Don't know

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sanderslaverne
Posts: 1
Joined: Mon Mar 18, 2019 1:20 pm
Facebook Username: Laverne Sanders

Don't know

Postby sanderslaverne » Mon Mar 18, 2019 1:42 pm

Can someone please tell me what do this mean. I was told I have Colon cancer on 1/20/2019 the tumor is 15 cm I will have surgery on 2/11/2019 I had it then on the 3/12/2019 read my tests this was written by the doctor. All resection margins are free from malignancy. The pathology stage ( pTNM is pT3 pNo. Nineteen pericolic lymph Nodes negative for Carcinoma 0/19. And Histology Type Adenocarcinoma Grade G2 moderate differentiated. Please tell me do I have to take Chemo or Radiation treatment.Thank you all my mind is going.

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: Don't know

Postby Lee » Mon Mar 18, 2019 10:06 pm

sanderslaverne wrote:. . . . Please tell me do I have to take Chemo or Radiation treatment.Thank you all my mind is going.


Only your doctors can tell you that. Do you have an oncologist? If yes, what is s/he saying? Because it looks like you are probably a stage II, you REALLY might want to get opinion at a major cancer hospital or treatment center. Stage II can be a grey area sometimes.

If you are asking me, I would want to do everything NOW and not look back with regrets (ie stage IV diagnoses down the road)

Good luck, sorry for the reason you are here.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: Don't know

Postby boxhill » Mon Mar 18, 2019 10:34 pm

Obviously, you need to discuss this with your doctor. Didn't anyone go over this with you before you left the hospital?

In any case, it sounds as if you are probably Stage IIa. That is an early stage, which is good.

https://www.cancer.net/cancer-types/col ... cer/stages

Some people with Stage II CRC have chemo after surgery, called adjuvant chemotherapy, and many do not. It depends on a number of factors. You should discuss this with your doctor. Here is an article that discusses the issue:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655109/

If you have been seeing a gastroenterologist, s/he might suggest that you consult with an oncologist to discuss whether or not you should do an followup treatment.

You should also get at least the basic genetic information about your tumor: is it MSS or MSI, KRAS and BRAF wild-type or mutated, If you don't know what these terms mean, google them.

Over all, your pathology report sounds very encouraging to me. Talk to you doctor, do research, and ask questions until you feel that you can calmly understand your situation. Ask a friend or family member to go with you to appointments if you need another set of ears to process information, take notes, or give you emotional support. Write down a list of questions you want to ask in advance. Don't worry about asking dumb questions: get what you need. At the same time, realize that there is always going to be some degree of uncertainty with cancer, so there may be some assurances your doctor cannot give you.

You can do this. Best of luck.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

Beckster
Posts: 438
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: Don't know

Postby Beckster » Tue Mar 19, 2019 5:08 am

Welcome!

I am a Stage IIa and did chemo for 6 months. According to what you reported, it sounds like IIa; however, you need to look at any high risk factors. This includes: preoperative CEA, obstruction, perforation, LVI,PNI, less than 12 lymph nodes, margins not clear, T4 and poorly differential tumor. Before making a decision, you might want to get a second pathology look from a major cancer center. As in the past on this forum, people who did this found out that their pathology report changed. I had a choice of whether or not to do chemo, and I decided to do everything possible to avoid a recurrence. My onc told me that because I was 57, Grade 3 and LVI...he would do the chemo as an insurance "policy."

How old are you and where was the tumor located?
57/F
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Type: Adenocarcinoma
Tumor size:3.5 cm x 2.5 x 0.7 cm
Grade: G3
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic
1/2/17 to 6/9/17- Xeloda
6/17,12/17,6/18,12/18,6/19,12/19,12/20,12/21 CT Scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8 12/17-2.8, 3/18-3.1, 6/18-3.0, 9/18 2.8, 12/18 2.5 3/19 3.1 6/19 3.1 9/19 2.6 12/19 2.8 6/20 3.0 12/20 2.7 6/21 2.9,[color=#000000]12/21 2.7[/color]
Clear Colonoscopy 10/17, 11/19,11/21 :D

User avatar
Maggie Nell
Posts: 1151
Joined: Wed May 27, 2015 1:57 am
Location: Central Highlands, Victoria, Oz

Re: Don't know

Postby Maggie Nell » Tue Mar 19, 2019 6:30 am

sanderslaverne wrote:Can someone please tell me what do this mean. I was told I have Colon cancer on 1/20/2019 the tumor is 15 cm I will have surgery on 2/11/2019 I had it then on the 3/12/2019 read my tests this was written by the doctor. All resection margins are free from malignancy. The pathology stage ( pTNM is pT3 pNo. Nineteen pericolic lymph Nodes negative for Carcinoma 0/19. And Histology Type Adenocarcinoma Grade G2 moderate differentiated. Please tell me do I have to take Chemo or Radiation treatment.Thank you all my mind is going.


Have you not been referred to an oncologist to discuss your options, a course of adjuvant chemotherapy being one of them.

The pathology report confirms that the tumour was excised with clean margins (free from malignancy) and that is the
best outcome for the first line of defence - surgical removal of the malignant neoplasm.

Perhaps you have yet to receive a letter or other notification advising you of a scheduled appointment with an oncologist and
for other post-surgery tests, such as a colonoscopy. Usually you are given the low-down before you leave hospital on when to
expect to be contacted.

Follow-up with your primary physician and get the ball rolling.
DX April 2015, @ 54
35mm poorly diff. tumour, incidental finding following emergency R. hemicolectomy
for ileo-colic intussusception.
Lymph nodes: 0/22
T3 N0 MX
Stage II CRC, no adjuvant chemo required.

DarknessEmbraced
Posts: 3816
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Don't know

Postby DarknessEmbraced » Tue Mar 19, 2019 10:17 am

I would speak to your oncologist. I was stage 2a with no high risk factors. Chemo wasn't recommended and I have been in remission since surgery in 2014. Everyone with stage 2 is different.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

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O Stoma Mia
Posts: 1709
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Stage IIA decision criteria

Postby O Stoma Mia » Wed Mar 20, 2019 2:40 am

Only your doctor can tell you whether or not you will need chemo. First, your doctor must look at all seven of the primary pathology risk factors:
According to the NCCN guidelines, high-risk features include the following:
  1. T4 primary tumors,
  2. poorly differentiated histology,
  3. presence of lymphovascular invasion (LVI),
  4. presence of perineural invasion (PNI),
  5. bowel obstruction,
  6. less than 12 lymph nodes evaluated in the pathology report, or
  7. close or indeterminate margins.

Then the doctor must look at other possible risk factors such as life-style risk factors, the existence of any major chronic illnesses you may have, and also other factors such as your age and general state of health. He/she should also look at MSI status (i.e., MSI vs.MSS) before recommending chemo.

After all of the relevant risk factors have been evaluated then the doctor may have a recommendation about whether or not to have chemotherapy.

If you have no risk factors of any kind then the doctor may recommend "No Chemo" or a very short, light-weight chemo regimen, but if you have any high risk factors at all, then a stronger regimen of chemo may be recommended: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655109/table/TB00696-1/?report=objectonly

Normally, Stage IIA patients with no risk factors at all are recommended for observation only (no chemo). This is because chemotherapy may not be very useful and may not be needed, and if it used it can be harmful and can have both short and long term side effects that affect long term Quality of Life:

The Effects of Chemotherapy on Your Body
https://www.healthline.com/health/cancer/effects-on-body#1

Late Effects of Cancer Treatment
https://www.livestrong.org/we-can-help/healthy-living-after-treatment/late-effects-of-cancer-treatment

Long-Term Side Effects of Cancer Treatment
https://www.cancer.net/survivorship/long-term-side-effects-cancer-treatment

Late and Long-Term Effects of Treatment
http://www.cancer.ca/en/cancer-information/cancer-journey/life-after-cancer/late-and-long-term-effects-of-treatment/?region=on

ooooo


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