roadrunner wrote:TiredandTroubled: It is a really good idea to figure out how to do a signature with specific details (or as specific as you can do (and fit within the character limit!)). It’s not too hard. This will really help the folks on here cut to the chase.
Jacques wrote:TiredandTroubled -
Thanks for creating a signature. This will help in the long run to allow members here to understand your situation at a glance, especially if you keep your signature up to date as new information comes in.
I have some comments on your initial signature, however. Given that your surgery is scheduled as soon as next week, I would say that there are some important items that should already be in the signature right now but are not there. The missing items (in my opinion) are:The fact that you have been given only a very sketchy description of what the mass really is and how aggressive or invasive it might be gives the impression that the surgeon is not really very concerned about details. There are some details (like how far down the lower cut will be made) that could be important for post-surgery recovery and quality of life. Also details about how much of the sigmoid colon the surgeon is planning to remove, e.g., left hemi-colectomy vs. sigmoid colectomy only.
- Specific type of cancer, e.g., adenocarcinoma, etc.
- Grade of tumor, e.g., G1, G2, G3, or G4, depending on level of differentiation detected
- Estimated T-value of the tumor on the TNM scale, e.g., T1, T2, T3, or T4, depending on the estimated depth of tumor invasion into or through the colon wall, as seen from the preliminary scans. By this point in time the surgeon should at least know whether the tumor has grown through the colon wall or not, and maybe should have also done an MRI to see the tumor outline in greater detail.
- Estimated N-value of local lymph node involvement on the TNM scale, e.g., N0, N1, or N2, depending on how many enlarged lymph nodes were detected on the preliminary abdominal CT scan. Given that your baseline CEA is 16, this strongly suggests that there is local lymph node involvement, i.e., either N1 or N2. In any event, the surgeon should already have an idea of how complicated the surgery will be and how difficult it will be to obtain clear surgical margins all around.
- Estimated stage, based on estimated TNM scale, e.g., Stage 1, Stage 2, or Stage 3 (assuming that M-value is M0, thereby excluding Stage 4)
- Type of surgical procedure - Several types of surgery are available for dealing with masses in the sigmoid colon, but your signature does not mention which type of procedure will be used.
- Precise location in the sigmoid colon, i.e., whether the mass is in the lower part of the sigmoid colon near the recto-sigmoid junction, or in the upper part of the sigmoid colon far away from the recto-sigmoid junction.
- MSI status - Since you already have the results from the IHC test with all 4 proteins being expressed normally, then your MSI status is pMMR (i.e., proficient mismatch repair) which is more or less equivalent to MSI status = MSS (i.e., microsatellite stable)
Before you have surgery you will probably have to sign an Informed Consent form. Be sure that all of your questions regarding the surgery have been answered before you sign this form.
TiredandTroubled wrote:Jacques wrote:TiredandTroubled -
He is a board certified surgeon at MSK and has great reviews. Now I’m getting concerned? He answered a lot of my questions but I didn’t know he was supposed to give me such detail.
kandj wrote:TiredandTroubled wrote:Jacques wrote:TiredandTroubled -
He is a board certified surgeon at MSK and has great reviews. Now I’m getting concerned? He answered a lot of my questions but I didn’t know he was supposed to give me such detail.
Which doctor is it at MSK? my husband's colon surgeon was Dr. Paty and he is one of the best.
TiredandTroubled wrote:
He is
Dr. Garcia Aguilar
TiredandTroubled wrote:... I’m scheduled to get surgery next week ...
Jacques wrote:TiredandTroubled wrote:... I’m scheduled to get surgery next week ...
Are you all set for your surgery next week? Do you now have all the things that you will need to have at home during the recovery period? For example, all of the right kinds of food and medical supplies that you will need to have close at hand ?
Now is the time to do some last-minute shopping, since you may not feel like doing much shopping just after you have been discharged from the hospital. Just a thought ...
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