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Am I Stage IV?

kbienapfl's picture
Posts: 61
Joined: Sep 2006

Hi All. I have only posted a few times and quite frankly I thought this board was in my past. I would appreciate any insight you might have regarding my current battle.

July 2006 (age 46) I was diagnosed stage II rectal cancer. At that time my treatment was 5-FU/radiation. No surgery, as there was no evidence of tumor after treatment. I thought I was done!

Fast forward, May 2007. PET scan results showed tumor in lung. Surgery for tumor June 2nd. Surgeon was able to remove tumor, but the lining of my lung was also found to have cancer. This was not able to be removed, as the surgery would have been too extensive.

I am now undergoing treatment with Folfox6 and Erbitux.

Is this considered Stage IV cancer? When I asked my oncologist this, he shrugged and said "not really". I'm confused.

Also, are there others out there that have dealt with this? Any idea of prognosis?

Yes, I am scared and would appreciate your input.


StacyGleaso's picture
Posts: 1249
Joined: Mar 2003

Maybe this can help....

Stage 0 or carcinoma in situ
Carcinoma in situ is very early cancer. The abnormal cells are found only in the first layer of cells of the primary site and do not invade the deeper tissues.

Stage I
Cancer involves the primary site, but has not spread to nearby tissues.

stage IA:
a very small amount of cancer - visible under a microscope - is found deeper in the tissues.

stage IB: a larger amount of cancer is found in the tissues.

Stage II
Cancer has spread to nearby areas but is still inside the primary site.

stage IIA: cancer has spread beyond the primary site.

stage IIB: cancer has spread to other tissue around the primary site.

Stage III
Cancer has spread throughout the nearby area.

Stage IV
Cancer has spread to other parts of the body.

stage IVA: cancer has spread to organs close to the pelvic area

stage IVB: cancer has spread to distant organs, such as the lungs

Recurrent disease means that the cancer has come back (recurred) after it has been treated.
Once a stage is assigned and treatment given, the stage is never changed. For example:

If a stage I cancer of the cervix is treated, and two years later a metastasis is found in the lung, it is not now stage IV, but remains a "stage I, with recurrence to the lung." However, some cancers may be re-staged.

The important thing about staging is that it determines the appropriate treatment, provides a prognosis, and allows for comparison of treatment results between different treatments.

From this web site: http://www.healthsystem.virginia.edu/uvahealth/adult_gyneonc/diagnosi.cfm

nudgie's picture
Posts: 1482
Joined: Sep 2006

The information given in 2006 was that from a Pathology Report?

Also you could always get 2nd & 3rd opinions from other Oncologists to determine the correct path of treatment.

Here are some other sites:






Posts: 8
Joined: Jul 2007

Even though it's scarry don't be afraid. Investigate, learn about your disease, and talk to others. I would appreciate it if you shared your experience with Erbitux with me as that's my next treatment plan. My cancer started in my cecum and spread to my liver, lungs and distant lymph nodes. Treatments now are better than 5yrs ago and I know even better treatments are coming.

kbienapfl's picture
Posts: 61
Joined: Sep 2006

Hi What2do,

Thank you for responding. Regarding the Erbitux, I have only had one infusion thus far. I broke out in the rash (80% of patients receive it) about one week after the infusion. Thus far, it is not painful. It is on my back, chest, face, scalp and ears. The worst part on me is my back. It looks very much like bad acne.

So far I have not experienced any pain. We will see what happens as we progress with future infusions.

Best of luck to you.

Posts: 304
Joined: Dec 2005

My husband has been on erbitux and irinotecan for 20 months now....it is keeping his cancer stable. He has had quite a history with the rash.....finally found meds that control it--soriatane and keflex. If you need more info -just let me know. I would be happy to spare anyone the tough journey my husband had with the rash. The good news is that anyone responding with the rash-it has been proven that it means the erbitux is working for you!

sladich's picture
Posts: 430
Joined: May 2007

The pathology report should have confirmed whether it was colon cancer or lung cancer? At the time of my surgery to remove my upper left lung, the surgeon didn't know which it was. It wasn't until a few days later that the pathology report came back and confirmed colon cancer. This bumped me up to a Stage IV. Hope this helps.


P.S. I would think your oncologist would want to know which type of cancer it was. Different treatments???

kbienapfl's picture
Posts: 61
Joined: Sep 2006

Hi Debbie, yes, the pathology came back as the same cancer. Squamous cell rectal. So, Stage IV.

Please tell me about your experience with the cancer in your lung. Did your cancer invade the lining? How much did they remove? Have there been adverse effects since surgery?

sladich's picture
Posts: 430
Joined: May 2007

Hi Kathy,

The tumor was found in my lower-left lung. It measured about 1cm. I was asked before surgery if I just wanted the tumor removed or the whole lower-left lobe. I chose the lower-left lobe. The lymph nodes came back clear. I don't notice any difference in my breathing, etc. I've been off chemo since mid-January 2007 and I feel great. I started walking/running again. It feels good. Let me know if you need more info. Best of luck!


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