Lee wrote:Hi and welcome, sorry for the reason you are here.
Yes signet cell can be scary, butt we do have a few survivors. Hopefully some will chime in here soon.
My best advice if you have not already done so, get a 2nd opinion at a major cancer hospital or treatment center. They tend to be on the leading edge of tomorrows standard care.
And make sure a colon rectal surgeon does her surgery vs a general surgeon. You want that extra bit a training.
All the best to your mom,
Lee
Punky44 wrote:I’m sorry you are here. I have seen signet cell discussed here before so make sure to browse the search and try to connect with someone here who may be more of an expert on the topic.
I will keep you and your mom in my prayers. Believe me, I know the feeling of “cant lose” someone you love so much.
friendship wrote:...
Any kind of input is really appreciated...
O Stoma Mia wrote:friendship wrote:...
Any kind of input is really appreciated...
Welcome to the Forum.
It would be good if you could provide more information about your mother's situation so that others here can determine whether or not they have anything pertinent to say.
There are indeed some folks here who can provide input in the SRC area, for example,
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=60493&p=479339#p479339
however, we need more information from you before making any suggestions.
For example, where is the tumor located? how large is the tumor? what grade or level of differentiation is the tumor? How did they get a tissue sample from the tumor? during a colonoscopy? is there a colonoscopy report? what did it say? are there scan reports? what kind? CT? MRI? ultrasound? X-ray? what did the scan reports say? are there any tumor-marker blood test results, e.g., CEA.? if so, what is the pre-chemo/radiation level of CEA? what kind of hospital is doing the chemo/radiation? what are the qualifications and experience of your oncologist? when will you decide on who the surgeon will be? etc.
At this point in time you are a Newly Registered User with limited Forum privileges. You need to post more messages before you can be promoted to regular status with more privileges. One way to do that is to post some messages that provide the missing information.
Colon and rectum
ICD10: C18-C20
A usually aggressive, poorly differentiated invasive adenocarcinoma characterized by the presence of malignant glandular cells in which the nucleus is pressed to one side by the presence of intracytoplasmic mucus.
Signet ring cell carcinoma of the colon and rectum
This variant of adenocarcinoma is defined by the presence of > 50% of tumour cells with prominent intracytoplasmic mucin, typically with displacement and moulding of the nucleus. Signet-ring cells can occur within the pools of mucinous adenocarcinoma or in a diffusely infiltrative process with minimal extracellular mucin in a linitis-plastica pattern. Large signet-ring cells can be termed "globoid cells". Some signet ring cell carcinomas are MSI-H and are low-grade, but those that lack MSI-H are usually highly aggressive 6 .
Carcinomas with signet-ring cell areas of < 50% are categorized as Adenocarcinoma with a signet-ring cell component. ◄◄ Note
Reference: https://codes.iarc.fr/code/2981
Caregiver to Mom/ F, xx years old
DX: Rectal Cancer (RC) ,
Tumor Location: 4 cm from AV
Tumor type: Adenocarcinoma with signet ring-cell features.
Tumor size: approx 6 cm
Tumor grade: G3: Poorly differentiated (high grade)
TNM code: TxN1aM0 (tentative staging)
Stage: Stage IIIA (tentative)
Positive lymph nodes: Tentatively: 1 (one) - (inferred by CT, and PET/CT, not by biopsy)
Mets: None observed on CT or PET/CT
Baseline CEA value: 1.4 ng/ml
Lymphovascular invasion (LVI) - absent
Perineural invasion (PNI) - present
Surgical margins: N/A (margins cannot be determined until after primary surgery)
MSI status (if known) – Important!! Adjuvant therapy cannot be determined without this finding.
Primary surgery type: Most probably ULAR, Either laparascopic or open resection (To be decided later)
Ostomy surgery: Ileostomy most likely. Decision at time of primary surgery
Radiation therapy: Chemo/radiation – 6 weeks
Adjuvant Chemotherapy: e.g., XELOX, CAPEOX, FOLFOX, etc., to be determined later
O Stoma Mia wrote:Here is a draft of your signature, showing the data known to date. Some items are missing and need to be specified later, when known.
Eventually you should create a proper signature in your profile so that other members here can see your mother's situation at a glance.Caregiver to Mom/ F, xx years old
DX: Rectal Cancer (RC) ,
Tumor Location: 4 cm from AV
Tumor type: Adenocarcinoma with signet ring-cell features.
Tumor size: approx 6 cm
Tumor grade: G3: Poorly differentiated (high grade)
TNM code: TxN1aM0 (tentative staging)
Stage: Stage IIIA (tentative)
Positive lymph nodes: Tentatively: 1 (one) - (inferred by CT, and PET/CT, not by biopsy)
Mets: None observed on CT or PET/CT
Baseline CEA value: 1.4 ng/ml
Lymphovascular invasion (LVI) - absent
Perineural invasion (PNI) - present
Surgical margins: N/A (margins cannot be determined until after primary surgery)
MSI status (if known) – Important!! Adjuvant therapy cannot be determined without this finding.
Primary surgery type: Most probably ULAR, Either laparascopic or open resection (To be decided later)
Ostomy surgery: Ileostomy most likely. Decision at time of primary surgery
Radiation therapy: Chemo/radiation – 6 weeks
Adjuvant Chemotherapy: e.g., XELOX, CAPEOX, FOLFOX, etc., to be determined later
friendship wrote:... Our oncologist is getting her started on chemo radiation for 6 weeks starting next week.
Any kind of input is really appreciated.
O Stoma Mia wrote:friendship wrote:... Our oncologist is getting her started on chemo radiation for 6 weeks starting next week.
Any kind of input is really appreciated.
For chemo radiation, it is important to follow the instructions closely. There are two areas that I think should be mentioned especially..
- Hydration - It is very important to keep hydrated by drinking water in order to keep the body's electrolytes in balance. If not, kidney stones or bladder stones can quickly develop and require the suspension of treatment until these problems are solved. Also, you can use sports drinks like Gatorade as a supplement just to make sure that the body is replenishing its electrolytes.
- Medications/chemo - Usually the chemo component is given in pill form to be taken twice daily 30 minutes after meals. If this is how they will be delivering the chemo, then it is very important to keep to the schedule and not forget to eat twice a day and take the pills at the right time. You can buy pill boxes with 14 compartments (7 days x a.m./p.m.) to organize the meds and make sure that none of the pill-taking sessions are skipped.
friendship wrote:... I have a question about the wait time between the chemo radiation and surgery. Our oncologist said that the chemo radiation would be for 6 weeks and then a 6 week break, then surgery. I am so worried - what if the cancer spreads in those 6 weeks of break. She is starting chemo radiation on Monday. This wait seems so long, how do we just wait and do nothing for 6 weeks?
-friendship
... Surgical treatment of the tumors was performed 4 to 8 weeks after completion of the chemoradiation. Surgical procedures included abdominoperineal resection, low anterior resection, transanal excision, and exploratory laparotomy. Since 1996, abdominoperineal resection and low anterior resection have been performed using sharp dissection according to the principles of total mesorectal excision. Pathologic response on postoperative staging was standardized such that the deepest bowel layer with microscopically viable tumor cells determined the T stage...
Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421320/
...She is also told to be stage 3. Does staging happen before surgery?
O Stoma Mia wrote:
Question: Can you find out what kind of radiation machine they will be using for the chemo/radiation? Does this machine have the IMRT / IGRT capability?
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=48936&p=372445#p372445
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