one month out - CT & EUS

nonichol

So, I finished radiation Aug. 28th and had a CT scan this Sept, 27th, Monday. Followed by an ultrasound yesterday. CT appears clear. Ultrasound significant improvement, Doc thinks just scar tissue showing up and will repeat the ultrasound in four weeks. Doc seemed pretty happy and I felt a huge relief. I am tired of this nightmare, so it is nice to hear something good. I am stage IV (which is freaky to me).
Norma

azkookie18

great news!
Hi Norma,
That is great news!! Did you have liver mets or?
Did they talk about your next steps? It is always nice to get some good news! congratulations!!

z

Norma
Hi Norma,

Good for you and your good results. I pray that you'll continue to have good news. Lori

mp327

Congratulations!
Hi Norma!

Congrats on your great results! I'm so very happy for you! My docs always tell me there is scar tissue too. I guess considering what the radiation does to us, it's understandable. May you get good results on your next ultrasound. For now, enjoy your good news and stay well!

nonichol

azkookie18 said:

great news!
Hi Norma,
That is great news!! Did you have liver mets or?
Did they talk about your next steps? It is always nice to get some good news! congratulations!!

az
No mets, at least yet. Just finished my radiation and chemo for anal nightmare. I am happy they think it is gone, however I am still depressed, I know I shouldn't be.
Norma

sephie

ultrasound
congrats!!!!! where did they take the ultrasound. just curious because i have only had CT and proctosigmoidoscopies to check my anal cancer. thanks rhelda

z

Norma
Hi Norma,

I see where you say you are stage IV, could you please tell me why your dr dx you as stage IV. Thank you, Lori

nonichol

sephie said:

ultrasound
congrats!!!!! where did they take the ultrasound. just curious because i have only had CT and proctosigmoidoscopies to check my anal cancer. thanks rhelda

where?
Where on my body? or where physical location? It was an Endoscopic UltraSound, Endo as in my rear end.

nonichol

z said:

Norma
Hi Norma,

I see where you say you are stage IV, could you please tell me why your dr dx you as stage IV. Thank you, Lori

stage iv
Lori,
Well my staging was done at my first endoscopic Ultrasound right before my treatment began. Staging as follows,T4N1MX. You can find staging info on this website. T4, stands for the size, N1 means I had 1 swollen Lymph Node, and MX the M stand for metastasis and X means undetermined if it has spread. From what I understand, I am stage iv because of the size of the tumor, the swollen lymph node and the fact the tumor was invading my vaginal wall.

So, what stage are you?

Norma

sephie

sephie said:

ultrasound
congrats!!!!! where did they take the ultrasound. just curious because i have only had CT and proctosigmoidoscopies to check my anal cancer. thanks rhelda

ultrasound
i have never had one of those. just had incisional biopsy and digital exams and proctosigmoidoscopy and ct. is rather funny how we get different types of exams. i like that i can ask my oncologist about this ultrsd. thingy. it might be because my tumor was at the very end of my anus and snaked into tissue. had an ulcer on the outside tip of anus also which was part of the cancer. thanks

z

nonichol said:

stage iv
Lori,
Well my staging was done at my first endoscopic Ultrasound right before my treatment began. Staging as follows,T4N1MX. You can find staging info on this website. T4, stands for the size, N1 means I had 1 swollen Lymph Node, and MX the M stand for metastasis and X means undetermined if it has spread. From what I understand, I am stage iv because of the size of the tumor, the swollen lymph node and the fact the tumor was invading my vaginal wall.

So, what stage are you?

Norma

Norma
Hi Norma,

I was stage II NOMO Anal verge cancer. The cancer was outside the perianal opening going into the anal canal at the anal verge, and my onco said it was invasive squamous cell. If I remember I was a T2 tumor. I will have to look that up.

I just went through the VATS surgery for a lung nodule, and it was 11mmx9mm, and in the OR there were 2 pathologists who said it was squamous cell cancer, which is the same as what the anal cancer was. Now they have to determine if it was a primary lung cancer, or a metasis. Of course I am praying for a primary lung cancer, as the whole lower right lobe was removed, and that would be the only tx I would require. Now if it is a metasis from the anal, then that would mean the cancer is in the blood stream as I had no lymph node involvment, therefore putting me at either a stage 1A lung cancer, or a stage 4 anal cancer. Lori

mp327

z said:

Norma
Hi Norma,

I was stage II NOMO Anal verge cancer. The cancer was outside the perianal opening going into the anal canal at the anal verge, and my onco said it was invasive squamous cell. If I remember I was a T2 tumor. I will have to look that up.

I just went through the VATS surgery for a lung nodule, and it was 11mmx9mm, and in the OR there were 2 pathologists who said it was squamous cell cancer, which is the same as what the anal cancer was. Now they have to determine if it was a primary lung cancer, or a metasis. Of course I am praying for a primary lung cancer, as the whole lower right lobe was removed, and that would be the only tx I would require. Now if it is a metasis from the anal, then that would mean the cancer is in the blood stream as I had no lymph node involvment, therefore putting me at either a stage 1A lung cancer, or a stage 4 anal cancer. Lori

Just FYI
Ladies, I started a new topic to let everyone know that the National Comprehensive Cancer Network has come out with their 2011 Treatment guidelines. There's a lot of info there about staging. Please check out the other thread and visit their website, get registered, and have all the latest info at your fingertips.

z

mp327 said:

Just FYI
Ladies, I started a new topic to let everyone know that the National Comprehensive Cancer Network has come out with their 2011 Treatment guidelines. There's a lot of info there about staging. Please check out the other thread and visit their website, get registered, and have all the latest info at your fingertips.

Martha
Hi Martha, I saw that thank you, I did go over and look, but I need to get the PDF application, so that the info will display, and I haven't done that yet. Lori

lizdeli

z said:

Martha
Hi Martha, I saw that thank you, I did go over and look, but I need to get the PDF application, so that the info will display, and I haven't done that yet. Lori

Catching up
Hi all, I've been out of town on business and am just catching up. Lori, I'm glad to hear you are feeling better. I was so bummed out to hear about your lung spot. It's a small spot so I'm glad that kept an eye on it. I'll be looking for your posts to see what the doctors say. You are in my prayers.

Norma, it doesn't sound like you are Stage IV since you don't have any mets (thankfully). Sounds like you are stage IIIa or b. Was your tumor larger than 5cm? My tumor was up against the vaginal wall as well. They never said if it truly invaded it or not. On one report I am a T2N1M0 (perirectal lumph node involved) on anohter I am a T4N1M0. My tumor was about 2.5 cm so the T4 is because of the location to the vaginal wall.

Liz

nonichol

lizdeli said:

Catching up
Hi all, I've been out of town on business and am just catching up. Lori, I'm glad to hear you are feeling better. I was so bummed out to hear about your lung spot. It's a small spot so I'm glad that kept an eye on it. I'll be looking for your posts to see what the doctors say. You are in my prayers.

Norma, it doesn't sound like you are Stage IV since you don't have any mets (thankfully). Sounds like you are stage IIIa or b. Was your tumor larger than 5cm? My tumor was up against the vaginal wall as well. They never said if it truly invaded it or not. On one report I am a T2N1M0 (perirectal lumph node involved) on anohter I am a T4N1M0. My tumor was about 2.5 cm so the T4 is because of the location to the vaginal wall.

Liz

the wall
Liz,
Apparently mine did invade the wall. Hopefully you are correct and I am not stage IV. Sounds good to me. Thanks for your input.
Norma

z

nonichol said:

the wall
Liz,
Apparently mine did invade the wall. Hopefully you are correct and I am not stage IV. Sounds good to me. Thanks for your input.
Norma

Norma
Hi Norma, I found the staging information:

STAGE INFORMATION

The anal canal extends from the rectum to the perianal skin and is lined by a mucous membrane that covers the internal sphincter. The following is a staging system for anal canal cancer that has been described by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer.[1,2] Tumors of the anal margin (below the anal verge and involving the perianal hair-bearing skin) are classified with skin tumors.



-- TNM definitions --

Primary tumor (T)
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
Tis: Carcinoma in situ
T1: Tumor 2 cm or less in greatest dimension
T2: Tumor more than 2 cm but not more than 5 cm in greatest dimension
T3: Tumor more than 5 cm in greatest dimension
T4: Tumor of any size that invades adjacent organ(s), e.g., vagina,
urethra, bladder (involvement of the sphincter muscle(s) alone is not
classified as T4)

Regional lymph nodes (N)
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in perirectal lymph node(s)
N2: Metastasis in unilateral internal iliac and/or inguinal lymph node(s)
N3: Metastasis in perirectal and inguinal lymph nodes and/or bilateral
internal iliac and/or inguinal lymph nodes

Distant metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis

-- Stage 0 --
Stage 0 anal cancer is carcinoma in situ. Rarely diagnosed, it is a very early
cancer that has not spread below the limiting membrane of the first layer of
anal tissue. Stage 0 anal cancer corresponds to the following TNM grouping:

Tis, N0, M0

-- Stage I --
Stage I anal cancer is cancer that is 2 centimeters or less in greatest
dimension and that has not spread anywhere else. There is no sphincter
involvement. Stage I anal cancer corresponds to the following TNM grouping:

T1, N0, M0

-- Stage II --
Stage II anal cancer is cancer that is more than 2 centimeters and that does
not involve adjacent organs or lymph nodes. Stage II anal cancer corresponds
to the following TNM groupings:

T2, N0, M0
T3, N0, M0

-- Stage IIIA --
Stage IIIA anal cancer is cancer that has spread to perirectal lymph nodes or
to adjacent organs. Stage IIIA anal cancer corresponds to the following TNM
groupings:

T1, N1, M0
T2, N1, M0
T3, N1, M0
T4, N0, M0

-- Stage IIIB --
Stage IIIB anal cancer is cancer that has spread to internal iliac and/or
inguinal nodes (unilateral or bilateral) or has spread to both adjacent organs
and perirectal lymph nodes. Stage IIIB anal cancer corresponds to the
following TNM groupings:

T4, N1, M0
Any T, N2, M0
Any T, N3, M0

-- Stage IV --
Stage IV anal cancer is cancer that has spread to distant lymph nodes within
the abdomen or to other organs in the body. Stage IV anal cancer corresponds
to the following TNM groupings:

Any T, Any N, M1

Norma, I hope this will help decide what your stage is. I am a T2NOMO anal verge cancer. I think whats confusing is the stage of the tumor for you is a T4, but you are a MX which means that a metasis is not determined and to be a stage IV you have to be a M1 as listed above. So, you are probably like Liz said a Stage III a or b. Maybe you could ask your dr to explain the stage to you. I wish you continued healing.

Lori

nonichol

z said:

Norma
Hi Norma, I found the staging information:

STAGE INFORMATION

The anal canal extends from the rectum to the perianal skin and is lined by a mucous membrane that covers the internal sphincter. The following is a staging system for anal canal cancer that has been described by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer.[1,2] Tumors of the anal margin (below the anal verge and involving the perianal hair-bearing skin) are classified with skin tumors.



-- TNM definitions --

Primary tumor (T)
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
Tis: Carcinoma in situ
T1: Tumor 2 cm or less in greatest dimension
T2: Tumor more than 2 cm but not more than 5 cm in greatest dimension
T3: Tumor more than 5 cm in greatest dimension
T4: Tumor of any size that invades adjacent organ(s), e.g., vagina,
urethra, bladder (involvement of the sphincter muscle(s) alone is not
classified as T4)

Regional lymph nodes (N)
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in perirectal lymph node(s)
N2: Metastasis in unilateral internal iliac and/or inguinal lymph node(s)
N3: Metastasis in perirectal and inguinal lymph nodes and/or bilateral
internal iliac and/or inguinal lymph nodes

Distant metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis

-- Stage 0 --
Stage 0 anal cancer is carcinoma in situ. Rarely diagnosed, it is a very early
cancer that has not spread below the limiting membrane of the first layer of
anal tissue. Stage 0 anal cancer corresponds to the following TNM grouping:

Tis, N0, M0

-- Stage I --
Stage I anal cancer is cancer that is 2 centimeters or less in greatest
dimension and that has not spread anywhere else. There is no sphincter
involvement. Stage I anal cancer corresponds to the following TNM grouping:

T1, N0, M0

-- Stage II --
Stage II anal cancer is cancer that is more than 2 centimeters and that does
not involve adjacent organs or lymph nodes. Stage II anal cancer corresponds
to the following TNM groupings:

T2, N0, M0
T3, N0, M0

-- Stage IIIA --
Stage IIIA anal cancer is cancer that has spread to perirectal lymph nodes or
to adjacent organs. Stage IIIA anal cancer corresponds to the following TNM
groupings:

T1, N1, M0
T2, N1, M0
T3, N1, M0
T4, N0, M0

-- Stage IIIB --
Stage IIIB anal cancer is cancer that has spread to internal iliac and/or
inguinal nodes (unilateral or bilateral) or has spread to both adjacent organs
and perirectal lymph nodes. Stage IIIB anal cancer corresponds to the
following TNM groupings:

T4, N1, M0
Any T, N2, M0
Any T, N3, M0

-- Stage IV --
Stage IV anal cancer is cancer that has spread to distant lymph nodes within
the abdomen or to other organs in the body. Stage IV anal cancer corresponds
to the following TNM groupings:

Any T, Any N, M1

Norma, I hope this will help decide what your stage is. I am a T2NOMO anal verge cancer. I think whats confusing is the stage of the tumor for you is a T4, but you are a MX which means that a metasis is not determined and to be a stage IV you have to be a M1 as listed above. So, you are probably like Liz said a Stage III a or b. Maybe you could ask your dr to explain the stage to you. I wish you continued healing.

Lori

stage
I do not find stage 3b to be much more comforting than stage 4. As my metasis is undetermined (note: none of the stages even mention MX). Also, from what I have read since one lymph node was swollen, cancer can travel that way or it could travel through the blood vessels since it had invaded my vaginal wall.
Of course, I have been depressed for awhile now so perhaps my outlook is skewed. Bottom line it seems to me is now I play the waiting game to see if it show ups in my liver, lungs or somewhere else. But actually I still need my next ultrasound to make sure tumor is gone, as that will be my two month mark after treatment. The Doc seems pretty sure it is gone, absolutely sure would be better.
Norma

mp327

nonichol said:

stage
I do not find stage 3b to be much more comforting than stage 4. As my metasis is undetermined (note: none of the stages even mention MX). Also, from what I have read since one lymph node was swollen, cancer can travel that way or it could travel through the blood vessels since it had invaded my vaginal wall.
Of course, I have been depressed for awhile now so perhaps my outlook is skewed. Bottom line it seems to me is now I play the waiting game to see if it show ups in my liver, lungs or somewhere else. But actually I still need my next ultrasound to make sure tumor is gone, as that will be my two month mark after treatment. The Doc seems pretty sure it is gone, absolutely sure would be better.
Norma

I will think good thoughts
I will think good thoughts for you, Norma, for your next ultrasound. May it show no more tumor and may you have no mets anywhere! I will keep you in my prayers.

Martha

lizdeli

mp327 said:

I will think good thoughts
I will think good thoughts for you, Norma, for your next ultrasound. May it show no more tumor and may you have no mets anywhere! I will keep you in my prayers.

Martha

Norma
Hi Norma,
I know it's scary. Since the anal wall and vaginal wall are so close the tumor grew in that direction (in my case). So from what I learned, it wasn't because it moved via blood or cells, it's the way it grew, thus it wasn't considered a met.

Regardless, I was very upset. There were others on another forum who had the same situation. Some 3 plus years ago, one 5 years ago. Both are still around and NED. Of course we worry, but what's more important about the stage is the care we get and how we heal. We have very good odds. I say all this because I recall myself going through the early stages just beyond myself. I didnt' find this forum until after I finished treatment so I felt very alone in the world of anal cancer. I feel that if I had found this site during treatment it would have alleviated much stress.

I was able to have full OBGYN exams and my doctors treating me included vaginal ultrasounds post treatment. It all came back clear.

Wishing you the same results!
Liz

nonichol

lizdeli said:

Norma
Hi Norma,
I know it's scary. Since the anal wall and vaginal wall are so close the tumor grew in that direction (in my case). So from what I learned, it wasn't because it moved via blood or cells, it's the way it grew, thus it wasn't considered a met.

Regardless, I was very upset. There were others on another forum who had the same situation. Some 3 plus years ago, one 5 years ago. Both are still around and NED. Of course we worry, but what's more important about the stage is the care we get and how we heal. We have very good odds. I say all this because I recall myself going through the early stages just beyond myself. I didnt' find this forum until after I finished treatment so I felt very alone in the world of anal cancer. I feel that if I had found this site during treatment it would have alleviated much stress.

I was able to have full OBGYN exams and my doctors treating me included vaginal ultrasounds post treatment. It all came back clear.

Wishing you the same results!
Liz

Thanks Liz
Liz,

Well, I mean cancer cells can travel through the blood vessels because the tumor invaded the vaginal wall. Yesterday, I realized I could be hit by a bus next week or next year, so worrying about cancer is a waste of time really. Oddly enough that made me feel better.

I am returning to work tomorrow, so I feel better about that too. Perhaps, I will get back to a little saner state of mind. Working is better than chemo and radiation, LOL.

I am glad I found this site before my treatment began, I wish you had too. Others do not understand if the have not been through it. So, I can imagine how alone you must have felt.

Thankss or you input. Thanks to everyone else also for helping me through this.

Norma

nonichol

nonichol said:

Thanks Liz
Liz,

Well, I mean cancer cells can travel through the blood vessels because the tumor invaded the vaginal wall. Yesterday, I realized I could be hit by a bus next week or next year, so worrying about cancer is a waste of time really. Oddly enough that made me feel better.

I am returning to work tomorrow, so I feel better about that too. Perhaps, I will get back to a little saner state of mind. Working is better than chemo and radiation, LOL.

I am glad I found this site before my treatment began, I wish you had too. Others do not understand if the have not been through it. So, I can imagine how alone you must have felt.

Thankss or you input. Thanks to everyone else also for helping me through this.

Norma

work
Returning to work was great. My first day was 12 hours, which is a normal day for me. I felt better than I thought I would and it helped my emotional state of mind. Ah perhaps I can leave the Twilight Zone now.
Norma