Post Operation Analysis - Sigmoid Colon Cancer - 1289975

thealimir
Posts:6

My father was Diagnosed with Sigmoid Colon Cancer (Adenocarcinoma) in November 2016. He undergwent an operation in December 2016 for Resection of affected area, as pre-operative CT scan showed it to be a T2 N1 M0 (5cm x 5cm approx size- copy attached). CT scan did not show any other related issues/ spread in the body.
His post- operative Histopath report of the removed mass concludes it as " Moderately Differentiated Adenocarcinoma with Mucinous Component - PT0 PN0 PMX" (copy of histopath report is attached).
However, in his post operative CT Scan (done in Jan 2017), there are 2x 7mm sized pulmonary nodules, which the report concludes as "likely metastatic" (copy of report attached).. (just for information- at the time of his post operative CT Scan, he had a viral infection (flu and cough) with 101 F temperature).
The oncologist has suggested Chemotherapy, however, he has given us not very high hopes..
My family is very much worried.. what are your views and opinions about this? What do you suggest?
Regards

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Reply # - February 4, 2017, 08:57 AM

JimC
Posts: 2753

Hi thealimir,

Welcome to GRACE. I'm sorry to hear of your father's diagnosis, and I hope that his surgery proves to have been successful in eradicating cancer from his body.

Although detailed analysis of scan/histology reports is beyond the scope of these forums, I would be concerned with the idea of moving immediately to chemotherapy on the basis of the scan results, especially in light of your father's illness at the time of the follow-up scan. In the context of an existing cancer diagnosis, the appearance of these nodules certainly makes them suspicious for cancer, but only a biopsy can confirm that. On the other hand, there are radiological features of such nodules which can increase the risk that they represent cancer, but none of those features are noted in the report. It might be good to discuss this subject with your father's oncologist. Dr. West has a good discussion of Imaging Features of Pulmonary Nodules here (the focus is on solitary pulmonary nodules, but some of the same principles apply).

Of course, if this is metastatic cancer your father will want to begin treatment without too much delay, but he may want to consider sending his records to another oncologist for a second opinion, as chemotherapy is a significant step, one which you'd like to avoid if it's not clearly indicated.

If your father is now feeling better after his viral infection, perhaps a repeat CT would be in order. If the nodules have resolved or remained stable rather than grown, the chances of metastasis are lessened.

JimC
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