Stupid Q of the Day: How do I know it's really cancer?

[SilverWedding]

Thank you for the help and insight you've already given. My sweet husband is strengthening so much to be ready for the 9/19 surgery next week. The surgeon will remove tumor (and lymph nodes? how do I know? idk) and says will try to do a J-pouch or D-pouch with a yet-to-be decided type of ostomy. Surgeon says he is trying to save enough muscle in the rectum to make a reversal possible. Then, you all know the deal - harsher chemo via a port one month after surgery.

QUESTION
My husband (and now I) am wondering if he really has cancer. So, since the oncology practice can't make our info portal work, I called and asked for all labwork. I've got the labwork and am oddly hoping to see some confirmation of cancer. So odd - never thought I'd say that. I don't see anything. I was looking for that CEA marker (still am going through it all but not finding) and can't find.

How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen.

Thank you for answering my stupid question,
Cynthia

[justin case]

Thank you for the help and insight you've already given. My sweet husband is strengthening so much to be ready for the 9/19 surgery next week. The surgeon will remove tumor (and lymph nodes? how do I know? idk) and says will try to do a J-pouch or D-pouch with a yet-to-be decided type of ostomy. Surgeon says he is trying to save enough muscle in the rectum to make a reversal possible. Then, you all know the deal - harsher chemo via a port one month after surgery.

QUESTION
My husband (and now I) am wondering if he really has cancer. So, since the oncology practice can't make our info portal work, I called and asked for all labwork. I've got the labwork and am oddly hoping to see some confirmation of cancer. So odd - never thought I'd say that. I don't see anything. I was looking for that CEA marker (still am going through it all but not finding) and can't find.

How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen.

Thank you for answering my stupid question,
Cynthia

Looking at your husbands history, if there is a tumor in the rectum, that close to the anal verge, it's not unlikely he needs a temp ostomy. That can be fixed , mine was much lower . I never had a CEA marker, but I did have 2 tumors, one in the sigmoid, and one in the rectum, about 3 cm away from the anal verge. . CEA is not recognized with all tumors depending on the person. My surgeon was able to save my sphincter muscles, and I have lived almost 8 years longer .

[Lee]

How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen.
Cynthia

These folks have been through medical school. They generally know cancer when they see it. When I was diagnosed, my GI doc told me during my scope procedure they had found cancer. They generally take samples to confirm, but if his doctor told him it was cancer, follow that path.

Good luck, with his upcoming surgery,

Lee

[justin case]

How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen.
Cynthia

These folks have been through medical school. They generally know cancer when they see it. When I was diagnosed, my GI doc told me during my scope procedure they had found cancer. They generally take samples to confirm, but if his doctor told him it was cancer, follow that path.

Good luck, with his upcoming surgery,

Lee

Listen to Lee !

[Jacques]

...How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen...

Have they done a post chemo/rad MRI? If so, how large does the tumor look now? How do the inflamed lymph nodes look now? Do you have a copy of the most recent MRI /scan?

If the surgeon is going to do a surgery next week, then I would expect that there would be some sort of recent pelvic scan with contrast in your husband's file.

The information on the type of cancer they found would be in the pathology section of the original colonoscopy report. Do you have a copy of the full colonoscopy report? The lab reports never say anything definitive about cancer. The definitive judgment would come from a biopsy done at the time of the colonoscopy or from a sigmoidoscopy biopsy done shortly thereafter, I think.

What makes your husband think he might not have cancer? Are there any reasons other than the CEA isue you mentioned? If he doesn't have cancer, then what does he think the mass in his rectum is?

[NHMike]

"How do I know it's really cancer?"

Someone should have taken a biopsy (surgically removed a small piece of the tumor) during a colonoscopy or other procedure and sent it to a pathology lab, either in-house or externally. A pathologist will examine the biopsy and make a determination as to whether or not it is cancerous.

In my case, I went to the ER and they took a CT scan and found a mass. That generally means cancer in this area but it was confirmed with a colonoscopy in the afternoon and a pathology report a few days later. Some pathology labs can also do a genomic analysis of the biopsy and tell you what your exact mutation(s) are. That is determining the type of cancer at the molecular level.

The biopsy sample was sent out to the Mayo Clinic for pathology as my local hospital doesn't provide this service.

The colonoscopy was done by a GI doctor and this was before an oncologist was involved. I did get the pathology report in the hospital portal but my oncologist was at another hospital. So the portal at the hospital where my oncologist wouldn't have had the pathology report.

[MeAndMine]

I know it's worrisome to wonder about tests and not know the information you need to know. I'm sure there is a report somewhere that you haven't seen. When I had my colonoscopy, the GI doctor told me it was cancer but he did send in a biopsy. I was so anxious when I got the envelope in the mail but instead of saying what it actually was, it was one piece of paper that just said "abnormal". I thought it was supposed to say the type, the size, something other than just the word "abnormal". I think at the time he wanted to give me the information face to face or something. It took so long to finally get back in to that appointment and that is when he gave me the biopsy paper that said it was a rectal adenocarcinoma.

I find that some doctors don't give you the reports. I'm glad he gave me that one but he never did give me the MRI results and I ended up getting them from the surgeon who got them from the hospital and gave me a copy.

Hopefully there is a report out there somewhere that you can get that tells you the information you need. I know it's all very hard and every day there is something that we have to figure out. I hope your husband is doing well and that he is ready for surgery next week.

[Lee]

How do I know the tumor is cancerous? Are doctors just making observations to determine cancer at this juncture? Do I call the doctor who did the colonoscopy? I'm not even sure that doctor took a specimen.
Cynthia

These folks have been through medical school. They generally know cancer when they see it. When I was diagnosed, my GI doc told me during my scope procedure they had found cancer. They generally take samples to confirm, but if his doctor told him it was cancer, follow that path.

Good luck, with his upcoming surgery,

Lee

Listen to Lee !

Waving Hi to Justin Case,

Lee