Signet Ring type, just starting out

[Toto456]

Hi, I have questions about how and when you found out information about your diagnosis and treatment plan along the way. My husband was diagnosed at a routine colonoscopy with no symptoms, pathology report includes poorly differentiated adenocarcinoma signet ring type invasive. He is scheduled for surgery to remove part of the colon in a week. We do not yet know what stage and have not received any tumor rating, etc. The oncologist we were referred to does not plan to meet with us until after he has the pathology report from the surgery. The surgeon has met with us once and says that the exact amount of the colon to be removed will depend on what he finds during surgery.

This process doesn't make sense to me, I thought the medical oncologist would be reading the reports and working with us to direct the treatment from day 1. I also assumed that with the relative rarity of the cancer type there would be discussions on how that effects treatment decisions. I know surgery is the most common treatment for colon cancer but I expected a discussion about it before being scheduled and to have some expectations set about what would be removed.

Is this similar to what you all went through when starting out with your diagnosis or did things happen in a different order for you?

Thank you!

[roarR40s]

Hi there,

I'm so sorry your husband has been diagnosed, as a caregiver I can completely understand how uncertain and terrifying this is.
My late husband had a mucinous-type that is rare like Signet Ring. When you have discussions with Oncologist, remember that EVEN with Signet Ring types, the cancer type and progression can be very individual. Noone can, hand on heart, know what one's life expectancy will be.
Did the surgeon order any staging scans? Pre-surgery they will order a CT-scan and sometimes Pet-scan to try gauge spread of disease. Although they won't know how extensive the surgery will be or if there is spread to lymph nodes, other organs /Peritoneum until they open him up. Even surgically examining tissues like lymph nodes is difficult - they need to send it off to pathology to determine it its positive etc but also for RAS mutations / microsatellite instability. That will usually sample more than one site. The pathology of the cancer will then determine staging and what treatment type and plan going forward. Also did the surgeon order any cancer blood markers? These (blood markers & scans) are very important to establish a baseline pre-surgery and then post surgery, as once chemo or other treatments starts , the window for getting this info will be missed. For blood-markers, most common is CEA, but there is also CA19.9 and CA125. Some bowel cancers are not CEA-expressing but also depending on site of cancer e.g peritoneum/surface of liver etc CA19.9 and CA125 may be additionally useful.
My late husband only met with Oncologist after Surgery, as there were too many variables beforehand.
Good luck with your husband's surgery, I hope all goes well. Hopefully you will have a follow-up appt with your surgeon beforehand to get more information; hang in there.

Regards,
CL