T4b, N1-N2, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or into areas of fat near the lymph nodes (N1 or N2). It has not spread to distant sites.
Any T, Any N, M1a: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to 1 distant organ (such as the liver or lung) or set of lymph nodes (M1a).
SkiFletch wrote:Well, not having performed the operation, none of us can answer this for certain. Technically you would fall into one of two staging categories from the AJCC scale, Stage IIIC or IVA. For IIIC:T4b, N1-N2, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or into areas of fat near the lymph nodes (N1 or N2). It has not spread to distant sites.
And for IVA:Any T, Any N, M1a: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to 1 distant organ (such as the liver or lung) or set of lymph nodes (M1a).
weisssoccermom wrote:Buckwirth,
Sorry but that's not necessarily true. For example, a T4 tumor in a woman with rectal cancer can be attached to the vagina - not the same organ as the primary, but....depending on the doc, is NOT necessarily considered a stage IV. In her situation, with the tumor being quite extensive in her pelvis, it's easy to see how the staging came about. Just another FYI to the original poster. Distant mets don't have to be confined to an organ. If, for example, you had positive lymph nodes in your chest but nothing in your lung/liver, that would also qualify as a stage IV.
I think the original poster is quite correct. In her situation, the staging isn't as important as getting the treatments and honestly, whether this is a stage IIIC or a stage IV is irrelevant at this point....as the treatments will be the same either way.
Good luck to you.
Jaynee
Gaelen wrote: It's not up to "the doctor" and s/he has no discretion in staging if s/he's working according to the AJCC guidelines.
And yeah - accurate evaluation of your staging makes a difference. For one thing, it determines which drugs you're eligible for as first and second line treatments, and what kind of medical follow-ups your insurance company will authorize.
sandrichelle wrote:Well, like I said before, really doesn't make a difference at this point..in my minds eye, the surgery removed all of the tumor and the fact that they did not find anything in my liver / lungs is only a good thing. I also like the fact that it was one single tumor..not more and that my doc saw clear margins on removal. Now time for the cleanup chemo.
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