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
06/2020 - 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