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Question about a CT Scan

Nico08
Posts: 19
Joined: Aug 2014

In regard to a CT scan, does a finding of "no evidence of metastatic disease" suggest there is no cancer in lymph nodes?  If "no evidence of metastatic disease" is the finding based on a CT scan, approximately how reliable is that finding in regard to whether the cancer has invaded the lymph nodes? Also, the CT scan report also says that there is no inflammation surrounding the area of the descending colon, where the tumor is located. And there is no bowel dilatation.  I have surgery scheduled for next week and I know that pathological staging is better than radiological staging, but I am just trying to get a sense of what I am dealing with here.  Thanks.

 

Trubrit's picture
Trubrit
Posts: 4964
Joined: Jan 2013

I don't know anything about inflamation. Sometimes I think I don't know anything about anything. I just pretend. 

Good luck with your resection. What date are you scheduled for? 

 

Nico08
Posts: 19
Joined: Aug 2014

I am scheduled for 9/19/14, Friday.  I will have it done at MD Anderson/Cooper in Camden, NJ. It will be laparoscopic, unless the surgeon can't do it that way.  He predicts I will be in the hospital for four days.  He says it will take about 3 hours. I am anxious about the surgery, because I never had surgery before, I fear complications, or that they will find something worse once they are in there.  But I also feel like I have no choice, if I want a chance at surviving, I need this surgery.

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

Sounds like you cancer may be contained in the colon, which would be great. I wonder why they didn't do a pet scan, but you may have not seen an Oncologist yet. Hope it remains the same. 

 

Try not to worry, stress will do you more harm than good.  You come to the right place to ask questions. 

 

Stay Strong. 

 

Trubrit's picture
Trubrit
Posts: 4964
Joined: Jan 2013

...but having the surgery is the right choice, in my opinion. 

I have had 11 surgeries, nine major. No real complications. Had an infection once, and wouldn't heal for a while. The rest were fine. Your's will go fine too. 

Keyhole surgery is great, with a quicker recovery time.

I hope that all goes well, and that they can remove the tumour with the keyhole surgery. If not, you'll do fine with a regular incision. Just have to follow Doctor's orders, eat healthy and you'll heal in no time. 

I will be flying to England on the 19th. I will raise a glass of water to you. 

Sue - Trubrit

Nico08
Posts: 19
Joined: Aug 2014

Thank you for the kind thoughts!

Easyflip's picture
Easyflip
Posts: 588
Joined: May 2013

That all sounds like good news to me. They will probably remove lymph nodes in the area of the tumor and check each one. I had 23 removed which seems high but my surgeon said he likes to be extra careful. They also see exactly how far the tumor has invaded into the colon wall and they grade the 'look' of the cells that make up the tumor. The surgery is safe and I recovered no problem. Good luck!

JanetRotundo
Posts: 13
Joined: Sep 2014

I just had my surgery on August 26 - robotic  assisted laproscopic. It was a much easier recovery than full open incision. I was in the hospital for 6 days, but spent much of each day walking the halls to build up my stamina. My CT scan showed one lymph node that was inflammed, and at surgery I acutally had 2 nodes that were positive. They did an abdominal scan which did not show any other spots, and I have a chest CT on Monday to check my lungs. My chemo starts on the 30th. I was very apprehensive before everything started, but many of the nurses on duty during my time on the surgical ward were actually overflow from the oncology wing so they spent a lot of time talking to me and explaining test results and future processes. I have only been a member of this site for a few days, but everyone is wonderful here and there are no "dumb" questions! 

Nico08
Posts: 19
Joined: Aug 2014

I am glad you made it through the surgery safely and I thank you for sharing your experience with me.

Yolllmbs's picture
Yolllmbs
Posts: 361
Joined: May 2014

Did not show anything in my lymph nodes.  I had the surgery in April and they found 2 positive lymph nodes out of 15.  They believe they removed all of the cancer.  I was not staged until the surgery and have been staged with IIIb.  I had 4 1/2 feet of colon removed.  I had cancer in the transcending and the sigmoid.  They removed it all.  I walked the halls and recovered from my surgery very well.  I went straight into Folfox chemotherapy.  I'm scheduled for 12 and I've done 8.  I feel like my medical team has been right on every time.  I got second opinions from the Mayo clinic but nothing changed.  I'm scheduled for round 9 next week.  I will tell you the people on this board ROCK!  All questions are good ones.  Good luck on your journey.

 

Yolanda

Phil64's picture
Phil64
Posts: 835
Joined: Apr 2012

Many of us have successfully gone through this type of surgery. And I agree with others, surly the surgery is the right choice. You will learn more after surgery.

Regarding scans. There are three types of imaging technologies commonly used to look for metastasis cancer. 1) CT Scan, 2) PET Scan, 3) MRI

They are all similar in that they create images of your internal organs. They are all limited in that they can not detect microscopic cancer cells. And they differ in how effective they see different parts of our body. They also differ in cost and time to take the images.

In my case CT Scans have proven reliable for seeing cancer in the lungs but unreliable for detecting cancer in the liver.

PET Scans have proven partially reliable for me. I recon a PET Scan similar to taking A movie vs. a still picture. And the "movie" is the metabolic activity in your body. Specifically it is trying to capture pictures of cancer cells taking in sugar. Hence the read a PET as uptake spots. In my case PET scans did detect a tumor on my colon where no other imaging did.

MRI was effective at detecting cancer in my liver. Both PET and CT showed a healthy liver where the MRI found tumors.

You can learn a lot more about these scans by googling PET vs CT vs MRI.

Another major tool used that may indicate the presence of metastasis Colorectal cancer (mCRC) is a CEA blood test. This only proves useful in some cases. In my case CEA is strongly correlated with the cancer growth.  When CEA has rissen we found cancer metastasis in my liver. Also important to note is CEA was not detectable when I had mets in my lungs and colon. only when in my liver.

Phil

Nico08
Posts: 19
Joined: Aug 2014

Hi Phil.  Thanks for the information.  After the colonoscopy that led to a preliminary diagnosis of colon cancer, the only other scan that I had was a CT scan which indicated that there was no evidence of metastasis.  I will have colon resection surgery on 9/19/14.  I gave blood for a CEA test during pre-admission/surgery clearance, but have not received the result on that at this time.  Should I have had a PET or an MRI before the surgery?

annalexandria's picture
annalexandria
Posts: 2573
Joined: Oct 2011

I believe the CT alone tends to be pretty effective at "seeing" mets in the liver and lungs, two of the main areas where spread tends to occur.

When the cancer spreads more locally, to other areas in the colon, the peritoneum (lining in the abdomen), and the lymph nodes, the CT can fail to pick up that spread.

But I think that the colonoscopy would have shown whether or not the tumor was fully contained in the colon (once it starts breaking through the colon wall, you get moved up to a higher stage).  Did they mention this in your report?

Without a PET to show possible lymph node involvement, I would want my surgeon to take as many as they can.  I had 38 nodes removed (5 cancerous), which seems like a lot, but I have read that the more they take, the better one's prognosis tends to be.  Despite the involvement of my nodes, I never had further spread through that route, and I've been NED (no evidence of disease) for almost 3 years after a stage 4 diagnosis.  So I do think it may help to take extra nodes out just to be on the safe side.

Stay strong, and let us know how you're doing after surgery!

Big hugs~AA

Nico08
Posts: 19
Joined: Aug 2014

Hi Annalexandria.  The colonoscopy report did not state whether the tumor was fully contained within the colon wall, unfortunately.  The CT scan did not say anything about the colon tumor at all, nothing about whether it appeared on the outside of the colon.

I told the surgeon I want as many lymph nodes removed as possible, but he said that part of what he can remove is dependent on my own anatomy which he will not know until he gets in there.

The second opinion on the colonoscopy biopsy came back from Columbia.  The original biopsy report stated- ulcerated colonic mucosa with at least intramucosal carcinoma and focal area with changes consistent with early invasion.  The Columbia report states- adenoma with high grade dysplasia (intramucosal carcinoma).  Biopsies are superficial and submucosal invasion cannot be assessed.

Is either of these reports more encouraging than the other?

Coppercent
Posts: 158
Joined: Jan 2012

I personally would not stress whether it was a PET or CT for right now.  My first pre-surgery CT picked up two lymph nodes.   I always had CT scans for monitoring and they worked well.  When I had my recurrence I was monitoring wtih CT scans.  They saw some nodes light up in my abdomen on the CT scan so a week later I followed up with a PET scan.  This was my first PET.  The PET scan showed the same thing as the CT which was two lymph nodes.  Fortunately I have a great surgeon who opened me up the old fasthioned way and he got the two cancerous nodes that lit up but also did some exploring and found numerous other suspected cancerous nodes that he also removed. These nodes did not show up on the PET or CT.  After they were tested it was confirmed that there was a lot more cancer then either the CT or PET showed.  Gladly now I have been in remission, for 15 months.  Good luck.

Nico08
Posts: 19
Joined: Aug 2014

Hi Coppercent.  I am glad to hear that you have 15 months of remission.  That is great.

annalexandria's picture
annalexandria
Posts: 2573
Joined: Oct 2011

but the word "early" does seem encouraging to me.

It does sound like you might still be an earlier stage and if so...awesome!  Very good survival rates and hopes for a cure.

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