Back in December of 2008 my husband was diagnosed with colon cancer. It was a fairly early stage, but did have lymphovascular invasion. Tumor was removed completely, and he had surgery to remove that part of his colon just to be sure they got it all (I think this was done due to the LVI). He had his 1year followup in January 2010, and then was told to come back in 2 years, which would make him due for colonoscopy in Janurary of 2012. For the last 3 weeks he has been having pain on the lower left side of his abdomen and back, foul smelling (worse than normal) gas and stool, and then last night he had stomach cramps, constipation and bright red blood in his stool (of course we know the blood could be due to the extreme constipation). Anyway he is going to call the doctor today, but should he push for an earlier colonoscopy or wait until January. I know that I hope it is unlikely his cancer would have come back so quickly, and the doctor who did the colonoscopy said they did not believe it would ever come back, but the repeat colonoscopies were just routine. I am scared a bit. He is only 47. I guess what I am asking is do these symptoms sound like he may have a recurrence, or are we just paranoid due to the word cancer having already been part of our lives? Last time he had a little blood in his stool, but they said that it probably wasn't even from the cancer, but more likely from hemorrhoids.
Has your husband been under the care of an oncologist? What stage colon cancer was he originally diagnosed with? Did he have any chemo after surgery? Where was the tumor located? What was his CEA before surgery and has it been repeated every 3 mos. as is standard for colon cancer? At the time of original diagnosis were CAT scans of chest/abd/pelvis performed to see if there was a problem anywhere else?
It is most unusual to not be followed on an at least semi-annual basis by the oncologist, since colon cancer is most likely to recur during the first three years after diagnosis. January is way too long to wait for the colonoscopy!!!! Since your husband is symptomatic he should insist on a colonoscopy and CEA level as soon as possible, as well as a CAT scan to determine what is going on.
You are definitely not being paranoid to worry about a recurrence. They do happen and the sooner treatment begins, the more successful the outcome.
Lynch Syndrome PMS2 mutation
2003 Colon Cancer Stage III 2+nodes 6 mos bolus 5FU & Leucovorin after right hemicolectomy.
1995 Endometrial Cancer Stage I TAH BSO
No he was never under the care of an oncologist. He had no chemo. It was stage I. The pathology report said well-differentiated adenocarcinoma, arising in a tubular adenoma. The tumor is characterized by well-formed glands, having mildly pleomorphic nuclei. There is focal high grade cytologic atypia. Focal areas of intraluminal "dirty" necrosis are seen. The tumor invades the submucosa, and comes to approximately 2 mm of the resection margin. The cauterized margin is free of malignancy or adenomatous change. Lymphovascular invasion is present. Deeper levels show similar histologic findings.
They said we just needed to get a colonoscopy in a year, he went in for that and it was clear. From there he said in 2 years and that is what we are approaching now. I do not believe he ever had a CEA level done at all, and no CAT scans.
He has an appointment for a colonoscopy on the 23. I guess we just wait and see.
No he has never been under the care of an oncologist. I guess they did not believe it was far enough along to warrant that. It was stage I, the concerning factor being the lymphovascular invasion. I do not believe he has ever had CEA testing done, and I know he has never had CAT scans of other parts of his body. Also, no chemo. He does have a colonoscopy scheduled for 8/23 now.
Age 47 is quite young for colon cancer. Is there a history of colon cancer in his family? Also to have lymphovascular invasion with stage I indicates an aggressive cancer. Did you get a copy of the pathology report? Was it considered well differentiated, moderately differentiated or poorly differentiated with well being closest to normal cells and poorly differentiated being the most distorted cells that also tend to be the most aggressive?
After his colonoscopy, even if it is negative for cancer, he should:
1) Have a consultation with an oncologist for continued follow up and monitoring; and,
2) Have a CAT of chest/abdomen/pelvis to see if his Stage I cancer from 2008 had spread anywhere that might be the cause of his pain.
My Stage I endometrial cancer was considered cured by the hysterectomy and "no need for an oncologist" said the surgeon. However, had I consulted an oncologist I would have been informed that I was at risk for colon cancer and urged to have a colonoscopy then and not wait until I was past 50 and possibly avoided developing the Stage III colon cancer.