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Question re: lymph nodes

vinny1
Posts: 10
Joined: Nov 2006

Hi,
I found this website last night and I am so grateful, very inspirational. My husband was diagnosed with rectal colon cancer end of July 06. He has been told he is a stage II. The MRI showed up some suspicious lymph nodes but they do not know if they are positive. He is being treated as a stage III; has gone through radiation and chemo which went very well, tumor has shrunk at least 50% if not more and has surgery Dec. 7. I am so anxious as one lymph node is away from the site (but still in the field of radiation) - it is an iliac node. The surgeon says he will probably not be able to remove this node, too dangerous. I am very anxious and confused as I get different stories. Radiologist says, its common, surgeon says its rare, not the normal path cancer follows. Radiologist thinks this is curable, surgeon says, well if the nodes are positive this dramatically changes your prognosis. Does this further site mean distant metastisis, can anyone shed any further light? We have been told by the radiologist we are going all out for a cure while the surgeon on the other hand didn't mention the word cure again and could not tell me what it would mean if this node was positive and could not be removed. I have been told by both I am fixated on the nodes. I am so afraid of the pathology results. My husband is amazing, very positive, very strong intending to beat this. Thanks again for all the inspiring messages, just what I needed!

kangatoo's picture
kangatoo
Posts: 2115
Joined: Feb 2004

Hiya Vinny...jest a little pep talk for yah here gal.Sorry to hear of his dx but hey...yer gunna make some friends here and you will find all tha support yah need too.Just scusey my eeengwish 'cos bein an ozzie I talk funny but don't hold that agin me.Anyway, hopefully the node will be ok and then they only have to "constipate" on tha rectal region. I wanted to lift your spirits a tad gal and tell you that I was stage 2(sigmoid cancer). I was fortunate because they said I "may" need a colostomy....luckily the cancer was not low enough and I escaped that.And.....even if that was the case with your hubby...here's a little extra good news. A friend of mine over here was also stage 2, needed a colostomy and is still alive n kickin today...18 years later!
Me?....well I am currently NED(no evidence disease) and have been for 2 years 9 months. I was not given an all out prognosis before surgery. The surgeon and specialist both told me a "wait and see" approach needed to be taken until they could have a good look inside me.Keep yah chin up gal as there are plenty of us stage 2'ers doing well!

alta29's picture
alta29
Posts: 435
Joined: Mar 2005

When spread just to lymph nodes is ussually DX as a stage 3. To be a stage IV it has to be in mayor organs...liver, lungs,bones, ovaries...Stage 3 have a verryyyy good chance.and as you read...there are a lot of stage IV survivors here, including myself...(just had a recurrance, but chemo is working)Like many people here will tell you fallow a diet...(there are many experts here with awesome survival stories.
God bless

vinny1
Posts: 10
Joined: Nov 2006

Thank you for your reply. Yes I know stage 3's have a very good chance at a cure. I spoke with one lady whose Mother and Father had colon cancer. Her Father had 12 positive lymph nodes and has been clean for 11 years!!!! I also spoke with a woman who 10 years ago had been given 6 months to live, colon cancer had spread to her liver. Well it's been 8 years now and although she still has tumors on her liver they haven't done anything in 8 years. I do have a question for you, from what I have researched rectal colon cancer is more likely to spread than colon cancer, any more info. on that? Thank you for your inspiration.

vinny3's picture
vinny3
Posts: 933
Joined: Jun 2006

Hi, welcome to the group. I had rectal cancer dx in April 2005. I was treated initially with chemo/radiation. Had a dramatic response. I had a local excision then two months later and no cancer cells were seen. However, I believe the surgeon did not remove all of the scar left from the chemo/radiation and 8 months later the tumor came back in almost the same spot. I then had an AP resection with a colostomy done in April of 2006. I then had 4 months of chemo which I just stopped.
On my scans a prominent lymph node was also mentioned but remained stable throughout the repeat scans. I have not had any scans since the surgery and will probably have one in March. My oncologist thinks doing one now would be negative since I had no evidence of disease after my last surgery.
Sorry for this long note but your husband's situation is somewhat similar to mine. The one thing that another oncologist told me is that with having the chemo/radiation before the surgery they have a more difficult time with adequate staging as the lymph nodes tend to shrink. At the time of my last surgery only 8 lymph nodes were removed. The more that can be removed, the better for accurately staging the disease. Do you know what surgery they plan for him? Usually for rectal cancer it will depend upon how close it is to the opening.

Hope this information is helpful. Dick

vinny1
Posts: 10
Joined: Nov 2006

Hi Dick,

Thank you for your response. Congratulations to to the end of your chemo! Where was the prominent lymph node, was it malignant and why was it not removed? What stage were you diagnosed at? I'm not quite sure what you mean by what surgery they plan for my husband. They are going through the abdomen (the tumor is quite low in the rectum) and they will try to put in a J pouch. He will have a temporary colostomy and shortly after surgery will have chemo. Thank you again for your reply and support

vinny3's picture
vinny3
Posts: 933
Joined: Jun 2006

I don't have my records with me but as I recall the node was in the pelvis but was noted at the beginning and never changed. I haven't had a scan since surgery so I don't know if they got that particular node out. I am not worried about it since it had been stable for so long. whether it is removed at the time of surgery will depend upon how difficult it is to reach. There are alot of nerves and vessels there which they (and you) would like to keep intact. Regarding the type of surgery it usually depends upon how low it is. Mine was just invading the sphincter muscle so the whole rectum and anus were removed. If it is a little higher (above 5 cm from the opening I believe) they can do an Anterior Resection in which one can be connected back later on. If he would end up with a permanent colostomy it is not that bad or difficult to handle.
Dick

Moesimo's picture
Moesimo
Posts: 1080
Joined: Aug 2003

Prior to my surgery, they could not determine if I was a stage 2 or a 3. There was a questionable lymph node on a cat scan, but it did now show on the endoscopic ultrasound. I was treated as a stage 3 with preop chemo and rad. Then I had a cat scan to check everything prior to my surgery. There was a questionable enlarged lymph node near my heart. The surgeon was able to remove it, it take him about 2 hours and alot of work during my surgery. It also was not the usu. path of mets. I did not sleep for a week.

I guess my point is, relax, take a deep breath. Could the surgeon maybe get a piece of it for pathology.

ps I ended up with 2 positive nodes where the tumor was.
Maureen

vinny1
Posts: 10
Joined: Nov 2006

Hi Maureen,

Thank you for your info. You were lucky that the surgeon was able to remove this node. Yes, they hope to biopsy the node in my husband. My main worry is that is it in fact malignant and they have to leave it in there. Also, from researching on the net, when lateral lymph nodes are involved the prognosis seems dire, especially when in comes to iliac nodes. I am gaining all this information myself, the surgeon would not give anything and the radiologist seems to think that this is not a huge deal, worrisome yes but he seems optomistic. I start to think that maybe there are more nodes in that area, I can't help remembering what the surgeon said, sometimes the nodes are not picked up. Anyway I am thankful for this site, I think I will gain better info. here than browsing the net. Thank you again, good luck to you.

spongebob's picture
spongebob
Posts: 2599
Joined: Apr 2003

Ahoy, Mrs. Vinny!

Not to knock on surgeons, but... remember that surgeons make their living by cutting stuff out. Their focus is on removing the bad parts or going in and doing physical repair to broken parts. If a surgeon can't go in and cut something out or fix it, his mindset would normally be that it won't be as easy to fix. Surgeons aren't always right (but try telling one that!). A perfect example is my surgeon telling me I wouldn't ever bea swimsuit model. Hello? I seem to recall modeling a swimsuit in a certain 2006 calendar! See they don't know it it all.

I would suggest talking to your oncologist. they are trained to merge ALL available disciplines - surgery, radiation, pharmacology, and - if you're lucky - diet and nutrition and other eastern medicine theories.

Be well...

- SpongeBob

jerseysue's picture
jerseysue
Posts: 626
Joined: Oct 2005

Interesting that he is going to get a J pouch. I haven't heard of anyone on this site having one. I have a friend who has one not because of cancer but because of colitus. I have stage IV as of 4/05 and it has come back I'm working on round 2 chemo. I also have colitus and I'm going to talk to my gastro doc about a J pouch. I have a colostomy right now.

vinny1
Posts: 10
Joined: Nov 2006

Hi,

You're right you don't hear about J pouches for rectal cancer. From what I remember he is getting a J pouch to make bowel movements "a more quality experience". It is not 100% that he will get this - only if it can work out during surgery.

ron50's picture
ron50
Posts: 1720
Joined: Nov 2001

HiVinny,
I'm not sure how the lymphatic system works in the rectal area , my cancer was in the descending colon. The nodes there are regional and are in the flange that joins the colon to the body. When they removed the cancer they take what they call a field which is the cancer ,with clear margins,and the flange containing the blood supply and regional nodes. When they removed my cancer the field contained 13 nodes ,six of which were cancerous. I had chemo every tuesday for 48 weeks and have been ca free since jan 98. Best of luck .
Ron.

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

Aw, Sue.....I have the one that Vinny is speaking of....done to create a new rectum when the old one is removed....uses part of the descending colon....usually when, like my case, the sigmoid colon is also removed. Gives a storage area...just like a J-pouch when all of the colon is removed.

Hugs, Kathi

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

Hey there. There is DEFINATELY hope!!!
Officially I was stage III rectal cancer. Squamous cell, which is sort of the wrong cancer for the rectum...but, there you are! One node 'interested'. In what, I don't know to this day!

Pre-surgical chemo/rads completely blew away the tumor. I decided to go ahead with the resection, because there was darn few stats on it, and all the frozen sections came back clear. No cancer. 12 nodes removed. Same thing. 1 1/2 years post-surgery, I have mostly normal bowel function, no external bag (found a surgeon who specialized in low-bowel resection). Also had a hysterectomy during the surgery.

"I went with a colon, came out with a semi-colon, and lost my period. So are the punctuations of MY life!"

Hugs, Kathi

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

both the surgeon and the radiologist are mechanics; they deal with their respective tools, and state their opinions based upon what they know..problem is, they don't always know, and even if they do, they are not likely to give you straight answers unless you really back them into a corner, which in my opinion, just results in qnother opinion.
More important than anything is your husband's attitude..it can shrink or kill tumors faster than any procedure..I have witnessed miracles-pray for a miracle. Bud

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