Stage 1 with no surgery...any thoughts?

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Andrea1976
Posts: 384
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 09, 2017 7:30 am

I think stage 1 is a wide range. From cancer in the polyp where the invasion to submucosa is minimal and in the polyp not in the colon wall. To the 4 cm rectal tumor t2 cancer. You have to talk to your doctors. If I had a rectal t2 polyp I would had the surgery. In your case with the minimal cancer 2 mm I would not. But there are always risks...in life.

Trig
Posts: 9
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Thu Jun 15, 2017 1:08 pm

Thank you everyone for your insight and answers...I appreciate it!! Well I pray and hope my follow up MRI is clean! I'm a little worried though cause from what I understand they won't be doing a catscan or chest X-ray

Andi
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Joined: Thu Jun 15, 2017 9:14 pm
Facebook Username: Andrea.Dow

Re: Stage 1 with no surgery...any thoughts?

Postby Andi » Thu Jun 15, 2017 9:30 pm

I'm guess I'm confused on this one... I just had a large polyp removed that they considered Stage 1 and called precancerous. They removed 4 1/2" of my rectum since the polyp was so large. It did not invade the tissue, that was found first through an ultrasound and then after through biopsy after the resection.
I don't want to worry you, that is not why I ask since that was my first thought when they found this is, is that it would just be cut out through a colonoscopy. Perhaps it had to do with the size of your polyp and the location?

Andrea1976
Posts: 384
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Thu Jun 15, 2017 11:30 pm

Were you told the polyp was stage 1? If yes, than it was not precancerous but malignant. Polyp cancers are early cancers. Most people end up being ok. But few are not. NCCN has guidance recommendations.

Page 37 and that includes follow up testing.

https://www.nccn.org/patients/guideline ... /colon.pdf

Trig
Posts: 9
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Fri Jun 16, 2017 7:26 am

As far as I know mine was considered stage 1...but the more I read the more I'm confused!! Mine is more in the rectum,..and from what I understand early budding. Does this make it stage 2? Both oncologists said no to chemo and radiation. And said there was a 10% chance of anything returning and after my first clean follow up the percentage drops. It they also said that if I have the surgery the cancer can still spread anyway!! So frustrating!! I'm so worried

Andrea1976
Posts: 384
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 9:14 am

How old are you? I was only 39 when my polyp was removed. You can't really do much at this point - just hope for the best. My 1st follow up colonoscopy was clear and no new polyp. Please ask your doc what type of polyp you had. Also read the NCCN guidelines / it will help you understand your situation.

Andi
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Joined: Thu Jun 15, 2017 9:14 pm
Facebook Username: Andrea.Dow

Re: Stage 1 with no surgery...any thoughts?

Postby Andi » Fri Jun 16, 2017 9:24 am

I'm 48, 47 was it was found in November. I had my resection surgery in January. The only follow up I am required to do is a colonoscopy in January 2018.

Thank you for the information Andrea.
I'm going to take a look at my biopsy sheet when I get home from work this afternoon.

Trig
Posts: 9
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Fri Jun 16, 2017 9:56 am

I am 44...and it was a mushroom type

Andrea1976
Posts: 384
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 10:06 am

Good - that's better than sessil. Based on the size of the cancer. You also only had level 1 haggit - cancer was limited to the head of the polyp. I had my pathology checked in 3 different hospitals and wasn't given budding report. I wonder if it wasn't there since they didn't report it. One report is from cancer center. I am also not having regular CT scans only had MRIs. All we can do is hope for the best. I was lucky because of this my Melanoma stage 0 was diagnosed on a mole that I had 12 years. I am not worried about my Melanoma. But glad it was diagnosed at non invasive stage and removed. Now I have to be monitored for both. My kids are 13 and 15. I am enjoying every day. Heading on cruise with them soon. Interesting part in all this that I have found out truth about a lot of people. I have been very private in all this. And only 2 close friends knew about this. I can say that neither of them stepped in. I didn't need much. Just to "talk". Well, big life lesson...

plastikos
Posts: 351
Joined: Wed Jan 14, 2015 6:09 am

Re: Stage 1 with no surgery...any thoughts?

Postby plastikos » Fri Jun 16, 2017 11:24 am

Like what others have said. A very tough and personal decision. I can only say what I would do. I would get surgery since it would in theory nip the cancer in the butt. For good. Keep in mind this is from the perspective of someone who was stage 4 and has had multiple recurrences and surgeries. So 1 surgery for a chance to be cancer free for a lifetime is a walk in the park.
St. IV Colon CA @ 37, male, Kras wild, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab started 12/2016 -> pseudoprogression(?) -> biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab again
Sept 2017 - SIRT - > NED
2019 NED

Andrea1976
Posts: 384
Joined: Sun Jan 03, 2016 10:32 am

Re: Stage 1 with no surgery...any thoughts?

Postby Andrea1976 » Fri Jun 16, 2017 12:22 pm

The problem is that there is no way to be 100% cured even with the surgery. Cancer could had already spread. In fact if you research this forum the people here who progressed to stage 4 from pedunculated t1 polyp had the surgery and clear lymph nodes. The cancer spread by blood.

If there are no risk factors than surgery is not indicated in the case of low risk pedunculated polyp. My cancer center simply refused to operate. I had a hard time with it. Surgical gastro oncologist sat with me during his off hours and basically said that that's what he would had done for his mom or sister. I had to put my life in his hands and hope for the best... it is a colorectal cancer dep in a cancer center.

mike1965
Posts: 118
Joined: Mon Jan 25, 2016 11:07 pm

Re: Stage 1 with no surgery...any thoughts?

Postby mike1965 » Tue Jun 27, 2017 1:36 am

It is a tough decision. I had a small polyp but it was flat. My surgeon recommend a wait and see. He would do scan every 3 months and check my labs every month. However the cancer board and other surgeon recommend surgery. I was very confused. I waited 6 months and he did the scans and labs every thing looked good. But I was not comfortable with this approach. I went with another surgeon and had LAR surgery. They found that the cancer had traveled to my fat cells near my lymph nodes so I went from stage 1 to Stage 3a very quickly. I am so glad I listened to the other experts. I then did 6 months of Chemo but I am glad that I had surgery. Personally I needed to know if there was more cancer or not. I could not live with the unknown. In my case all the experts wanted surgery except for my original surgeon. I am glad I listen to them. Each of us has to make a hard decision and be comfortable with that decision. I wish you luck and pray all goes well.
Colonoscopy 09/06/15 Doctor removed polyp
DX - Rectal cancer 09/10/2015 T1M0N0
Surgeon recommended wait and see approach 09/2015
Tumor board recommended LARs Surgery 10/2015
Oncologist and PCP recommended LARs Surgery 11/2015
Seeking 2nd opinion from another Surgeon 01/2016
Having Sigmoidscopy on 02/01/16.
Figured out treatment 02/2016
LARS Surgery 03/2016
Stage 3A T1 N1C M0
Chemo Folfox to begin 04/18/16

Trig
Posts: 9
Joined: Tue Jun 06, 2017 2:17 pm

Re: Stage 1 with no surgery...any thoughts?

Postby Trig » Thu Jan 11, 2018 7:39 pm

Hi everyone......it has been 9 months since being diagnosed....I have had 2 MRI and 3 Cat scans...they all have come back clean...so I am a little bit of a control freak and I went to pick up the clinical reports from the hospital. Well this was on my report " a very nonspecific lymph node finding in the posterior mesorectum" So needless to say I am freaking out right now!! Why wasn't I told this?? We have chosen a close surveillance treatment....that I worry about every day!! I don't even know what that means!! It's bad enough I had to go to 2 doctors for opinions as this one left the decision of surgery completely up to me!! And my other one said if it was him or his mother etc etc he wouldn't do surgery!! I am completely terrified I have made the wrong decision, and my husband and 16 year old daughter will end up paying the price of my decision!! Any help would be appreciated :cry:

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: Stage 1 with no surgery...any thoughts?

Postby Rikimaroo » Thu Jan 11, 2018 11:16 pm

Relax, breath. Even though this is something to be concerned, highlighted lymph nodes can mean many things. Inflammation is one of them. Did you do a CEA test? If its good indicator for you then and its low, you are fine.

I on the other hand should of done surgery, look at my history. I am way worse. I made a bad decision, but I am still curable and so are many with Stage 4. It's a rough road, chemo sucks, butt just take a breath and relax.
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

mike1965
Posts: 118
Joined: Mon Jan 25, 2016 11:07 pm

Re: Stage 1 with no surgery...any thoughts?

Postby mike1965 » Sat Feb 03, 2018 8:51 pm

I know how you feel with the wait and see approach. It is very hard mentally. I did it for six months and got scans. The scans were clear. But I had one doctor say you do not need surgery and I had one doctor say I needed surgery. I talked to people on this board and read other posts and I concluded I had to do everything in my power to get rid of the cancer. I needed that piece of mind. I am thankful I did because I went from Stage 1 to Stage 3A if I would have continued the wait and see it could have gone to my lymph nodes and to my other organs. Personally I could not handle the wait and see it did not seem like a plan to me. They could not tell if the cancer was in my lymph nodes. I feel lost and anxious. I have a wife and kids and I could not live with no knowing each day. I needed a plan. What if I made wrong decision by waiting how would I feel. Each person is different. I pray all goes well,
Colonoscopy 09/06/15 Doctor removed polyp
DX - Rectal cancer 09/10/2015 T1M0N0
Surgeon recommended wait and see approach 09/2015
Tumor board recommended LARs Surgery 10/2015
Oncologist and PCP recommended LARs Surgery 11/2015
Seeking 2nd opinion from another Surgeon 01/2016
Having Sigmoidscopy on 02/01/16.
Figured out treatment 02/2016
LARS Surgery 03/2016
Stage 3A T1 N1C M0
Chemo Folfox to begin 04/18/16


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