newly diagnosed stage 2a @ 38

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erins
Posts: 43
Joined: Sun May 27, 2018 12:41 pm

newly diagnosed stage 2a @ 38

Postby erins » Sun May 27, 2018 1:08 pm

Hi all
this has been a roller coaster of a month for me--my mom passed away mid-April and I had a colonoscopy on May 4th after a month of bloody stools where they found a mass in my sygmoid colon. The got me in for a CT the same afternoon and saw no evidence of spread. I have no family history of colon cancer, so this was a complete surprise.

Fast forward to this week and I had robotic laparoscopic resection of my Sygmoid colon on Monday. I've been home since Wednesday, and am doing very well recovery-wise.

Pathology found A T3 tumor, no involvement of the lymph nodes (0/17), and no mets. I had negative margins in all orientations, and my tumor was low grade (G1). It is MSS from the colonoscopy biospy results. So I guess I'm T3N0M0 G1 MSS .

I meet with my oncologist next week.
I did have some questions--I know stage 2a is a bit of a grey-zone for follow-up chemo--and I wanted to know what kinds of questions to ask. I also wanted to know if anyone has dealt with fertility treatments while facing colon cancer.

Thanks.
38 yr old female
Rectal bleeding for 1 month—>
5/4/18 colonoscopy found mass in sigmoid colon
5/21/18 LAR
stage 2a, 0/17 lymph, clean margins
T3N0M0 G1
LVI neg, PNI neg, MSS
9/21/18 CEA 0.8
11/16/18 CEA 0.8 & CT clear
12/7/18 iron infusion
2/1/18 iron improved, CEA stable.

SurvivorsSpouse
Posts: 88
Joined: Sun Nov 22, 2015 12:38 pm

Re: newly diagnosed stage 2a @ 38

Postby SurvivorsSpouse » Sun May 27, 2018 2:27 pm

My wife was diagnosed 2A after pathology 5 1/2 years ago with no high-risk factors. Our oncologist discussed a chemo option with us but said he recommended against it because at stage 2A with no high risk factors there was a very small percentage improvement vs the potential for liver damage. Additionally, he wanted to keep all chemo options open if we needed it. At the end, he said the choice was ours and he had no objections to electing chemo. He had many patients elect the chemo option but had also had many go without and go on to live normal lifespans. He had also seen patients in both categories come back with recurrences.

There is no universal right choice in stage 2A, it is an individual one based on the factors that are important to you.

My wife was seen every 3 months for 3 years and went to 6 months for years 4 and 5 and is now on yearly visits. So far NED and our Onc is very comfortable with her progress.

The only blip is that my wife’s CEA hovers around 2.4- 2.6, but our Onc is unconcerned. Scans have been clean and it goes up and down. His comment was that CEA wouldn’t go down by any amount if there was a recurrence to worry about.

We are getting our treatment at a highly rated major cancer center, so we trust that this is the state of the art medical protocol.

Good luck.
Last edited by SurvivorsSpouse on Sun May 27, 2018 7:33 pm, edited 3 times in total.

SurvivorsSpouse
Posts: 88
Joined: Sun Nov 22, 2015 12:38 pm

Re: newly diagnosed stage 2a @ 38

Postby SurvivorsSpouse » Sun May 27, 2018 2:27 pm

Double post...sorry

erins
Posts: 43
Joined: Sun May 27, 2018 12:41 pm

Re: newly diagnosed stage 2a @ 38

Postby erins » Sun May 27, 2018 4:22 pm

SurvivorsSpouse wrote:My wife was diagnosed 2A after pathology 5 1/2 years ago with no high-risk factors. Our oncologist discussed a chemo option with us but said he recommended against it because at stage 2A with no high risk factors there was a very small percentage improvement vs the potential for liver damage. Additionally, he wanted to keep all chemo options open if we needed it. At the end, he said the choice was ours and he had no objections to electinng chemo, he had many patients elect the chemo option but had also had many go without and go on to live normal lifespans. He had also seen patients in both categories come back with recurrences.

There is no universal right choice in stage 2A, it is an individual one based on the factors that are important to you.

My wife was seen every 3 months for 3 years and went to 6 months for years 4 and 5 and is now on yearly visits. So far NED and our one is very comfortable with her progress.

The only blip is that my wife’s CEA hovers around 2.4- 2.6, but our Onc is unconcerned. Scans have been clean and it goes up and down. His comment was that CEA wouldn’t go down by any amount if there was a recurrence to worry about.

We are getting our treatment at a highly rated major cancer center, so we trust that this is the state of the art medical protocol.

Good luck.


Thanks! This is really helpful—glad you & your wife are doing well!
38 yr old female
Rectal bleeding for 1 month—>
5/4/18 colonoscopy found mass in sigmoid colon
5/21/18 LAR
stage 2a, 0/17 lymph, clean margins
T3N0M0 G1
LVI neg, PNI neg, MSS
9/21/18 CEA 0.8
11/16/18 CEA 0.8 & CT clear
12/7/18 iron infusion
2/1/18 iron improved, CEA stable.

Beckster
Posts: 386
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: newly diagnosed stage 2a @ 38

Postby Beckster » Sun May 27, 2018 6:14 pm

Welcome!

I am a Stage 2A, but because I had a Grade 3 and LVI, my oncologist suggested chemo, but it was up to me. The high risks for Stage 2 are: T4, perforation, obstruction, LVI, PNI, and less than 12 lymph nodes examed. If you do not have any of these in your pathology report, you are considered low risk for recurrence. You can ask your oncologist to take the OncotypeDX test, which will test the tumor for other genetic risk factors. Your oncologist will be able to guide you. However, like me, it is up to you. Even with the 2 risk factors, which were subjective, I decided to do chemo for 6 months.

Good Luck
Beckster
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 (path) G2 (pre-op)
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic reaction to oxaliplatin on first infusion
1/2/17 to 6/9/17- Xeloda monotherapy
6/17,12/17,6/18,12/18 6/19 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
Clear Colonoscopy 10/17 :D

Teddybear
Posts: 37
Joined: Sun Feb 11, 2018 3:23 pm

Re: newly diagnosed stage 2a @ 38

Postby Teddybear » Sun May 27, 2018 7:17 pm

Hi Erins.
I am another 2A. Sorry about the passing of your mom. You can read from my signature we are close except I was G2. You are smart to think about your questions before your visit. With 2A they will not tell you what you should do. I consulted 3 oncologist and took the oncogene dx test before making a decision. The test is for stage2 cancer and it will tell your recurrence rate and if Xeloda or oxi will work for your tumor based on genes found in your tumor. FYI - Not all doctors feel this rest is worth the money or makes any difference. For me it came down to wanting to do everything to destroy any cell that could have escaped. I chose Xeloda for 6 months. I have started my third cycle and find it doable. I do have side effects but I am managing.
1. I would ask your doctor what they believe your recurrence rate is.
2 . If you do or don’t take chemo does it change your treatment opitions or outcome if you have a recurrence?
3. How does this effect your fertility?
4. What is the risk for you taking chemo? There is a risk/reward with treatment and with your profile the risk may be greater than recurrence. For me the oncogene dx test showed Xeloda would cut my risk in half based on my genes. But again, some doctors don’t use this test and may not agree.


Good luck next week and message me if you want to talk.
DX CC Feb 2018
Feb 2018 Lap sigmoind resection
2A
T3N0M0/G2
0/14 nodes
Oncogene 14
Margins clear
MSS
April-June 2018 Xeloda

User avatar
muskokamike
Posts: 220
Joined: Tue Feb 25, 2014 4:38 pm

Re: newly diagnosed stage 2a @ 38

Postby muskokamike » Sun May 27, 2018 7:43 pm

For me there was no debating even with a pcr. I did the chemo. It was my choice also and I simply asked my onc what she would do if she was me. Due to the fact I was also a T3 and had one suspicious node which she doubted was cancerous (we will never know) I wanted to be treated as a stage III. I did the chemo. It was the roughest part of my year battle but I am a big 'what if" person.
What if I had a recurrence and what if I never did the mop up chemo.
If I ever get a recurrence I know I threw everything at my original cancer. Lots here have not done the mop up and have regretted it.
53M Dx rc10/31/13
and a huge WTF?....then
CT scan, BONE scan
MRI/T3N0M0 1 suspicious node
5 wks chemo/rad
LAR open TME 2/26/14
temp ileo
0/24 nodes pCR - pathological
Mop up Folfox (8) Mar/28-Jul/4
Aug/14 clear CT scan
8/27/14 reversal
Feb/15 clear scope
July/15 clear CT scan
Feb/16 clear CT scan
Feb/17 clear CT scan
Feb/18 clear scope
Feb/18 clear CT scan
Sep/19
CEA levels 1.6 dx
1.6,1.4,1.7,2.4,2.9, 2.7 2.3 2.5 2.2 2.1 2.5 2.6
2.7 Feb 19
0-4 normal

https://kicknasscancersass.blogspot.com/

DarknessEmbraced
Posts: 3327
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: newly diagnosed stage 2a @ 38

Postby DarknessEmbraced » Mon May 28, 2018 2:10 pm

I was diagnosed with stage 2a at 36 in 2014. My tumor was T3N0M0. No risk factors. The oncologist I saw advised against chemo because he said the side effects outweighed any benefit. He said my change of recurrence was 10% to 15%. I chose not to do chemo and have been in remission since surgery.
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

erins
Posts: 43
Joined: Sun May 27, 2018 12:41 pm

Re: newly diagnosed stage 2a @ 38

Postby erins » Tue May 29, 2018 4:52 pm

Thanks all, this is super helpful.
In my case I have an additional factor to consider since I have Polycystic Kidney Disease, which means preserving kidney function has to be factored into the mix.
My meeting with the oncologist is tomorrow—thanks for the perspectives and of course all the support!
38 yr old female
Rectal bleeding for 1 month—>
5/4/18 colonoscopy found mass in sigmoid colon
5/21/18 LAR
stage 2a, 0/17 lymph, clean margins
T3N0M0 G1
LVI neg, PNI neg, MSS
9/21/18 CEA 0.8
11/16/18 CEA 0.8 & CT clear
12/7/18 iron infusion
2/1/18 iron improved, CEA stable.

erins
Posts: 43
Joined: Sun May 27, 2018 12:41 pm

Re: newly diagnosed stage 2a @ 38

Postby erins » Wed Nov 14, 2018 7:50 am

6-month scan today! My 3 month bloodwork looked good, and I’ve been lucky to have almost no side effects from the surgery, so here’s hoping that luck holds.
38 yr old female
Rectal bleeding for 1 month—>
5/4/18 colonoscopy found mass in sigmoid colon
5/21/18 LAR
stage 2a, 0/17 lymph, clean margins
T3N0M0 G1
LVI neg, PNI neg, MSS
9/21/18 CEA 0.8
11/16/18 CEA 0.8 & CT clear
12/7/18 iron infusion
2/1/18 iron improved, CEA stable.

Teddybear
Posts: 37
Joined: Sun Feb 11, 2018 3:23 pm

Re: newly diagnosed stage 2a @ 38

Postby Teddybear » Wed Nov 14, 2018 4:00 pm

Hi Erin’s,
Glad you’re feeling good from the surgery. I have had no real side effects from my surgery either. I did have plenty from the xeloda! Let us know how the scan goes. I just had my check up last week and all looked good.
DX CC Feb 2018
Feb 2018 Lap sigmoind resection
2A
T3N0M0/G2
0/14 nodes
Oncogene 14
Margins clear
MSS
April-June 2018 Xeloda

Nohogirl
Posts: 114
Joined: Sun Oct 14, 2018 12:15 am

Re: newly diagnosed stage 2a @ 38

Postby Nohogirl » Wed Nov 14, 2018 10:15 pm

My husband is also stage 2A T3N0M0. Even before his surgery and pathology report, my husband's oncologist strongly recommended my husband to have a mop op chemo as it reduces the chances of reoccurrence. After surgery, he suggested 4 rounds of Folfox but if we wanted more agressive approach he can have 8 rounds instead.
The only risk factor for my husband was the grade of his cancer which was moderate to poorly differentiated adenocarcinoma. so we opted for a more aggressive chemo, 8 rounds. Hopefully this was the right decision for us.

Good luck to you
04/18 DH 49 Stage 2A T3N0M0 rectal cancer moderately differentiated.
05/18 chemorad. (Xeloda) 28 days
08/18 Surgery- 24 cm, including entire rectum out
Path -Stage II T2N0M0 moderate to poorly diff. adenocarcinoma
0 of 15 lymph nodes
No PNI
No LVI
Clear margins
10/18-02/19 8 cycles of Folfox
02/19 Pet Scan. NED
08/19 Pet Scan NED
08/19 Colonoscopy Clear

erins
Posts: 43
Joined: Sun May 27, 2018 12:41 pm

Re: newly diagnosed stage 2a @ 38

Postby erins » Mon Mar 25, 2019 4:30 pm

Sorry for not updating!
My scans came back clear, and my Bloodwork looks good as well. I did two iron infusions, which helped a bit with my anemia, but my Oncologist and I think it’s more of a feature than a bug in my case.

I also did a round of fertility preservation, which also went well.

I really came back to state how my little (ok, he’s not THAT little, he’s 34) brother got HIS colonoscopy today (I told him it was the only thing I wanted from him for my birthday).

Even tho there’s no family history, and my genetic tests came back negative for factors like Lynch, they found and removed three small polyps during his scope. They’ll test to make sure they’re just polyps, but we’re taking it as a victory and as a warning. I’m just so glad he got checked!

My one year scope will be in May, so hopefully that’ll come back clear!
38 yr old female
Rectal bleeding for 1 month—>
5/4/18 colonoscopy found mass in sigmoid colon
5/21/18 LAR
stage 2a, 0/17 lymph, clean margins
T3N0M0 G1
LVI neg, PNI neg, MSS
9/21/18 CEA 0.8
11/16/18 CEA 0.8 & CT clear
12/7/18 iron infusion
2/1/18 iron improved, CEA stable.


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