Perineural invasion

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rdavis12
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Joined: Sun Feb 25, 2024 5:30 pm
Facebook Username: Robbie Davis

Perineural invasion

Postby rdavis12 » Sun Feb 25, 2024 6:09 pm

I’m new here diagnosed initially as stage 3 N1 rectal cancer had TNt treatment at Duke and my LAR surgery on 12-5-23. Pathology came back as T3NOMO with Perineural invasion can anyone comment on this and is long term remission possible.

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CRguy
Posts: 10474
Joined: Sun Feb 10, 2008 6:00 pm

RE: Perineural invasion

Postby CRguy » Mon Feb 26, 2024 4:21 pm

Welcome to the forum. I am sure others will eventually chime in here BUTT ...
for now you may wish to browse some of the other posts from previous discussions.

Forum Search for perineural invasion posts

Best wishes to you
CRguy on the Journey
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

rdavis12
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Joined: Sun Feb 25, 2024 5:30 pm
Facebook Username: Robbie Davis

Re: Perineural invasion

Postby rdavis12 » Mon Feb 26, 2024 7:26 pm

Thanks for the response I was expecting more people to help out I’m so lost and afraid
Staged T3N1MO at diagnosis 4-23
After TME surgery pathology staged T3NOMO 0/14 nodes involved only other thing on report was Perineural Invasion Present.
6 weeks Radiation Duke
4 mos Capox
CEA-4.7 at Diagnosis
1.8 after Chemo
12-5 LAR surgery
Currently in surveillance.

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Green Tea
Posts: 461
Joined: Mon Oct 24, 2016 10:48 am

Re: Perineural invasion

Postby Green Tea » Mon Feb 26, 2024 8:53 pm

Hello rdavis 12, and welcome to the Forum.

In my opinion, there is not too much for you to worry about as long as you seriously follow the three main principles of survivorship:

Three Pillars of Survivorship

I had Perineural Invasion in my pathology report 12 years ago, but I never had a recurrence. However, I was extremely serious about following the main principles of survivorship, especially for the first two years after finishing all of my treatments.

If you are being followed up by the team at Duke, I think you are in good hands.

Has your team prepared a Survivorship Plan for you? If not, you should ask them to do that.


https://www.dukehealth.org/duke-cancer-institute

https://www.dukehealth.org/treatments/cancer/colon-cancer

rdavis12
Posts: 6
Joined: Sun Feb 25, 2024 5:30 pm
Facebook Username: Robbie Davis

Re: Perineural invasion

Postby rdavis12 » Tue Feb 27, 2024 12:24 am

Could u point me toward a good diet to use
Staged T3N1MO at diagnosis 4-23
After TME surgery pathology staged T3NOMO 0/14 nodes involved only other thing on report was Perineural Invasion Present.
6 weeks Radiation Duke
4 mos Capox
CEA-4.7 at Diagnosis
1.8 after Chemo
12-5 LAR surgery
Currently in surveillance.

Pagola44
Posts: 340
Joined: Mon Jul 03, 2023 7:57 pm

Re: Perineural invasion

Postby Pagola44 » Tue Feb 27, 2024 1:30 am

rdavis12 wrote:Could u point me toward a good diet to use


Hi, welcome to the forum

I'm not an expert but from my research it seems a plant based diet and/or Mediterranean diet is best,
Focus on eating well (vegetables , fruits (berries),
Eating tree nuts ,
Fatty fish e.g. salmon
Eating beans/legumes
Health fats such as olive oil

generally avoiding, high sugar, sweets, sugary drinks, alcahol and red meat etc.
29m Male.
DX: CC, Right Hepatic Flexure, 4cm, T3, G2, M0
Stage III3B , Positive lymph nodes: (2/20)
Baseline CEA value: 1.98
LVI and PNI: absent
Surgical margins: clear
No lynch Syndrome or MSI
Primary surgery type: Laparascopic

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Green Tea
Posts: 461
Joined: Mon Oct 24, 2016 10:48 am

Re: Perineural invasion

Postby Green Tea » Tue Feb 27, 2024 5:23 am

rdavis12 wrote:Could u point me toward a good diet to use

If you want an expert opinion, I would suggest looking for a CSO dietitian in your area. CSO stands for "Board Certified Specialist in Oncology Nutrition".

There are several CSO dietitians in your area. You could ask your doctor for a referral, and see if your insurance will cover the cost.

Some possibilities:

Raleigh

Durham

rdavis12
Posts: 6
Joined: Sun Feb 25, 2024 5:30 pm
Facebook Username: Robbie Davis

Re: Perineural invasion

Postby rdavis12 » Tue Feb 27, 2024 7:48 am

I went to Duke but I live in Southwest Virginia so my options are slim unfortunately.
Staged T3N1MO at diagnosis 4-23
After TME surgery pathology staged T3NOMO 0/14 nodes involved only other thing on report was Perineural Invasion Present.
6 weeks Radiation Duke
4 mos Capox
CEA-4.7 at Diagnosis
1.8 after Chemo
12-5 LAR surgery
Currently in surveillance.

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Green Tea
Posts: 461
Joined: Mon Oct 24, 2016 10:48 am

Re: Perineural invasion

Postby Green Tea » Wed Feb 28, 2024 3:03 am

rdavis12 wrote:I went to Duke but I live in Southwest Virginia so my options are slim unfortunately.

I see that you must live in a remote area away from a large cancer hospital. In that case, I think you could start off with something conservative like the Mediterranean diet that Pagola44 suggests:

Pagola44's diet:
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=66943&p=517406#p517406

Then when you have time you can look at the dietary advice on some major cancer center websites, for example, MSKCC's website:

Diet Plans for People with Cancer
https://www.mskcc.org/experience/patient-support/nutrition-cancer/diet-plans-cancer

I think that eventually you can come up with a good diet that's well-balanced for protein, fats, and carbohydrates, and focuses on fresh food items rather than on junk food and on highly processed items that contain lots of dangerous additives.

Whenever you come up with a proposed diet be sure to check with your doctor first to make sure that the diet will be good for your particular case.

I_will_fight
Posts: 148
Joined: Mon Jun 29, 2020 3:38 pm

Re: Perineural invasion

Postby I_will_fight » Fri Mar 01, 2024 8:53 am

Hi there.

PNI means that cancer cells have been found growing inside or along your nerves, this is a potential route for cancer cells to invade other parts of the body, but please mark the word "potential".... it might happen, but most likely it wont.

Perineural invasion (PNI) is a risk factor, similar to lymphovascular invasion (LVI). There are many other risk factors that you don´t have, such as the already mentioned LVI, T4, emergency presentation (obstruction or perforation), fewer than 12 lymphatic nodes collected during surgery, so looking at the good side, yes, you have one risk factor but there are many others you don't have.

Good luck!
46 yo male Spain
06/2020 - 6cm T3N0M0 CC splenic flex
3 and 4 mm lung ground glass
lymp 0/37
dMMR MSH6
KRAS mt G13D
V/LNI absent
PNI present
07/20 - hemicol surg, optimistic surgeon.
11/20 - 4 x CAPOX completed.
12/20 - Clear colonoscopy
02/21 - MRI liver lesion unchanged.
11/21 - Clear CT
02/22- Colonoscopy: Sessil polyp 3mm
05/22- Clear CT
06/22- Negative Signatera
12/22- Negative Signatera
01/23- Clear CT
07/23- Clear CT, normal markers.
09/23 - Negative Signatera
01/24 - Clear CT


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