Jul 23, 2008 - 11:14 am
I have not posted a comment on this site for several months, therefore, this will be a larger than normal post.
I am a 72 year-old retired organic/polymer chemist living in Englewood, FL. In early December 2007 I had a colonoscopy that revealed a single large polyp in the sigmoid colon that was aggressively removed, subsequently resulting in a perforation of the colon at the site of the polyp. While on antibiotics in the hospital, the surgeon assigned to me informed me that the removed polyp was cancerous. I had colon resection surgery in early January 2008 that resulted in removal of a 12-inch section of colon as well as numerous associated lymph nodes. These were evaluated and no cancer was found. The diagnosis was Stage I colon cancer. There was one problem: my CEA level after surgery was elevated, 7.7, and it was recommended that I start seeing an oncologist at Florida Cancer Specialists in order to resolve the CEA problem. Subsequently, I had a CEA test about two weeks after surgery that showed a result of 4.4. The oncologist thought that the CEA test results were probably nothing but ordered a CT scan of the chest/abdomen/pelvic area in order to be on the safe side. This CT scan showed nothing. However, a subsequent CEA test showed an elevated result, 8.2. It should be mentioned that the three CEA tests were done at three different labs.
A PET/CT scan of the head to mid-thighs was then ordered for Feb. 15. The results showed two areas of concern. Although there were no hot spots on the liver, the liver was not uniform in brightness. I had an MRI done on the liver in early March that showed no abnormalities. The other problem revealed by the PET/CT scan was more serious as there were three small hot spots in the deep chest area but with no lung involvement. The oncologist identified the hot spots as lymph nodes that might or might not be cancerous. He told me that access to these lymph nodes was difficult and would require the expertise of a thoracic oncologist. He said that the best way to access these lymph nodes for evaluation was a procedure called mediastinoscopy. As Florida Cancer Specialists did not have this capability it was recommended I consider consulting with a thoracic oncologist at Moffett Cancer Center in Tampa if the spots again showed up a subsequent Pet/CT scan scheduled for early May. In the meantime I had a repeat colonoscopy that showed nothing, I had a digital prostate examination that revealed nothing and my PAS test result was 0.79.
In the repeat PET/CT scan the three small hot spots in the deep chest area were still present. There were no other problem areas. As my wife and I planned to head North to the northern shore of Lake Erie in mid-June, my oncologist suggested that I see a thoracic oncologist at Strong Memorial Hospital in Rochester, NY or one at Roswell Memorial Cancer Institute in Buffalo, NY. We were familiar with both and had no difficulty in selecting Roswell over Strong. Our Florida oncologist set up an appointment for me to see a thoracic oncologist at Roswell in late June. At that meeting it was decided that I should have the mediastinoscopy procedure done. The surgery was done on Wednesday, July 17. No cancer was found in any of the three hot lymph node sites. Needless to say, this was a big relief for me as well as for my wife. I will meet with my oncologist at Roswell on Thursday (July 24) to go over the pathology results, recent CEA results and to determine what comes next
However, I suspect that it is not over yet as my CEA level is probably still elevated and the search will have to continue. Once you have cancer, the search never ends, even when you are NED.
I guess I would like to know if my situation is unusual or if it is normal for someone who is a colon-cancer survivor. Currently, I am in a catch-22 situation with respect to my CEA level. It is always great when you are told that no cancer was found but if cancer really is present elsewhere in the body and it is not quickly found, treatment could be fatally delayed. Because of this thought, I sometimes find myself thinking that it might be better to find cancer so that treatment could be promptly started. But I usually realize that positive thinking in this situation would be the better course.