouse
Posts: 88
Joined: Sun Nov 22, 2015 12:38 pm

Re: Need help with lab report

Postby SurvivorsSpouse » Thu Jan 17, 2019 2:45 pm

The "y" designator means after chemoradiation

the p means "pathological," in other words, a direct look at the specimen.

So, you would look at it like this:

Upon initial clinical evaluation (i.e. scans, ultrasound etc) your tumor was staged T3N2MO

You underwent chemoradiation prior to surgery, which adds the "y."

If they scanned you prior to surgery, then you would see something like ycTxNXMX with the "c" meaning "clinical."

After surgery, the specimen was sent to Pathology to be directly examined, which adds the "p."

So, after treatment and surgery, you were staged as ypT2N1AMO.

So, either chemoradiation downstaged your tumor depth, or it was over staged on clinical evaluation.

Hope this helps.

Punky44
Posts: 453
Joined: Mon Oct 01, 2018 4:29 pm

Re: Need help with lab report

Postby Punky44 » Thu Jan 17, 2019 3:03 pm

What SurvivorSpouse said! :)
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
Latest update: 6/20–Clear CT; 9/22—CEA 2.4

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

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: Need help with lab report

Postby Eleda » Thu Jan 17, 2019 3:27 pm

Thanks lads, that explains it perfect
Adele X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

User avatar
LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Need help with lab report

Postby LPL » Thu Jan 17, 2019 3:38 pm

Eleda wrote:
it was originally moderately differencated at biopsy,,,, Then poorly - And now moderately again at pathology??? More confusing???

When hubby was diagnosed, I was ‘praying’ for some good signs/test results. (I have stopped praving now.. it’s not me.. and it doesn’t work for me)
Anyway, after hoping/praying without success(!) for ‘benign tumor’.. then please not stage IV.. then please not Kras mutant... then please MSI..
Then suddenly I saw that the Grade had changed! It had changed from G3 at biopsi to G1 at pathology (after resection). I thought Yes!! :-) finally something that sounds good that I can mention/ask about at the Onc appointment with DH. (I did not want ask about stuff I knew was ‘not good’). DH’s Onc replied: “that does not matter since he is stage IV”. Sigh :-( Yes I understand that now.. but didn’t at the time.
As I understand it you have no metastasis so this might make a difference to you? Please ask your doctor.
Yes all this is confusing and maybe hard to answer ‘for sure’.
I wish you all the best!
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

macpudd
Posts: 120
Joined: Tue Jul 21, 2015 7:00 pm

Re: Need help with lab report

Postby macpudd » Fri Jan 18, 2019 6:29 pm

Hi Eleda, hopefully you reports are way more positive than orignally thought. Its good to see you are getting hepl from poeple who have good knowledge. Keep it lit celtic friend !
Dx 10/13/2014 right hemicolectomy 10/15/2014 pT4b N0 M0
Folfox x12 from Dec 2014 to July 2015
01/16/18 tonic seizure hospital admission
01/17/18 ct and mri 2cm tumor on left side of brain
commenced anti epileptic and steroids and
insulin.
01/25/18 brain craniotomy 80% of tumour removed pathology says gbm4
6 weeks of rad and Temodar chemo and then 6 monthly cycles of Temodar
MRI in Oct no tumor
Mri Jan 2019 tumour growth Feb Pet scan tumour 6cm, no surgery, starting Avastin also Lomustine

User avatar
O Stoma Mia
Posts: 1602
Joined: Sat Jun 22, 2013 6:29 am

Re: Need help with lab report

Postby O Stoma Mia » Sat Jan 19, 2019 4:59 am

Yes, what SurvivorsSpouse said is correct, but I have a couple of points to add:

Technically speaking, your staging after surgery can be represented in any of three ways, either:

1: ypT2 N1A cMO

or

2: ypT2 N1A MX

or, simply

3: ypT2 N1A

The point at issue is the "M" component of the TNM scaling. When a pathologist receives the specimen from a colorectal resection, he/she receives the resected primary tumor and the block of nearby lymph nodes, which will allow him/her to assess the "T" and "N" components of the TNM scale. He/she does not usually receive any tissue specimen that would allow the "M" component to be assessed. Thus, the pathologist has three options for reporting the findings. In Option 3, the M component is simply ignored because the pathologist has no information on it. In Option 2, the designation "MX" is used, which signifies "Metastasis cannot be measured". In Option 1, the lower-case "c" prefix is used to indicate that there is indeed information in the patient's file about the "M" component, but it comes from an independent, clinical, source (e.g., CT scan report).

One thing you could do is to ask your doctor about the "M0" in your current staging. Where did it come from? From a CT scan? If so, how old was the CT scan, and when are they planning to do a new, up-to-date one?

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: Need help with lab report

Postby Eleda » Mon Jan 21, 2019 5:35 am

Thanks OSM, The MO was on the paragraph with the original DX, it's a short report sent to my GP so not much detail I. It, I can't upload a pic otherwise u could read it urself!!


DIAGNOSIS
1 Yp2 N1a rectal carcinoma

BACKROUND HOSTORY
1 low rectal cancer, clinically staged T3N1 at least treated with long course radiation fini9th Feb 2018.
2 surgery with laparoscopic low anterior resection and cooanal anastomosis preformed may 10th2018. Pathology consistent with yT2N1. 1/20 lymph nodes positive for moderately differencated andeocarcinoma RO resection. Mandrad regression grade 4 or cancer greater than fibrosis.
3 CT Scan April negative
4 MRI SCAN June no new dieease, no breach of anastomosis
5 MMR Intact
6 Adjuvant FOLFOX treatment
7 CT TAP OCT 15 NORMAL

THIS IS THE REPORT WORD FOR WORD,,,
THANKS ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: Need help with lab report

Postby Eleda » Mon Jan 21, 2019 6:04 am

MC Pudd,
I would be lost without the people on this page, because mostly people don't have the knowledge on any of this and I crave information so if I don't know
I can't sleep till I do, so I will be forever grateful for the support Vive been given here!!!

Great to see Ur still active, how r u doing ATM??? Hope as well as can be my Celtic friend :D

ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

macpudd
Posts: 120
Joined: Tue Jul 21, 2015 7:00 pm

Re: Need help with lab report

Postby macpudd » Mon Jan 21, 2019 6:42 pm

Good to hear from you Eleda, I've been up and down this last while, hard tl stay positive, some teeth broke broke and some loose also one side of face twitching. Short time memroy poor. Still walkin 5 or 6 times a week and was very bold saturday drank bottle of wine because i am a :oops: . Its great to hear from you, hope you are good, and if I can tell you anything positive its that i an now 4 yrs clear of bowel cancer, it is beatable. Its just a pify i have the gbm4. Hope we talk again soon I will try to engage in the forum more often.
Dx 10/13/2014 right hemicolectomy 10/15/2014 pT4b N0 M0
Folfox x12 from Dec 2014 to July 2015
01/16/18 tonic seizure hospital admission
01/17/18 ct and mri 2cm tumor on left side of brain
commenced anti epileptic and steroids and
insulin.
01/25/18 brain craniotomy 80% of tumour removed pathology says gbm4
6 weeks of rad and Temodar chemo and then 6 monthly cycles of Temodar
MRI in Oct no tumor
Mri Jan 2019 tumour growth Feb Pet scan tumour 6cm, no surgery, starting Avastin also Lomustine


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