Question about adenocarcinoma

[Guest guest]

Hi,

I wrote yesterday about my dad having surgery the Monday before last and having

problems with swelling (he had eight inches of his colon removed, plus some of

the

intestinal wall, apparently). He went back to the doctor today and she said

that

everything looked fine and that some people swell up more than others. She also

said that the purple discoloration was nothing to worry about.

They also found out what kind of cancer it was: adenocarcinoma. She said it was

very

small and had gone into the intestinal wall, but not further. She said that she

removed it all, but suggested that he meet with an oncologist to be on the safe

side.

She said that as far as she could tell, it wasn't in the lymph nodes and they

caught it

before it metastisized.

My parents aren't really ones to research and ask a lot of questions, so I want

to find

out if there is anything we should be aware of, any questions to ask the

oncologist,

etc. I'm so glad that they seemed to catch this cancer before it spread, but in

the

back of my mind, I'm still worried and scared for him.

Thanks for any help,

Karin

[Guest guest]

> Hi,

>

> I wrote yesterday about my dad having surgery the Monday before

last and having

> problems with swelling (he had eight inches of his colon removed,

plus some of the

> intestinal wall, apparently). He went back to the doctor today and

she said that

> everything looked fine and that some people swell up more than

others. She also

> said that the purple discoloration was nothing to worry about.

>

> They also found out what kind of cancer it was: adenocarcinoma.

She said it was very

> small and had gone into the intestinal wall, but not further. She

said that she

> removed it all, but suggested that he meet with an oncologist to be

on the safe side.

> She said that as far as she could tell, it wasn't in the lymph

nodes and they caught it

> before it metastisized.

>

> My parents aren't really ones to research and ask a lot of

questions, so I want to find

> out if there is anything we should be aware of, any questions to

ask the oncologist,

> etc. I'm so glad that they seemed to catch this cancer before it

spread, but in the

> back of my mind, I'm still worried and scared for him.

>

> Thanks for any help,

>

> Karin

Hi Karin,

Did your dad,s Dr. remove any lymph node,s and have them tested,or

did the Dr. just say they looked okay?

hugs and prayers Jana

[Guest guest]

Hi Jana,

Thank you so much for your reply and your kind words. I don't know if she just

looked at them or had anything tested. I will ask her. I have a feeling that

she didn't

do any testing; otherwise, it seems like she would have told us.

My biggest fear is that this small cancer that was removed is a metastized

cancer

from somewhere else. He's always had problems with his esophogus (not cancer),

and I've read that a person can get this type of cancer in that area. I'm

definitely

going to go with them when they see the oncologist.

Thanks again,

Karin

> Hi Karin,

> Did your dad,s Dr. remove any lymph node,s and have them tested,or

> did the Dr. just say they looked okay?

> hugs and prayers Jana

[Guest guest]

> Hi Jana,

>

> Thank you so much for your reply and your kind words. I don't know

if she just

> looked at them or had anything tested. I will ask her. I have a

feeling that she didn't

> do any testing; otherwise, it seems like she would have told us.

>

> My biggest fear is that this small cancer that was removed is a

metastized cancer

> from somewhere else. He's always had problems with his esophogus

(not cancer),

> and I've read that a person can get this type of cancer in that

area. I'm definitely

> going to go with them when they see the oncologist.

>

> Thanks again,

>

> Karin

Karin,

If I were you I would be sure to go to the Dr. with them when they go

back. My story is my mom was diagnosed with the same thing in oct 03

they found it during a colonoscopy. She had surgery the 20th of oct

they removed about a foot of her colon and 19 surrounding lymph nodes

had the nodes tested and 4 were bad she is now in chemo,and since 4

nodes were bad she is stage 3. I am new to this also so I probably

can,t help you a lot but I will do the best I can.If it was my dad

when you go to the Dr. I would ask these questions. Ask what his cea

was before surgery. What is it now.What stage is he.Did they remove

any lymph node,s and test them, if so were any bad. The Dr. should

have all these answers when you go back. My mom is the same way, she

researche,s nothing so I do it all. This is a great site, you gain a

lot of knowledge here. If you ever post and find that no one is

responding re-post and in your subject box write urgent and hopefully

someone will answer you soon.When doe,s your dad go back to Dr.?

Please keep us posted.Try to hang in there,I know this is all so

scary and you will need your strength and wit,s about you. sometimes

this is a long road.One thing is for sure you have found a lot of new

friend,s here, and we will all keep you in our thought,s and prayer,s.

You also can go through all the archive,s there are a lot of great

link,s to cancer site,s.I will pray for you.

Hugs and Prayers

Jana

>

> > Hi Karin,

> > Did your dad,s Dr. remove any lymph node,s and have them

tested,or

> > did the Dr. just say they looked okay?

> > hugs and prayers Jana

[Guest guest]

Hi Karin,

Karin wrote:

<<adenocarcinoma. She said it was very small and had gone into the

intestinal wall, but not further>>

<<She said that as far as she could tell, it wasn't in the lymph

nodes and they caught it before it metastisized>>

Sounds like to me your Dad has an excellent prognosis...it was

definitely caught early and is most likely a stage I or IIA cancer

http://tinyurl.com/swpw

I don't think they ever give chemo for stage I...and most oncs don't

recommend for stage IIA either. But of course you still need to get

an appt with some oncologists to have them review your Dad's case and

hear this directly from them!

Survival rates for early stage cancers are extremely high (for stage

II, I think they run around 75-80%), so there is a lot of reason for

optimism!

If the oncologist you visit recommends chemo, you will probably have

a few questions about that. If not (most likely scenario), he's home

free and there may not be a lot to talk about! I'd probably just

inquire about the survival rates with/without chemo for whatever your

Dad's stage of cancer is, and the " controversy " over whether chemo is

needed or not for stage IIA colon cancers (if that turns out to be

what your father has). The medical literature I have seen only seems

to discuss stage IIB cancers, and it appears an uncertain chemo

advantage even for this more advanced case (there is no conclusive

clinical trial evidence I know of that chemo will increase survival

for stage IIB, although it is possible that it does).

Hope this helps!

Best Wishes,

PS Here's why I think your Dad is stage I or IIA - the snip below is

from the link I gave above regarding staging. Note stage IIB

says " The cancer has grown through the wall of the colon or rectum

into other nearby tissues or organs " . This seems to be more advanced

than what you are describing. Therefore, sounds like his cancer is

earlier stage.

********************************************************************

Stage I: T1, N0, M0, or T2, N0, M0: The cancer has grown through the

mucosa into the submucosa (T1) or it may also have grown into the

muscularis propria (T2), but it has not spread into nearby lymph

nodes (N0) or distant sites.

Stage IIA: T3, N0, M0:, The cancer has grown through the wall of the

colon or rectum, into the outermost layers (T3). It has not yet

spread to the nearby lymph nodes (N0) or distant sites.

Stage IIB: T4, N0, M0: The cancer has grown through the wall of the

colon or rectum into other nearby tissues or organs (T4). It has not

yet spread to the nearby lymph nodes (N0) or distant sites.

*********************************************************************

You might also want to print out a copy of this document, the " Colon

Cancer PDQ http://tinyurl.com/zoxe and take it into the oncologist

for discussion. This document contains the " official " recommended

treatment guidelines for colon cancer. Note for stage I, chemo is

not recommended. For stage II, the situation is more ambiguous

[snip]

Although subgroups of patients with stage II colon cancer may be at

higher than average risk for recurrence (including those with

anatomic features such as tumor adherence to adjacent structures,

perforation, complete obstruction, or with biologic characteristics

such as aneuploidy, high S-phase analysis, or deletion of 18q),[3-5]

there is no consistent evidence that adjuvant 5-fluorouracil-based

chemotherapy is associated with an overall improved survival compared

with surgery alone.[6] In some trials, subset analysis of adjuvant

chemotherapy has demonstrated benefits in disease-free and overall

survival compared with surgery alone,[7,8] but such treatment has not

been considered standard for all stage II patients.

> Hi,

>

> I wrote yesterday about my dad having surgery the Monday before

last and having

> problems with swelling (he had eight inches of his colon removed,

plus some of the

> intestinal wall, apparently). He went back to the doctor today and

she said that

> everything looked fine and that some people swell up more than

others. She also

> said that the purple discoloration was nothing to worry about.

>

> They also found out what kind of cancer it was: adenocarcinoma.

She said it was very

> small and had gone into the intestinal wall, but not further. She

said that she

> removed it all, but suggested that he meet with an oncologist to be

on the safe side.

> She said that as far as she could tell, it wasn't in the lymph

nodes and they caught it

> before it metastisized.

>

> My parents aren't really ones to research and ask a lot of

questions, so I want to find

> out if there is anything we should be aware of, any questions to

ask the oncologist,

> etc. I'm so glad that they seemed to catch this cancer before it

spread, but in the

> back of my mind, I'm still worried and scared for him.

>

> Thanks for any help,

>

> Karin

[Guest guest]

Karin,

Nodes SHOULD have been tested - this is rather standard procedure, I

think. If they were NOT tested in the lab, staging is not accurate

at all. You should also inquire as to HOW MANY nodes were tested - it

has been shown that staging is also not always accurate if they only

removed/checked a " small " number of nodes (fewer than 10 or so).

I would ask for copies of ALL medical records...operative report, lab

reports, and anything else they might have. You can learn a lot of

stuff by reading these that the doctors somehow " forget " to

mention!!! I found many questions to ask just from these records

alone...

Best,

> Hi Jana,

>

> Thank you so much for your reply and your kind words. I don't know

if she just

> looked at them or had anything tested. I will ask her. I have a

feeling that she didn't

> do any testing; otherwise, it seems like she would have told us.

>

> My biggest fear is that this small cancer that was removed is a

metastized cancer

> from somewhere else. He's always had problems with his esophogus

(not cancer),

> and I've read that a person can get this type of cancer in that

area. I'm definitely

> going to go with them when they see the oncologist.

>

> Thanks again,

>

> Karin

>

> > Hi Karin,

> > Did your dad,s Dr. remove any lymph node,s and have them

tested,or

> > did the Dr. just say they looked okay?

> > hugs and prayers Jana

[Guest guest]

Thank you SO much, and Jana, for all the good information. I'm going to

call

and ask his doctor about the lymph nodes and how many were tested. I certainly

hope she tested them because I'm sure cancer isn't always visible to the naked

eye.

I'm also going to ask about testing for CEA levels. I'd never even heard about

that.

And those links were really helpful. That's a great idea about getting copies

of his

medical records. I'm going to do that really soon. Thanks for taking the time

to

respond to my message.

Karin

[Guest guest]

I was told that a pathology report is required by insurance on

anything that is removed during surgery; otherwise, the insurance

won't cover the costs of surgery. The surgeon will try and get as

many nodes in the area as they readily can. My surgeon got 48 nodes

but I think a couple dozen is more likely the usual number.

Bottom line, I'd bet money that lymph nodes were removed and

analyzed. You probably want to get copies of all the surgery

records, pathology reports, CAT/PET scan reports, etc... since YOU

are paying for it (the insured, that is). The pathology report will

stage the tumor.

Best of luck,

Cliff H.

(not the other cliff on this board :-)

> Karin,

>

> Nodes SHOULD have been tested - this is rather standard procedure,

I

> think. If they were NOT tested in the lab, staging is not accurate

> at all. You should also inquire as to HOW MANY nodes were tested -

it

> has been shown that staging is also not always accurate if they

only

> removed/checked a " small " number of nodes (fewer than 10 or so).

>

> I would ask for copies of ALL medical records...operative report,

lab

> reports, and anything else they might have. You can learn a lot of

> stuff by reading these that the doctors somehow " forget " to

> mention!!! I found many questions to ask just from these records

> alone...

>

> Best,

>

>

>

>

<snip>

[Guest guest]

> Thank you SO much, and Jana, for all the good information.

I'm going to call

> and ask his doctor about the lymph nodes and how many were tested.

I certainly

> hope she tested them because I'm sure cancer isn't always visible

to the naked eye.

> I'm also going to ask about testing for CEA levels. I'd never even

heard about that.

>

> And those links were really helpful. That's a great idea about

getting copies of his

> medical records. I'm going to do that really soon. Thanks for

taking the time to

> respond to my message.

>

> Karin

Karin,

You are very welcome.Like I said there are some really great people

here and they all will help you. keep us posted.

Hugs Jana