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Medical Forum / Diseases and Disorders / Cancer / April 2004Introduction & question (colon)
Dear group, When I began to suspect that my husband was ill, I began lurking. I can't say how wonderful it is to see such a supportive, kind, and informative newsgroup. Today my husband had a colonoscopy and the doctor said he had an good-sized, ulcerating tumor that has been in place for at least two years. He's sceduled for a CAT scan next week as well as a meeting with a colo-rectal surgeon. He'll meet the oncologist the week after. A biopsy was taken, and we'll get those results within the week, but the doctor today said there was no question about what the tumor was. My question is about staging. Will the biopsy tell us how advanced the cancer is, or will the surgeon make that determination? My husband is incredibly pragmatic and stoic about this. I am the one panicking. I have no idea what questions to ask, or who to ask. I've been Googling, but I keep getting details on symptoms and descriptions of stages rather than _how_ those determinations are reached. Sorry is this is a jumble. I hope you can make sense of it! Thanks in advance, Best, Morgs > Dear group, > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 18 lines] > Best, > Morgs Hello Morgs, welcome to alt.support.cancer I'm sorry to hear about your husband's cancer. If you've been reading for a while, you know I'm not an expert but it's my understanding that some of the staging is visual (depending on the depth of the cancer into the colon wall) during surgery and pathology, some depends on sampling lymph nodes and some involves various scans. Then all the available information is pieced together. Who tells the patient depends on the health system. In some places, the patient sees a surgeon at one hospital and a radiation oncologist at another. I would think both should know the full staging before any further surgical or treatment decision is proposed. Here's part of where I'm getting my information (whcih kind of confirms what my thoughts were when I saw your post). http://www.merck.com/mrkshared/mmanual_home2/fg/fg131_1.jsp Colon Cancer Staging Shows lymph and layers of the colon http://www.esmo.org/reference/referenceGuidelines/html/MCR4.htm Staging provides essential prognostic information relevant for choosing adequate therapy and should also identify patients with operable solitary or confined liver or lung metastases. Preoperative staging consists of clinical examination, blood counts, liver and renal function tests, chest X-ray, CT-scan of the abdomen and/or liver ultrasound, and colonoscopy of the entire large bowel, i.e. with postoperative repeat colonoscopy if proximal parts of the colon were not accessible preoperatively [D]. Pathologic staging shall be done according to the TNM system with optional listing of the modified Dukes stage: {end quoted material] (the TNM section there is kind of blurry). This website shows the TNM and Modified Duke Staging System of staging http://www.oncologychannel.com/coloncancer/staging.shtml Watch for other replies, we have other colon cancer posters here and Steph, radation oncologist. Post anytime, will try to help as best I can J > > Dear group, > > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 57 lines] > Post anytime, will try to help as best I can > J Hello J, Thanks very much for your response, the extensive information, and the link. My husband's work (?) is being done between two different practices in town, and apparently that may extend to include a third. I've just spoken to him, and he doesn't remember a thing about talking to the doctor, myself, or a friend earlier. In other words, he's just learned of his test results. I'll be sure to print your post off for him to look at. Thanks again. Best, Morgs > Dear group, > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 18 lines] > Best, > Morgs Accurate staging is really done after surgery - on the specimen > > Dear group, > > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 23 lines] > > Accurate staging is really done after surgery - on the specimen So it may take some time then. But pre-operative staging, although not completely accurate, gives some kind of indication, doesn't it? But I may be pushing for answers too early. Thank you very much for your reply. Morgs > > > Dear group, > > > When I began to suspect that my husband was ill, I began lurking. I [quoted text clipped - 35 lines] > Thank you very much for your reply. > Morgs If the cancer is in the rectum, consideration should be given to pre-p radiotherapy. If it's colon, then surgery is first, and other treatment decided after That's what I thought Steph from what I read. So the size of the tumor doesn't really indicate what stage the cancer is ? > > Dear group, > > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 23 lines] > > Accurate staging is really done after surgery - on the specimen > That's what I thought Steph from what I read. So the size of the tumor > doesn't really indicate what stage the cancer is ? Size, no The stage is dependant on the infiltration of the bowel wall, nodes and distant mets. But larger tumours are more likely to be higher stage, more likely but not directly related Hi, I just got here myself last week after my mom was diagnosed with the same thing. I was pretty devastated at the news and was barely keeping it together. But me and my mom faced the fear and laughed about it Don't let fear overwhelm you, take one day at a time and try to think positive. My mom is also a strong willed woman and highly motivated in all she does till this day. Hell she came to this country not speaking the language and raised three boys in New York's Hell's Kitchen. She willed Breast Cancer out of her 4 years ago and she will do the same with colon cancer. After getting advice from the good people here I decided to get a specialist that does colon cancer surgeries exclusively because the outcomes can be significantly better. I also got her into Sloan-Kettering one of the best cancer hospitals in the world today but not before they told me they were booked till the end of the month and to look at some other hospitals. I guess an angel opened up a slot for us on Tuesday. Good Luck to you and your family. In three months were going to be laughing about this :) > Dear group, > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 18 lines] > Best, > Morgs > Hi, > I just got here myself last week after my mom was diagnosed with the same [quoted text clipped - 17 lines] > Good Luck to you and your family. > In three months were going to be laughing about this :) MAC, Thanks for your reply and for sharing your mother's story. She's a remarkable woman. I'm convinced my husband has it in him to beat it. It is hard to stay in the moment, but we'll try our best to do so. We'll know more later in the week. The doctor who performed the colonoscopy said that both the colo-rectal surgeon and the oncologist were very good. We've just moved into the area in August, and I have no idea where to find out if he's right. But we'll do it one step at a time. Best, Morgs <snip> > > Dear group, > > When I began to suspect that my husband was ill, I began lurking. I can't [quoted text clipped - 21 lines] > > Best, > > Morgs Do a google search on his name and hospital and see what pops up! http://www.google.com/ I was able to get info on the surgeon who will be seeing my mom on Tuesday. He was crepitated on many studies on PUBMED and was on the list of 100 top minimally invasive surgeons in the book...the kindest cut of all, best doctors. There are also some pay services that will give you info on the docs history and any outstanding complaints or disciplinary actions against him. They will pop up when you do a google search. I can't vouch for anyone of them but it may be something you might want to consider if you don't get any info. BTW she spent the last three days shopping, cooking and baking for Easter. > > Hi, > > I just got here myself last week after my mom was diagnosed with the same [quoted text clipped - 63 lines] > > > Best, > > > Morgs BTW what area of the country are you from? All the best! MAC > Do a google search on his name and hospital and see what pops up! > http://www.google.com/ [quoted text clipped - 84 lines] > > > > Best, > > > > Morgs > BTW what area of the country are you from? > All the best! > MAC <big snip> Could you please bottom post and snip who you are not replying to and their text? (repeating to make a point) It's hard to know who exactly you are asking the question of when there's 3 other people in the text to which you are replying. Best, J > > BTW what area of the country are you from? > > All the best! [quoted text clipped - 7 lines] > Best, > J Okay, I post on other NG's never had a problem before but I'll try to bottom post and snip. > "J" <abacus@invalid.anon> wrote in message > [quoted text clipped - 6 lines] > Okay, I post on other NG's never had a problem before but I'll try to bottom > post and snip. Thank you very much, MAC J > Hi, > I just got here myself last week after my mom was diagnosed with the same [quoted text clipped - 17 lines] > Good Luck to you and your family. > In three months were going to be laughing about this :) Oh I see, the surgical doctors were booked up? Did they have you send files and reports before they replied? I'm curious what you mean by "willed away"? Did she have surgery only for the breast cancer? Or did she have chemo also and/or radiation therapy? J PS Could you please bottom post and snip who you are not replying to and their text? > Oh I see, the surgical doctors were booked up? > Did they have you send files and reports before they replied? [quoted text clipped - 5 lines] > PS Could you please bottom post and snip who you are not replying to and their > text? Yes the surgical colorectal Doc's were all booked up till the end of April but my mom's colon is almost blocked according to the GI so I don't want her to be rushed to the emergency room if that happens.However she say's all is well, no problem going to the bathroom. If you read the context of my post what I mean by "willed away" is she has an incredible strong demeanor and spirit. But yes she had surgery on a tumor 1/2 the size of a baseball, six months of radiation and chemo. > > Oh I see, the surgical doctors were booked up? > > Did they have you send files and reports before they >replied? I almost forgot but Yes I sent the colonscopy, biopsy and cat scan reports and two days later they told be they were booked till about the end of April. But Samantha one of their specialists told me she'll keep trying and sure enough one hour later I got a phone call for Tues april 13 to go see a surgeon. I was never so happy...how ironic is that? to have my mom cut up! > > > Oh I see, the surgical doctors were booked up? > > > Did they have you send files and reports before they >replied? [quoted text clipped - 4 lines] > sure enough one hour later I got a phone call for Tues april 13 to go see a > surgeon. I was never so happy...how ironic is that? to have my mom cut up! Fabulous ! They will probably do a preoperative/preanesthetic check and review the scans. I wonder if they'll decide immediately and keep her there ? (something for you to consider). If so, all my best to you and your Mom and we'll hear from you when you have a chance to report back. J > > > > Oh I see, the surgical doctors were booked up? > > > > Did they have you send files and reports before they >replied? [quoted text clipped - 12 lines] > chance to report back. > J two hours before spaced 1/2 hour apart they want my mom two have two fleet enemas. What would that be for? They also want the cat scan films and biopsy slides which I will be bringing with me. Do you think they would keep here there? I'm actually going to the surgeon's office on 53rd st and 3rd ave, Sloan_Kettering is on 67th st and first ave. The cat scans show all her organs are fine, no tumors anywhere but in her mid-sigmoid colon.No metastatic process identified. I guess thats a good sign :) Thanks buddy for your interest and concern MAC > > > > > Oh I see, the surgical doctors were booked up? > > > > > Did they have you send files and reports before they >replied? [quoted text clipped - 30 lines] > Thanks buddy for your interest and concern > MAC Hi MAC it sounds like they're planning a Sigmoidoscopy http://www.gicare.com/pated/epdgs23.htm Whether theyre just going to look, do something, or transfer her immediately to the hospital, I really don't know. I was thinking that you could either call and ask and/or have her make up small luggage of things in case she's transferred immediately. That way all her fav stuff (slippers, robe etc) would be packed and ready for you to take later that day to her, including a list of OR her medications if any. If it's not needed that day, it will be needed another time, so it would be a "dry run" of preparing to go in for surgery or she could keep the suitcase with some of the stuff in it and just add the rest just before she finally goes in. HTH keep in touch and let us know. J > Hi MAC > it sounds like they're planning a Sigmoidoscopy [quoted text clipped - 10 lines] > HTH keep in touch and let us know. > J Yep Sigmoidoscopy was done and I watched. Tumor is the size of a lemon. I asked him to estimate staging in his opinion knowing proper analysis is done after surgery. His estimated stage 2 or 3. Can anyone offer any opinions on long term survival? He was also able to get scope past tumor where the first Doctor who did her intial colonoscopy said he couldn't proceed any further. So the surgeon ordered another colonscopy to check down stream before surgery. I forgot to ask but wouldn't the cat scan have picked any further tumors or would they have to be a certain size? |
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