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A little help on diagnosis please

mwellsg
Posts: 66
Joined: Jan 2011

I am obviously head and neck with tumor at base of tongue and two lymph nodes involved.

Here is their little cryptic code:

T2N2cM0

So I read that as T2: tumor is a stage (or is it size) 2 out of 4.
N2c: both side lymph nodes involved, but what is the c
M0: no metastasis

Do I have it right? They say I am stage IVa - how does that relate to their coding?

I thought I had the worst form of this you could get listening to them, but there seems to be a little encouragement in this.
No fluff, now. If it's not encouraging, you can say so.

I am not suggesting the treatment isn't going to be a b*+#€, but maybe I'm a little better of than I thought.

Mike

Skiffin16's picture
Skiffin16
Posts: 8297
Joined: Sep 2009

T2N2cM0

T2 = Tumor
N2c = Metastasis in bilateral (both) or contralateral (opposite side) lymph nodes, none more than 6 cm in greatest dimension.
M = Metastases
0 = 0 (no metastases)

H&N Staging

According to the chart on the site I linked above, the T2N2c is what causes the STG IVa for you (I believe).

Hope this gives you the detail you are seeking...

Best,
John

Pumakitty's picture
Pumakitty
Posts: 652
Joined: Mar 2010

This sounds very much like what my dad had, only his tumor was a size 3 or 4. I think he only had nodes involved on one side. He finished treatment of 6 weekly chemos and 35 rads in June of 2010. He is doing great. The treatment was really rough, but he made it through. He has his next scan in March. When he had one 2 monthes after treatment there was a spot lighting up on his tongue. He oncologist is pretty sure it was scar tissue.

You can make it through the this treatment and beat this horrible thing. Please never hesitate to ask this group and questions. Our family could not have gotten through this the way we did without the people on this board.

Kathy

ratface's picture
ratface
Posts: 1320
Joined: Aug 2009

T2N2cM0

T2: tumor is larger than 2cm across, but smaller than 4 cm (about 1 /1/2 inch)

N2c: the cancer has spread to one or more lymph nodes on both sides of the neck or on the side opposite the primary tumor, but none larger than 6cm across.

MO: no distant spread

Your staging is comming out of the "N2" classification, second option.

option 1- one lymph node on the same side of the head and neck (3-6cm across)
option 2 (you) one lymph node on the opposite side of the head and neck (less than 6cm across)

option 3- more than one lymph node (either side, all smaller than 6cm across)

ratface's picture
ratface
Posts: 1320
Joined: Aug 2009

and it would not change your stage. The "c" is the abc-c or 1-2-3- part of N2. It's just item "c". It's aphabetic, it does not stand for CANCER.

mwellsg
Posts: 66
Joined: Jan 2011

How did people get thru this stuff before this forum. As they say down here - all ya all - are great. Thanks again.

MarineE5's picture
MarineE5
Posts: 926
Joined: Dec 2005

Mike,

I am reading the same as Ratface, T2- Tumor sized between 2cm and 4cm. Your N2c is lymphnodes involved on both sides and M0= no Metastasis/ no spreadig to other areas.

Of course the way to handle this is going to be up to you and the Doctors. I had lymphnode involvement on one side only. So, I had a Radical Neck Disection done, part of my tongue removed, trache, and PEG Tube. But, that was 6 years ago and things have been improving quickly since that time. Many people get the Robotic Operation now and don't have the same side effects as I do.

In my case, I only had Radiaton as the Surgeon and Radiation Oncologist wanted to keep Chemo as my safety net in case the cancer returned.

As mentioned, come here often with questions to get answers. Lean on us for support when you need it.

My Best to You and Everyone Here

mwellsg
Posts: 66
Joined: Jan 2011

Thanks for feedback, what do you think of this:

I pressed the doc on killing it and keeping it away. He said killing it was pretty sure. Said i'm a dream parient because I'm in shape, no other illness, good nutrition, ... But he said this bugger is "level 3", in his words "potent".

So I asked him if low dose chemo and 30 radiation treatments was the only course. He said we could start with high dose strong chemo, weaken the cancer and shrink it as much as possible and then follow with low dose chemo and radiation. Says he thinks I can take it and it will have a better chance of not only killing what I have now, but stopping it from coming back.

What do you guys think?

Pam M's picture
Pam M
Posts: 2196
Joined: Nov 2009

Induction chemo for three rounds (three "heavy hitters"), followed by weekly carboplatin with radiation for seven weeks (well, six - had one chemo canceled for failing blood test). What my doc said was "I think your body would be able to tolerate it". Now they say I tolerated treatment fantastically. I did end up having to have a modified radical neck dissection nine months after rads ended, though (started with primary tumor and two bad lympn nodes - one of the nodes survived the chemo and rads, and started to grow and become more active again). If I could go back a little in time and change my treatment, and skip the induction chemo, I would not - I'd do both the induction chemo and chemo rads. Course, there are folks here, I'm sure, who would say that they would not do the induction chemo. I think a lady here had a doc tell her it would not improve her odds. I know it's rough, constantly second-guessing yourself, and trying to come up with the best possible game plan. Do well.

Skiffin16's picture
Skiffin16
Posts: 8297
Joined: Sep 2009

Never any guarantees it'll not come back.

But having the same regime you speak of personally. An from what I've read, that course is one of the current stradegies they are using with very promising results.

Best,
John

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