I'm writing about my mom, who was diagnosed with colon cancer last week, nearly six months after her saga began. I'll try to keep this short-ish, but here's her story: In late March, she started dealing with bothersome constipation and stomach cramps. After a week or two, it was so bad that she was doubled over and moaning in pain. We originally thought she was dealing with IBS or even appendicitis, but she started having bladder symptoms such as pain and burning when she urinated. She kept saying she felt like something was pulling in her groin area. She saw her PCP, who prescribed an antibiotic for a UTI, and oddly enough, her intense stomach cramps cleared up nearly overnight after taking the medication.
Nevertheless, she went back to having IBS-type symptoms, and in menopausal women, symptoms like that can signify ovarian cancer, so she saw her gynecologist, who felt a cyst/mass when he did a pelvic exam. He ordered an ultrasound, which showed an echogenic mass with internal vascularity near her bladder. We still thought we might be dealing with ovarian cancer, so the doctor ordered an MRI in late May. The scan showed a complicated cystic mass with a fluid-fluid level right near where her right ovary would be, so she was then referred to a gynecologist oncologist. The oncologist scheduled surgery to remove the presumptive mass in mid-July, and in the meantime, she was seen by a urologist to deal with the bladder issues and to rule out bladder cancer. It was around this time that she had a CT scan and an apple core lesion was seen in her cecum. Of course, a colonoscopy was scheduled, and a large mass was found in her cecum near the ileocecal valve. The GI doc who did the procedure said the mass looked strange and not like colon cancer usually looks, so she made sure to take a lot of biopsy samples. We were relieved when the samples -- even deeper level samples -- came back as tubular adenoma.
Thankfully, June and July weren't too bad for her pain wise, but things were a bit rough again in August and September. The intense pain came back, as did the bladder symptoms. We strongly suspected she had a fistula because she'd have constant bacterial UTIs, along with air coming out when she urinated and bladder pain/pressure. Her cystoscopies showed irritation on the right side of her bladder. She even did the poppy seed test, and she passed poppy seeds in her urine, thus confirming the fistula.
Anyway, to wrap things up, because of the size of the mass (> 5 cm) and because her gynecological surgery showed her ovary was stuck to her colon, she was referred to a colorectal surgeon, who recommended a right hemicolectomy. So after doctor visits in the double digits, an ultrasound, an MRI, a CT scan, cystoscopies, a colonoscopy, gynecological surgery, and several red herrings, she finally had her surgery last week. Unfortunately, the surgeon confirmed colon cancer, as she had a T4 tumor that was adhering both to her ovary and to her abdominal wall. Apparently, it was the size of a baseball and had perforated her bowel. It also had been pressing on her bladder. She'll need to have chemo even if her cancer is only stage II due to her high risk tumor.
Needless to say, she's had some bad luck, with one rarity after the other: She grew a pretty large T4 tumor three years after a colonoscopy (granted, presumably benign sessile polyps were removed from the same area during that 2018 colonoscopy); she presented with a fistula; and she had a false negative biopsy. I keep wondering what other piece of bad news we'll receive. I'm a wreck waiting for her pathology results, and I keep worrying that she'll have a rare type of colon cancer with a horrible prognosis, like a neuroendocrine carcinoma or a signet ring carcinoma. Yet another rarity to add to our collection of bad news!
I apologize for the length of this post, and I hope y'all don't mind if I ask a few questions:
1. If you've had colon cancer between colonoscopies, what size was your mass? Did you have an especially aggressive tumor? I'm really curious to hear your story.
2. Does a large T4 tumor three years after a colonoscopy mean her cancer will be more likely to be high grade/poorly differentiated?
3. How quickly do aggressive tumors metastasize to other organs? She had her CT scan in late June, and her liver was fine then. Her lymph nodes looked okay, too, but you can't always tell.
4. I know we've got quite the journey ahead of us, so what's your advice for us, if you don't mind my asking? This is all so new and overwhelming.
If you've read this far, thank you so much. I've been lurking this forum for a month or so, and reading here has brought me a lot of comfort.
Caregiver to Mom (63)
-Symptoms since March 2021
-CT in June 2021 showed a mass in cecum. No mets seen then.
-Colonoscopy in July 2021 confirmed large mass. Biopsy showed tubular adenoma.
-Right hemicolectomy on 9/17/21; 5 cm x 4.5 cm tumor removed from cecum.
-Pathology came back as a poorly to moderately differentiated ulcerated adenocarcinoma.
-Current (tentative) staging: T4aN0Mx.