New Sigmoid colon cancer diagnosis

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KG60222
Posts: 7
Joined: Thu Jul 07, 2022 10:14 am
Facebook Username: Kriste.Gerhard

New Sigmoid colon cancer diagnosis

Postby KG60222 » Sun Jul 10, 2022 9:39 pm

Hello ,

So I will start by saying I am sorry overwhelmed ! So much I don’t know !!!

I was diagnosed during routine colonoscopy on June 2,2022. And then came the tests !!! One after the other . New doctors …

I met with a second opinion surgeon two weeks ago and have surgery scheduled for July 22,2022. It feels so rushed !

Ct scan showed a cyst on my spleen and ultrasound discovered polyp on my gallbladder .

I can’t get a clear answer about stage .. the surgeon made an educated guess at stage 3… she says they won’t know until after surgery. I didn’t even want surgery . Now they are talking chemo .

Where do I begin? Is this all true? ?
July 22, 2022 Colon resection - Invasive adenocarcinoma
23/43 Lymph Nodes Metastatic carcinoma detected
Lmph Vascular Invasion
pT4a -pN2b
Additional Peritoneal Nodule - Adenocarcinoma
50 year old married Female
June 2,2022 standard screening colonoscopy
3-4 cm tumor in the sigmoid
7.1 CEA
Moderately diff adenocarcinoma
Ct scan clear
Ultrasound polyp on gallbladder
MMR proficient
Eccentric mural thickening of the distal sigmoid

I_will_fight
Posts: 103
Joined: Mon Jun 29, 2020 3:38 pm

Re: New Sigmoid colon cancer diagnosis

Postby I_will_fight » Mon Jul 11, 2022 1:27 pm

Hi KG60222, sorry to read you are going through this, but at least you are in a friendly pleace where you can get information and support.

It is normal to be terrrified, but please dont be afraid of either surgery or chemo, Cancer is the enemy, surgery and chemo are there to cure you, and more often than not they will do just that.

I know it may feel rushed, but once the extent of the lesion is known there is no reason to delay surgery. Surgery is the first crucial step for colon cancer (it is a bit different for rectal cancer)

So your surgeon will take the lesion out and a lot of surronding tissue forming an "envelope", he will take the opportunity to look around and see if there is anything suspicious.

All this tissue will be sent to your pathologist who will examine it and determine the nature of the lesion. The pathologist will check which colon layers are affected and will look for cancer signs in your lymph nodes. Based on this and the imaging CT scans/Ultrasound/MRI you will be staged and a treatment will most likely follow.

If the surgery is succesful (and it normally is) and the imaging does not show any concerning spot then they will declare you cautiously NED (no evidence of disease) but depending on your stage you may be recommended chemo to kill any microscopic cells that may have been somewhere else in your body, this is referred to as Adjuvant Chemotherapy (ACT)

Chemo is not fun, but it is not the living hell that you often see in movies and it affects people in different ways and to different degrees.

If you are indeed stage 3, the standard of care recommends 6 months of CAPOX or FOLFOX.

A few things to ask your oncologist:

1- At which point they will determine whether you are MSI-High, this is one of the most important features and one that may help guiding the treatment.
2- if it is possible to use any liquid biopsy (there are a few out there and they may be more sensitive than the traditional markers)
3- by the way, they may have already taken blood samples with your CEA and CA19.9 values. These may be important to track your disease so it is good to know what the baseline is.

But for now, the single most important thing is to have a good surgeon. Your future is quite literally in his hands. I understand the standard technique nowadays for colon cancer is called CME (complete mesorectal excision) which results in higher lymph node yield (it is important that the number of lymph nodes is quite higher than 12... although this is the norm today).

I am not an expert and I am sure a lot of people with a lot more knowledge and experience will soon be here to guide you, in the meantime please post all your questions and browse through the forum, you will get a lot of information and also rad testimonies from long time survivors (which is always comforting)

Welcome to the forum,

Javi.
46 yo male Spain
06/20 - 6cm T3N0M0 CC splenic flex
No liver mets, 3 and 4 mm lung dots (unlikely to be mets)
lymp 0/37
MSH6- other MMR+
KRAS mt G13D
V/LNI absent
PNI present
07/20 - hemicol surg, 13cm clear margins, optimistic surgn.
08/20 - CAPOX regime, 4 cycles.
11/20 - CAPOX completed. CAT scan: lesion in liver, suspect hemoangioma, no changes lung dots.
12/20 - Clean colonoscopy
02/21 - MRI liver lesion is nonspecific, stable.

KG60222
Posts: 7
Joined: Thu Jul 07, 2022 10:14 am
Facebook Username: Kriste.Gerhard

Re: New Sigmoid colon cancer diagnosis

Postby KG60222 » Mon Jul 11, 2022 8:51 pm

Thank you ! That was a lot of very good information ! I see the Surgeon tomorrow for pre op I have a large list of questions .
July 22, 2022 Colon resection - Invasive adenocarcinoma
23/43 Lymph Nodes Metastatic carcinoma detected
Lmph Vascular Invasion
pT4a -pN2b
Additional Peritoneal Nodule - Adenocarcinoma
50 year old married Female
June 2,2022 standard screening colonoscopy
3-4 cm tumor in the sigmoid
7.1 CEA
Moderately diff adenocarcinoma
Ct scan clear
Ultrasound polyp on gallbladder
MMR proficient
Eccentric mural thickening of the distal sigmoid

rp1954
Posts: 1596
Joined: Mon Jun 13, 2011 1:13 am

Re: New Sigmoid colon cancer diagnosis

Postby rp1954 » Tue Jul 12, 2022 3:20 pm

We struggled with getting accurate information on several fronts during the first year, including staging.
Turned out part of our ground reality was in better blood work, especially better baseline data before and after surgery.
Self ordered tests cut through the medical/insurance foot dragging and get irreplaceable data.

Some of my prior discussion if you drill down on the links:
viewtopic.php?f=1&t=61062&p=483786#p483786

More recent members have done some liquid biopsy work with various tech that's more pricey.
Various lab work over the basic pathology can also be done on the surgical sample.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper to almost nothing mid 2018, mostly IV C

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horizon
Posts: 1654
Joined: Tue Apr 12, 2011 10:10 pm

Re: New Sigmoid colon cancer diagnosis

Postby horizon » Wed Jul 13, 2022 8:50 am

It's awful and overwhelming at the beginning and waiting for tests/appointments/surgery can feel overwhelming. You have lots of people on here that can sympathize with what you're going through because they've been there.
I'm just a dude who still can't believe he had a resection and went through chemo (currently 11 years NED). Is this real life?

User avatar
Kick'nAssCancer'sAss
Posts: 242
Joined: Tue Feb 25, 2014 4:38 pm

Re: New Sigmoid colon cancer diagnosis

Postby Kick'nAssCancer'sAss » Wed Jul 13, 2022 7:30 pm

Hi Kriste

Welcome

You are right about being overwhelmed so take a deep breath and take it one day at a time.

During my journey this forum was by far my most valuable source of info. Anything and everything you need to know about colon/rectal cancer you will find it right here on Colon Talk.

And, do yourself a favour stay away from Dr. Google.

Chin up

Mike
53M Dx RC Halloween 2013
easily the scariest day of my life
My Journey Journal
over 12,000 reads globally
https://kickingasscancersass.blogspot.com/

DarknessEmbraced
Posts: 3701
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: New Sigmoid colon cancer diagnosis

Postby DarknessEmbraced » Sat Jul 16, 2022 7:25 am

I'm sorry for your diagnosis. *hugs* It is very overwhelming especially at the beginning. There is a lot of support here.
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
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

KG60222
Posts: 7
Joined: Thu Jul 07, 2022 10:14 am
Facebook Username: Kriste.Gerhard

Re: New Sigmoid colon cancer diagnosis

Postby KG60222 » Sat Jul 16, 2022 12:26 pm

Thank you ! I am happy to see you have had Five years clear !
July 22, 2022 Colon resection - Invasive adenocarcinoma
23/43 Lymph Nodes Metastatic carcinoma detected
Lmph Vascular Invasion
pT4a -pN2b
Additional Peritoneal Nodule - Adenocarcinoma
50 year old married Female
June 2,2022 standard screening colonoscopy
3-4 cm tumor in the sigmoid
7.1 CEA
Moderately diff adenocarcinoma
Ct scan clear
Ultrasound polyp on gallbladder
MMR proficient
Eccentric mural thickening of the distal sigmoid

michelle c
Posts: 1926
Joined: Wed Dec 02, 2009 3:58 am

Re: New Sigmoid colon cancer diagnosis

Postby michelle c » Mon Jul 18, 2022 6:14 am

Hello,

A cancer diagnosis is very overwhelming!
I had surgery nine days after my diagnosis. I have to say that I was glad it happened quickly. I just wanted it out. I’m not a very patient person, and waiting longer would have heightened my anxiety. Although I was a bit anxious about surgery, it couldn’t come fast enough for me.

Thankfully, you caught it before it metastasized. You won’t know your stage until after surgery. I was stage III and adjuvant chemo was recommended. I really didn’t want chemo but had it to give myself the best chance. That was in 2009. I don’t come here very much anymore but just check in every so often to see if there is someone I can help. We are here to support you and answer any questions you might have. There is always someone who understands what you’re going through.
May 25 2009 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
Jun 3 2009 LAR - Stage III 3/10 lymph nodes
Jul 6 - Dec 10 2009 - 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 2012 port removed & hernia repair

LynnMarie
Posts: 4
Joined: Thu Feb 20, 2020 2:52 pm
Facebook Username: Lynn M Frankel
Location: Baltimore, MD

Re: New Sigmoid colon cancer diagnosis

Postby LynnMarie » Tue Jul 19, 2022 11:03 am

Hello,
Sorry about your diagnosis but it's great that you already found this site. I also recommend Colontown on Facebook. Both have helped me enormously.

It seems you and I have similar cases. My colon cancer was also found during a routine colonoscopy in 2020. I had just turned 51. It was in the sigmoid, 3-4 cm. Based on the info in your signature, it looks like they already removed the tumor/polyp since you know its moderately differentiated. Or did they just biopsy it? Mine was completely removed during the colonoscopy--poorly differentiated. I had surgery 1 month after the colonoscopy. Yours will likely be similar: remove the entire sigmoid + surrounding lymph nodes. If nothing is found in the nodes, you will be Stage II. It was found in 1 out of 18 of my lymph nodes, so I'm Stage III. For either stage, highly recommend getting a ctDNA test. It can help you make decisions about chemo. Also highly recommend getting full genetic testing on the tumor, so you know all your mutations. Treatments are getting more and more specific based on genetics, so it's very good to have all the info from the beginning.

Don't worry about chemo yet until you have all the facts. You may not have to get it, and if you do, it's not as terrible as you might think. Never be embarrassed or hesitant to ask for second opinions. Wish I had known this for my own surgery: Acupuncture can help with the pain and recovery.

Wishing you the best of luck!
Fem, 51 yo at DX CRC Stage IIIa
3 cm tumor removed from sigmoid during colonoscopy 1/10/20 (51 yo)
adenocarcinoma, poorly differentiated
colon resection 2/4/20 = 1 of 18 lymph nodes positive
port 3/1/20
Genetic testing: MSS KRAS G12V
FOLFOX 3/4 - 8/14/20 (last 5 no oxi because of allergic reaction)
CEA: 1/22: 2.5; 3/4: 2.14; 7/15: 1.4, 11/13: 4.11; 12/7: 2.81
CT Scan 8/12 NED
Now what?

Koreysue
Posts: 248
Joined: Mon Apr 30, 2018 2:36 pm

Re: New Sigmoid colon cancer diagnosis

Postby Koreysue » Sat Jul 30, 2022 2:41 am

Sorry you are here, but welcome!
It is so important to take one day at a time. It is overwhelming but you will get the hang of it.
Try to stay off google. If I had questions I would have my friend google it so she could sort through all the noise and just give me the answer I was lookin for. So much stuff on there that can get people worked up. Surgery and chemo are important!
Take care,
Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5
CEA 5/21 4.2
CEA 10/21 3.4
colonoscopy 10/2021 10mm polyp
CEA 4/22 3.7
CEA 7/22 3.8

KG60222
Posts: 7
Joined: Thu Jul 07, 2022 10:14 am
Facebook Username: Kriste.Gerhard

Re: New Sigmoid colon cancer diagnosis

Postby KG60222 » Sun Jul 31, 2022 5:01 pm

Thank you for responding to me .

July 22,2022 I had surgery and they found a second tumor . The tumor was not localized . The cancer has spread to my lymph nodes . 23 of 42 ! Stage three it is!

Seeing the dr on Friday to get more information on the next steps . Chemo it is !! Folfox is what the surgeon says it will be .
July 22, 2022 Colon resection - Invasive adenocarcinoma
23/43 Lymph Nodes Metastatic carcinoma detected
Lmph Vascular Invasion
pT4a -pN2b
Additional Peritoneal Nodule - Adenocarcinoma
50 year old married Female
June 2,2022 standard screening colonoscopy
3-4 cm tumor in the sigmoid
7.1 CEA
Moderately diff adenocarcinoma
Ct scan clear
Ultrasound polyp on gallbladder
MMR proficient
Eccentric mural thickening of the distal sigmoid

Koreysue
Posts: 248
Joined: Mon Apr 30, 2018 2:36 pm

Re: New Sigmoid colon cancer diagnosis

Postby Koreysue » Mon Aug 01, 2022 2:59 pm

KG60222 wrote:Thank you for responding to me .

July 22,2022 I had surgery and they found a second tumor . The tumor was not localized . The cancer has spread to my lymph nodes . 23 of 42 ! Stage three it is!

Seeing the dr on Friday to get more information on the next steps . Chemo it is !! Folfox is what the surgeon says it will be .



Well at least now you have a plan of attack! I have a couple tips for folfox- keep gloves by the freezer, because reaching into the cold will hurt! During treatment weeks, drink luke warm or warm beverages- not cold, and eat what sounds good to you! Keep the doc informed about any numbness in your hands and feet. Now go kill that cancer!
Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5
CEA 5/21 4.2
CEA 10/21 3.4
colonoscopy 10/2021 10mm polyp
CEA 4/22 3.7
CEA 7/22 3.8

KG60222
Posts: 7
Joined: Thu Jul 07, 2022 10:14 am
Facebook Username: Kriste.Gerhard

Re: New Sigmoid colon cancer diagnosis

Postby KG60222 » Mon Aug 01, 2022 3:23 pm

Thank you !
July 22, 2022 Colon resection - Invasive adenocarcinoma
23/43 Lymph Nodes Metastatic carcinoma detected
Lmph Vascular Invasion
pT4a -pN2b
Additional Peritoneal Nodule - Adenocarcinoma
50 year old married Female
June 2,2022 standard screening colonoscopy
3-4 cm tumor in the sigmoid
7.1 CEA
Moderately diff adenocarcinoma
Ct scan clear
Ultrasound polyp on gallbladder
MMR proficient
Eccentric mural thickening of the distal sigmoid


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