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Medical Forum / Diseases and Disorders / Cancer / April 2004

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Colon cancer--grades?

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Jamo - 17 Apr 2004 18:21 GMT
Dear list,
Can anyone please help me understand the diagnostic grading system? I've
been on Google trying to figure this out, but to no avail. What I'm asking
about is exactly what is  "invasive grade 2 adenocarcinoma". I know what
invasive is, and I know what adenocarcinoma is, but I can't sort out what
the _grade_ is.
Thank you very much.
Best,
Morgs
MAC - 17 Apr 2004 18:32 GMT
> Dear list,
> Can anyone please help me understand the diagnostic grading system? I've
[quoted text clipped - 5 lines]
> Best,
> Morgs

You really won't know the grade till after the tumor is removed along with
lymph nodes to see to how deeply
the cancer has penetrated into the colon lining and if node involvement is
present.
try this link:
http://nihseniorhealth.gov/colorectalcancer/toc.html

http://www.merck.com/mrkshared/mmanual_home2/sec09/ch131/ch131i.jsp
MAC - 17 Apr 2004 19:03 GMT
Soory I goofed, you were talking about pathology and I gave you links to
staging.
I can't find much in layman's terms for adenocarcinoma grades.

> > Dear list,
> > Can anyone please help me understand the diagnostic grading system? I've
[quoted text clipped - 14 lines]
>
> http://www.merck.com/mrkshared/mmanual_home2/sec09/ch131/ch131i.jsp
Jamo - 17 Apr 2004 19:15 GMT
> Soory I goofed, you were talking about pathology and I gave you links to
> staging.
[quoted text clipped - 20 lines]
> >
> > http://www.merck.com/mrkshared/mmanual_home2/sec09/ch131/ch131i.jsp

Thanks, MAC.
I asked about staging, and the doctor said he couldn't do it until after
surgery (I expected him to say this, as it's what's been said in messages
here). I glanced at Baz's report though, and it said "grade 2," which
prompted my question. I _think_ I found out what it means --medium
differentiated cells as opposed to well-differentiated. I relaly need to get
a medical dictionary today :-)
All the best,
Morgs
MAC - 17 Apr 2004 19:49 GMT
> > > You really won't know the grade till after the tumor is removed along
> with
[quoted text clipped - 16 lines]
> All the best,
> Morgs

I asked the surgeon about about my mom's pathology report which said
moderately differentiated.
Basically what he said was a midly aggressive form. What well diferrentiated
means  the tumor closely
matches the the tissue it formed from which is good. Poorly differented
means it has no resemblemce to it's original
state and has mutated and can be more aggressive. We are in between at
medium/moderatley.

look up
Cell-Differentiation at  http://www.cancersupporters.com/asc/glossary.html#c
Jamo - 17 Apr 2004 22:22 GMT
> > > > You really won't know the grade till after the tumor is removed along
> > with
[quoted text clipped - 30 lines]
> look up
> Cell-Differentiation at  http://www.cancersupporters.com/asc/glossary.html#c

Thanks again, MAC.
I assume that's where Baz is too according to what I saw on the report.
Best,
Morgs
J - 17 Apr 2004 23:43 GMT
> Dear list,
> Can anyone please help me understand the diagnostic grading system? I've
[quoted text clipped - 5 lines]
> Best,
> Morgs

Hello Morgs,
I'm not sure that I've ever heard anyone ever mention grade with colon cancer.

It's not mentioned in these places
http://www.oncologychannel.com/coloncancer/index.shtml
http://www.merck.com/mrkshared/mmanual_home2/fg/fg131_1.jsp

I do see it mentioned when describing symptoms (vomiting, diarrhea,
neuropathy) on the internet.
Example here
http://www.nci.nih.gov/cancerinfo/pdq/treatment/colon/healthprofessional/ from

http://www.nci.nih.gov/cancer_information/cancer_type/colon_and_rectal/

Also I've seen it mentoned with dysplasia which is precancerous lesions. Is it
possible that your husband has a frank tumour and precancerous lesions? Or
they were describing his current symptoms?
In any event, if so, they'll likely be removing that part, so I'm confused as
to why you are searching this out??
Just wondering.

Also wanted to say it's good to hear there's no mets.  Perhaps he won't need
chemotherapy at all?
My Dad was partially paralyzed. He's a Brit too, but lived most of his life in
Canada.
He was found to have cancer in his colon, he had one surgery when he blocked
up so they removed part of whatever was the problem. Then he had to have
another one a year or so later and had to have a colostomy.  He was so
grateful that it had been caught early, he lived alone (Mom had passed away)
and no one to help him but he managed quite well.
So hopefully your husband will come to terms and by the time he's done with
the doctors, and the surgery and the nurses helping him out, he'll be more
comfortable with the idea.  I've seen posts or websites mentioning little
accidents that sometimes happen or which clothing is better to wear. I've also
seen mention of difficulties using public washrooms. That and driving is
definitely something to look into (be prepared for).
If a person can take it with a bit of humour, it's all for the better.  Dad
was quite open about discussing everything to the last detail to the point of
driving people away. <g>

I'm sorry that Michelle is no longer here. Her posts really cracked us up. It
really wasn't always funny but she tried to put a humorous spin on it. Here's
two of her many classic posts. While she was battling rectal cancer, her
mother was battling bile duct cancer. We must be grateful for small blessings
especially if you are in good health yourself.
http://tinyurl.com/yv7vj Privacy, modesty, getting used to the idea (before
too long she was posting very private stuff to the newsgroup, in order to get
questions answered and to make others feel more comfortable with their
diagnosis and problems).

http://tinyurl.com/288v8 Desperate to get out of hospital and had to pee
first.

Perhaps if you relay the above to your husband, it'll help him somewhat?

If there's a local ostomy support group, perhaps he'll also find help and
support there.
Best,
J
Jamo - 17 Apr 2004 23:56 GMT
> > Dear list,
> > Can anyone please help me understand the diagnostic grading system? I've
[quoted text clipped - 26 lines]
> to why you are searching this out??
> Just wondering.

I was looking it up because I want some idea of what's going on with his
body. I may well be creating something out of nothing.  I don't relay any of
this to my husband, btw--he's freaked out enough as it is.

> Also wanted to say it's good to hear there's no mets.  Perhaps he won't need
> chemotherapy at all?

The surgeon wants him on chemo and radiation before surgery; we don't know
about after. The surgeon did say that he's known a combination of radio and
chemo pre-surgery often zaps Baz's kind of cancer into nothingness, but he
still wants to pursue surgery to make certain it's gone.

> My Dad was partially paralyzed. He's a Brit too, but lived most of his life in
> Canada.
[quoted text clipped - 12 lines]
> was quite open about discussing everything to the last detail to the point of
> driving people away. <g>

Thanks for sharing this--I am so grateful to hear it. I'm glad your Dad was
able to deal with it so well. I think Baz will come around, but he is
naturally squeamish, and added to that he feels humiliated and kind of
shamed. He thinks he'll have to wear special clothes. I plan on finding him
some help. He's very resistant to seeing a therapist,
but he's indicated that he'll sit in with a support group.

> I'm sorry that Michelle is no longer here. Her posts really cracked us up. It
> really wasn't always funny but she tried to put a humorous spin on it. Here's
> two of her many classic posts. While she was battling rectal cancer, her
> mother was battling bile duct cancer. We must be grateful for small blessings
> especially if you are in good health yourself.

Thanks--I'll look at these.

> http://tinyurl.com/yv7vj Privacy, modesty, getting used to the idea (before
> too long she was posting very private stuff to the newsgroup, in order to get
[quoted text clipped - 10 lines]
> Best,
> J

First thing Monday I'm checking with the doctor's office for one. Again,
thanks for all of this information! You're a Godsend.
Best,
Morgs
Trish Knight - 18 Apr 2004 01:39 GMT
<snip>

>  You're a Godsend.

Yes, she is!!!

> Best,
> Morgs

Hi Morgs,
Welcome to a.s.c.  Sorry you have to be here, but it's a good place to be.

Hugs,
Trish
Jamo - 18 Apr 2004 01:57 GMT
> <snip>
> >
[quoted text clipped - 10 lines]
> Hugs,
> Trish

Thanks, Trish.
When I was in lurker mode I couldn't believe how generous people were, and
now that I'm posting I am absolutely grateful for it.
Best,
Morgs
Steph - 18 Apr 2004 03:08 GMT
> The surgeon wants him on chemo and radiation before surgery; we don't know
> about after. The surgeon did say that he's known a combination of radio and
> chemo pre-surgery often zaps Baz's kind of cancer into nothingness, but he
> still wants to pursue surgery to make certain it's gone.

Standard management in Europe and most of Canada for operable rectal cancer
is pre-op radiotherapy for 1 week, followed by surgery, and the best surgery
is a type called TME. The results are excellent.
Inoperable cancers which the surgeon can't remove are often treated by preop
radiotherapy plus chemotherapy, to shrink them and render them operable.

In the US, preop radiotherapy plus chemotherapy is often given for even
operable cancers, but that will change eventually........
 
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