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Got my pet scans results- update

everclearpc82's picture
everclearpc82
Posts: 21
Joined: Jun 2012

Well got my results back yesterday and found a spot on my liver and one on my lungs.I go for my liver biopsy in the morning.I also have an appointment next Thursday for my consult for radiation.I feel and the doctor does too that of course the cancer has spread so that makes me a stage 4 so this is going to be a long and difficult fight but I am up for it:)

Well my liver biopsy was awful could not get it with an ultrasound so they had to use the C.T. scan which my I.V messed up so i had to have contrast three times,and they had a hard time getting to my liver they went in between a rib and took three samples.The pain was really harsh and did not subside until this afternoon:(

tommycat's picture
tommycat
Posts: 790
Joined: Aug 2011

Sorry to hear this Patsy---it's going to be an uphill hike for sure, but you're right, you can do it.
You will amaze yourself by what you're capable of.
As someone else put it, this site is a soft place to fall. Use it as you need it.
Hang tight and know that you are not alone.
Take good care~
Tommycat

dmj101's picture
dmj101
Posts: 527
Joined: Nov 2011

I could be wrong..
but my doc still refers to me as stage 3 since I have no lynph node action..
do you have lymph nodes.. lighting in the PET?

smokeyjoe
Posts: 1428
Joined: Feb 2011

Wow what a shock at your young age having to deal with this disease. Keep us posted as to how your treatments go. Ask any questions you may have, there are a lot of folk on this board who have been at this for years....no question is off limits, you can't put us off with TMI......

everclearpc82's picture
everclearpc82
Posts: 21
Joined: Jun 2012

My doctor said if the liver biopsy comes back as cancer(which he thinks it will)then he said it would be stage 4.I dont know but will ask him when I go see him next week . thank you dmj

jjaj133's picture
jjaj133
Posts: 857
Joined: Mar 2011

So sorry to hear this. stage four is when it travels to another part of the body. i have had 2 liver resections and never any lymph node involvement. I am considered stage four.
I wish you luck and will be sending prayers and healing thoughts your way.
hugs,
Judy

dmj101's picture
dmj101
Posts: 527
Joined: Nov 2011

I have no liver mets.. just lungs and spine and spleen. And definitely no lymph node action.
But they have told me these are mall inor at this point and the hope is meds will knock them, out.. but who ever really knows that outcome.. early catch thanks to endocronologist not my previous onc.. sorry to bash her but she wasn't doing her job fully - I think she may have never had a patient like me who questioned her practices.
I have read about staging alot. .and even my initial stage could have gone stage 2 or stage 3 depending on how you interpret it.. so.. I am confuses somewhat.. but I have never been told I was stage 4.. I started as stage 2 then they upgraded to stage 3 than later back to stage 2 and lately they refer to stage 3 with no change.. :(

Momof2plusteentwins's picture
Momof2plusteentwins
Posts: 482
Joined: May 2012

Any time that it travels from the primary location to another organ it is stage IV. I just went through surgery June 19 and had my rectal tumor, liver tumor and gallbladder taken out. I have 33 staples down my abdomen. You can do this! You are probably still in shock stage, I feel I still am. Ask us anything you can think of. This board has helped me more than they will ever know.
Take care,
Sandy

steved
Posts: 836
Joined: Apr 2004

Below is a long description of staging- it is the clearest I have found and is long because it is complex (made worse by there being two different systems TNM vs Dukes). DMJ101 I think you need to talk calerly with your oncs to understand your stage as it does affect treatment and prognosis which you need to understand (Esp as you are somebody with background knowledge and clearly a good level of understanding).

To be honest I am confused what the hell I am some days and probably need to have teh same conversation with my docs!

steve

AJCC (TNM) Staging System

A staging system is a standardized way in which the cancer care team describes the extent of the cancer. The most commonly used staging system for colorectal cancer is that of the American Joint Committee on Cancer (AJCC), sometimes also known as the TNM system. Older staging systems for colorectal cancer, such as the Dukes and Astler-Coller systems, are mentioned briefly below for comparison. The TNM system describes 3 key pieces of information:
• T describes how far the main (primary) tumor has grown into the wall of the intestine and whether it has grown into nearby areas.
• N describes the extent of spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections.
• M indicates whether the cancer has spread (metastasized) to other organs of the body. (Colorectal cancer can spread almost anywhere in the body, but the most common sites of spread are the liver and lungs.)

Numbers or letters appear after T, N, and M to provide more details about each of these factors. The numbers 0 through 4 indicate increasing severity. The letter X means "cannot be assessed because the information is not available."

T categories for colorectal cancer

T categories of colorectal cancer describe the extent of spread through the layers that form the wall of the colon and rectum. These layers, from the inner to the outer, include:
• The inner lining (mucosa)
• A thin muscle layer (muscularis mucosa)
• The fibrous tissue beneath this muscle layer (submucosa)
• A thick muscle layer (muscularis propria) that contracts to force the contents of the intestines along
• The thin, outermost layers of connective tissue (subserosa and serosa) that cover most of the colon but not the rectum

Tx: No description of the tumor's extent is possible because of incomplete information.

Tis: The cancer is in the earliest stage (in situ). It involves only the mucosa. It has not grown beyond the muscularis mucosa (inner muscle layer).

T1: The cancer has grown through the muscularis mucosa and extends into the submucosa.

T2: The cancer has grown through the submucosa and extends into the muscularis propria (thick outer muscle layer).

T3: The cancer has grown through the muscularis propria and into the outermost layers of the colon or rectum but not through them. It has not reached any nearby organs or tissues.

T4a: The cancer has grown through the serosa (also known as the visceral peritoneum), the outermost lining of the intestines.

T4b: The cancer has grown through the wall of the colon or rectum and is attached to or invades into nearby tissues or organs.

N categories for colorectal cancer

N categories indicate whether or not the cancer has spread to nearby lymph nodes and, if so, how many lymph nodes are involved. To get an accurate idea about lymph node involvement, most doctors recommend that at least 12 lymph nodes be removed during surgery and looked at under a microscope.

Nx: No description of lymph node involvement is possible because of incomplete information.

N0: No cancer in nearby lymph nodes.

N1: Cancer cells are found in or near 1 to 3 nearby lymph nodes
• N1a: Cancer cells are found in 1 nearby lymph node.
• N1b: Cancer cells are found in 2 to 3 nearby lymph nodes.
• N1c: Small deposits of cancer cells are found in areas of fat near lymph nodes, but not in the lymph nodes themselves.

N2: Cancer cells are found in 4 or more nearby lymph nodes
• N2a: Cancer cells are found in 4 to 6 nearby lymph nodes.
• N2b: Cancer cells are found in 7 or more nearby lymph nodes.

M categories for colorectal cancer

M categories indicate whether or not the cancer has spread (metastasized) to distant organs, such as the liver, lungs, or distant lymph nodes.

M0: No distant spread is seen.

M1a: The cancer has spread to 1 distant organ or set of distant lymph nodes.

M1b: The cancer has spread to more than 1 distant organ or set of distant lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity).

Stage grouping

Once a person's T, N, and M categories have been determined, usually after surgery, this information is combined in a process called stage grouping. The stage is expressed in Roman numerals from stage I (the least advanced) to stage IV (the most advanced). Some stages are subdivided with letters.

Stage 0

Tis, N0, M0: The cancer is in the earliest stage. It has not grown beyond the inner layer (mucosa) of the colon or rectum. This stage is also known as carcinoma in situ or intramucosal carcinoma.

Stage I

T1-T2, N0, M0: The cancer has grown through the muscularis mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes or distant sites.

Stage IIA

T3, N0, M0: The cancer has grown into the outermost layers of the colon or rectum but has not gone through them (T3). It has not reached nearby organs. It has not yet spread to the nearby lymph nodes or distant sites.

Stage IIB

T4a, N0, M0: The cancer has grown through the wall of the colon or rectum but has not grown into other nearby tissues or organs (T4a). It has not yet spread to the nearby lymph nodes or distant sites.

Stage IIC

T4b, N0, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has not yet spread to the nearby lymph nodes or distant sites.

Stage IIIA

One of the following applies.

T1-T2, N1, M0: The cancer has grown through the mucosa into the submucosa (T1) and it may also have grown into the muscularis propria (T2). It has spread to 1 to 3 nearby lymph nodes (N1a/N1b) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites.

T1, N2a, M0: The cancer has grown through the mucosa into the submucosa (T1). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.

Stage IIIB

One of the following applies.

T3-T4a, N1, M0: The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 1 to 3 nearby lymph nodes (N1a/N1b) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites.

T2-T3, N2a, M0: The cancer has grown into the muscularis propria (T2) or into the outermost layers of the colon or rectum (T3). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.

T1-T2, N2b, M0: The cancer has grown through the mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites.

Stage IIIC

One of the following applies.

T4a, N2a, M0: The cancer has grown through the wall of the colon or rectum (including the visceral peritoneum) but has not reached nearby organs (T4a). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.

T3-T4a, N2b, M0: The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites.

T4b, N1-N2, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or into areas of fat near the lymph nodes (N1 or N2). It has not spread to distant sites.

Stage IVA

Any T, Any N, M1a: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to 1 distant organ (such as the liver or lung) or set of lymph nodes (M1a).

Stage IVB

Any T, Any N, M1b: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to more than 1 distant organ (such as the liver or lung) or set of lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity) (M1b).

Sundanceh's picture
Sundanceh
Posts: 4347
Joined: Jun 2009

Hi there.

I used to be under this assumption as well...in fact, my first oncologist said that when things spread to other organs, that the classification is a 4.

But as mentioned from Steve, there is a big difference between being an Initial Stage IV vs Mestatic IV.

A friend of mine, who recently passed away here a month or so ago, explained it to me this way.

If we're metastatic we are the stage we are diagnosed - with mCRC added behind it.

For example, if you were a IIb let's say and metastasized.....

You would not be a Stage IV, rather you would be a "IIB mCRC"

But the bottom line, is when it spreads, the fight escalates to new levels.

Good luck with your fight - and am sorry you are dealing with this at such a young age.

-Craig

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