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Old 09-14-2006, 01:05 AM   #1
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bossan HB User
My Pathology and CT Scan

I've never done this before but I thought I'd share. Here's the sigmoidoscopy report:
The specimen consists of multiple tan-yellow fragments of soft tissue ranging from 0.1 to 0.5 cm in greatest dimension. The specimen is entirely submitted in one cassette. IT - 1 XX

Sections reveal cytological and architecturally malignant glands, consistent with at least intramucosal adenocarcinoma.


Then... the pertinent points of the CT Scan read;
There is a persistent retroperitoneal lymphadenopathy. A left periaortic node measures 1.0 x 1.6 cm on the current exam (2/225) versus 0.6 x 1.2 cm on the previous exam . An inferior left periaortic node measures 0.9 x 1.3 cm on the current exam (2/40) versus o.8 x 1.1 cm on the previous exam. There are no new enlarged retroperitoneal nodes. There is no pelvic lymphadenopathy.

The rectum remains asymetrical with soft tissue density at the left anterolateral wall of the rectum apparently inseperable from the prostate: however, the CT appearance is not significantly changed.

Impression:
1. There appears to have been interval decrease in the size of the mass previously identified in the dome of the right hepatic lobe. One of the two small low-density lesions in the lateral segment of the hepatic lobe is no longer visible.

2. Retroperitoneal lymphadenopathy is again noted, and there has been a slight interval increase in the size of the two largest periaortic nodes, as described. No new enlarged nodes are demonstrated.

3. Stable asymmetry involving the left anterolateral wall of the rectum.
........................................ ........................................ .............

I was feeling relatively good about my deal, now I freakin depressed....damn doctors and their secret code.

Please help.

 
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Old 09-14-2006, 02:02 AM   #2
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ktee_uk HB User
Re: My Pathology and CT Scan

Hey bossan

Well it hurt my head just reading. I am sure CDad will help out with something more meaningful than I can put forward. However, of the 3 "impressions", 2 of them look favourable and the other one mentions "slight increase". Now i know you would obviously prefer no increase at all but now that you have read about i think it would be good to call your doc and discuss it. i.e. is it significant? do you need to be doing something different?

sorry i cant be of more help my footie friend.

good luck
ktee

 
Old 09-14-2006, 04:59 AM   #3
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Nassau one HB UserNassau one HB UserNassau one HB UserNassau one HB User
Re: My Pathology and CT Scan

Hi Bossan, I agree with Ktee, though it is too technical for me, I am certainly reading more positive elements in this than negative. Obviously the "slight interval increase" is bothering you but please do not lose heart. Talk to your doctor about it and see what the action plan is or could be. What a rollercoaster for you! I know it is emotionally draining to go through this but I think once you decide, with the help of your doctors, what to do now, you will regain your determination and strength. It is the waiting for the treatment plan that is the most challenging.

Know that you are in my thoughts and prayers,

Much love,
__________________
Husband dx July 2003, advanced rectal cancer stage 111C; myself dx July 2006 indolent lymphoma; husband dx February 2010, stage 2 prostate cancer.

 
Old 09-14-2006, 05:15 AM   #4
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CancerDad HB User
Re: My Pathology and CT Scan

Boss:
I just saw your e-mail and am printing it. I am going away for a couple days but will try to respond on the hotel's computers.

Fondly,
CD
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ATTITUDE IS EVERYTHING!

 
Old 09-14-2006, 07:30 AM   #5
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Jeni61 HB User
Re: My Pathology and CT Scan

Bossan, I am not as knowledgable as some and I would sure wait to hear from CD when he gets back, but I concur with the others - there are 2 good pieces of news here and one bad, and the bad one is very slight.

Anyone out there correct me if I am wrong, but at this peritoneal thing, where the increase is, is there anyway they could remove it surgically or
radiate it ? Anyone out there know ? If chemo isn't holding it totally at bay or destroying it, could it be dealt with in another way ?

But it sure looks like the chemo regimen did its stuff on the other areas.
Hang in there, Bossan, there is truly more good than bad here. And remember, the increases are tiny !

Jeni

 
Old 09-14-2006, 07:56 AM   #6
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LESLIETOO HB UserLESLIETOO HB User
Re: My Pathology and CT Scan

Bossan:

There can be interpretive differences in size depending on who did the CAT, what the angle was, (same or slightly different slice) and was it on same machine as last one. Also, there is a margin of error assumed on most tests, which may account for the slight increase in size. Perhaps you can speak to the radiologist and have it compared not just to the last scan but to the one prior to that to see if there is a pattern.

Leslie

 
Old 09-14-2006, 10:44 AM   #7
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shnswms HB User
Re: My Pathology and CT Scan

You might still have small trace amounts of adenocarcinoma left in your rectum, which can be rid of by radiation, resection or other means possibly. I know periaortic means surrounding or adjacent to the aorta, which is a great artery that supplys blood to your body. The left periaortic lymph node shows slight increase. The inferior left lymph periaortic node shows decrease. There are no new enlarged lymph nodes. The rectum shows no further change, but does not appear significantly changed. I'm not sure what that means compared to what it was before. The mass in the right lobe of your liver is smaller and one is no longer visible. That is my interpetation of it. I see no cause for any let down on this. This is still good news! Do not substitute my reading for your physicians The increase could be any number of things. It didn't increase enough to worry, it could have been any number of things such as the way it was imaged. Good luck man!

Last edited by shnswms; 09-14-2006 at 10:45 AM.

 
Old 09-14-2006, 11:18 AM   #8
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bossan HB User
Re: My Pathology and CT Scan

Thanks for the good wishes. I see the results for what they are. The Onc said its not all gone, but its still all great news. I got down hoping the tumor would be gone even though where it is now is still a miracle.

I have been off chemo since July and feeling pretty good. My only problem is my rear is sore and I'm getting light spots of blood on the toilet paper,but that has been going on and off since all this started.

I have a fear that the onc will put me back on Campostar/Avastin since it was working so well....I can take it, but I'm not going to like it!

 
Old 09-20-2006, 10:42 AM   #9
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CancerDad HB User
Re: My Pathology and CT Scan

Quote:
Originally Posted by bossan
I've never done this before but I thought I'd share. Here's the sigmoidoscopy report: Thank you for sharing!
The specimen consists of multiple tan-yellow fragments of soft tissue ranging from 0.1 to 0.5 cm in greatest dimension. The specimen is entirely submitted in one cassette. IT - 1 XX Your MD submitted all the specimens in one container, versus putting the specimens in different jars for the pathologist to analyze.

Sections reveal cytological and architecturally malignant glands, consistent with at least intramucosal adenocarcinoma. You still have signs of cancer cells present.
Then... the pertinent points of the CT Scan read;
There is a persistent retroperitoneal lymphadenopathy. A left periaortic node measures 1.0 x 1.6 cm on the current exam (2/225) versus 0.6 x 1.2 cm on the previous exam . An inferior left periaortic node measures 0.9 x 1.3 cm on the current exam (2/40) versus o.8 x 1.1 cm on the previous exam. There are no new enlarged retroperitoneal nodes.

You have two nodes that grew very slightly located behind the peritoneum or lining that contains your organs--liver, stomach, intestines, colon, etc. They are located along the peri-aortic chain of nodes around a major vessel (around the aorta-- the major vessel that runs through your body... having many branches, so without the CT we don't know EXACTLY where. However, I would guess it's the abdominal or thoracic branch as they say that there are no inflamed nodes in the pelvis.)
The rectum remains asymetrical with soft tissue density at the left anterolateral wall of the rectum apparently inseperable from the prostate: however, the CT appearance is not significantly changed. The rectum still has cancer present.There is no pelvic lymphadenopathy. There are no inflamed nodes in the pelvis.Impression:
1. There appears to have been interval decrease in the size of the mass previously identified in the dome of the right hepatic lobe. One of the two small low-density lesions in the lateral segment of the hepatic lobe is no longer visible. This is AWESOME news, as the tumors in your liver have shrunk, possibly to the point where you can talk with a surgeon regarding removal or what is left of the tumors.

2. Retroperitoneal lymphadenopathy is again noted, and there has been a slight interval increase in the size of the two largest periaortic nodes, as described. No new enlarged nodes are demonstrated. Same as I typed above-- you still have 2 nodes sligntly enlarged, possibly as Leslies stated, due to use of a different machine or slight variations. The nodes are still around the aorta or periaortic.

3. Stable asymmetry involving the left anterolateral wall of the rectum.
........................................ ........................................ .............

I was feeling relatively good about my deal, now I freakin depressed....damn doctors and their secret code.

Please help.
Boss:

I am VERY SORRY that my reply to you did not go through. I went away for a couple days and posted a reply from the hotel on the TV internet... it went blank right after I submitted, but I thought my response went through.

Boss, you should be anything BUT depressed about this news in my opinion. You have come a long journey, and through it all you have managed to decrease the size of the liver tumors to the point where you can probably have them resected. You also have managed to keep your rectum from developing any new tumors, although there are stray cells present, which very well could be COMPLETELY killed off using chemoradiation.

I'm sorry this is such a quick assessment. I do hope its not too late and that you are uplifted by reading. You know we are all pulling for you and wish you the best man!

Best Regards,
CD
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ATTITUDE IS EVERYTHING!

 
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