Question about cure T4,N1,M0

Anne1986

My father is currently undergoing treatment for T4,N1,M0 anal squamous cell carcinoma (some of this terminology is still mew to us). He just completed his week 3 of radiation olus oral chemo tablets. When discussing prognosis his doctor was first very positive of cure. Later, on the basis of his latest MRI right before start of treatment (difference between first diagnostic MRI and start of treatment almost 4 months. Long story) he stated ‘since involvement of skeletal muscle the probability of achieving full cure much less as difficult to eradicate from ‘adjacent structures’. As my father was about to start his chemo/radio after a harrowing 4 minths wait which included an emergency stoma we did not press on to doscuss this. Earlier it had been diagnosed as T3N1M0 and doctor had given a curative percentage as high as 84%. Can anyone shed light on how low the initial percentage for cure would be due to the ’skeletal muscle’ involvement? I know he is the best one to clarify but I teally don’t want to demoralize my father during his treatment as doctor also said that there is no affect on proposed treatment of this new finding.

ACinNC

Skeletal muscle

Hi Anne1986,

So sorry your father got this unwelcome news after initially receiving a better prognosis.  It seems there must be more to the report that would provide a better understanding of his stage. Do you have access to the written reports to know what organs, nodes, or structures are involved? 

The only muscle I can think of that could be involved in proximity to an anal cancer is the pelvic floor muscles, specifically  the elevator ani which are outside the rectum.  And as I understand it, treatment is unchanged if it is involved.  The area of radiation is expanded to include the involved muscle. That is just what happened to me.  I haven't asked about my statistics. Rather, I wanted to get through therapy and see how I came out on the other side. I was T4 N3 M0.  The earlier a tumor is caught and the lower the stage of course gives you better odds. If the doctor didn't know the full extent of his cancer, he may have thought he was an earlier stage.

What your father needs now is support and encouragement as he heads into the roughest weeks of his therapy. For most of us the last couple of weeks can be brutal.  And he should not be worried about things that are out of his control for the time being. Once he has recovered from the worst of it, he can seek out other opinions if it looks like they didn't  get it all.  Keep in mind that radiation continues to work on killing the cancer for many weeks after it is completed. So they may not know for some months.

I am sure others will chime in with their understanding of odds.

Let us know how he is doing.

feckcancer

t4n1mo

i am not sure if this is right but apparently the radiation to tumour and lymph node (s) kills the tumour +cancer cells in lymph node(s) and the chemo makes the radiation more intense plus kills any cancer cells that might be floating around in the body . t4 means stage 4 which means the size of the tumour. but n1 means only 1 lymph node involved and m0 means it has not spread amywhere else  (metastasized) . involvement of skeletal muscle probably means tumour has grown into a muscle attached to a bone. but i am not sure i am not a doctor. hope this helps. good luck

hope all goes well

 

Wisteria83

Staging

When I first saw my rad onc, he told me he planned to cure me.  He was very optimistic.  He thought I had T1 or 2, N0, M0.  After my PET scan he changed that to T4, N0, M0.  Still with plan to cure.  The tumor had also invaded my vagina.  So staging can change depending on what scans show.  I'm over a year past treatment and so far, so good.  I have lots of issues from treatment, like fecal incontinence, bladder incontinence, vaginal stenosis, but I'm still here and so far there is no cancer in my body according to scans and anoscopies and DRE's.  Radiation does damage your body, but it also kills cancer cells, so I'm just glad to be here, even dealing with the side effects, I keep telling myself it could be worse.

I think your dad should come out of this ok.  He may have side effects that could last a lifetime, but at least he'll still be here.  Stay with positive thoughts.

 

Anne1986

Thank you ACinNC, Feckcancer

Thank you ACinNC, Feckcancer and Wisteria83 for your replies. They have been very informative and helpful in understanding what the technical terms mean for my dad practically. I realize that at the end of the day cancer is cancer and you never can quite predict how things will go on basis of stats etc. BUT it has been very reassuring talking to you all and reading ur responses. My dad is doing alright so far in terms of side effects. Will continue focussing on one phase at a time and not try to do calculations. Two and a half more weeks of chemo-radiotherapy for him. Will keep focussing on positives. My thoughts and prayers for you all. Will keep you posted.