Diagnosis Q

[Selinaleigh]

My mother had a colonoscopy today and they found a mass and the screening dr. said he was 99% sure it was cancer, and she is scheduled to consult with a surgeon tomorrow.  I'm afraid that since he was so positive it is cancer (without doing a biopsy or anything) that this means the cancer is advanced.  She had experienced a change in bowel movements, but I'm not sure what kind or for how long (I think at least a few months).  Is this necessarily a bad thing?  Also, when we meet with the surgeon tomorrow, what questions should we ask?  How do you find a good oncologist?

[molyba]

I just went through all of this with my father.  He passed June 27, 2008.  By the time the doctor found his, he was already in stage 4 of the cancer.  From what you've posted, I don't think your mother is too far along.  But I'm no doctor.  I'm 27 and have already had a colonoscopy because of my father.  They found a few pollups, but they were not cancerous.  You say the doctor found 1 lump?  He didn't find any thing anywhere else?  If that is so, depending on size and shape and color of the lump, that is how the doctor was able to tell it was cancerous just by looking at it and not biopsying.  It may be possible your mother is in the first stage of colon cancer.  But finding just one lump is good.  If so, your chances are higher for surviving.  Your chances are always higher in the beginning stages.  I suggest going to ****.*** for more information.  As for choosing a doctor, if you trust your family doctor, I would ask him for a good referral.  I hope this is helpful.   Sincerely,      Molyba

[jdwithhcv]

At this point the surgeon probably has more questions than answers.  Your mother can expect him to order a lot of tests, bloodwork, CT scan, PET scan, perhaps (depending on the location of the mass) a sigmoidoscopy.  These tests are necessary for staging the cancer, and can take a few weeks to complete.  Once the cancer is staged, the case will be presented to the tumor board for multidisciplinary review, and a plan of treatment will be determined.  Treatment can include chemotherapy, radiation and surgery.  Frequently all three treatments are indicated, with the patient undergoing chemo and radiation first (to reduce the stage of the mass) then surgery to remove the mass, often with a temporary colostomy or ileostomy, followed by more chemotherapy and surgery to reverse the ostomy.

If radiation is indicated, first the patient is "mapped"  You will want to ask about the radiation oncologist's plan for dealing with the side effects of radiation (diarrhea, fatigue, burns and scar tissue are common).

If chemotherapy is indicated the patient typically has a chemo port implanted first.  The medical oncologist will also have to assist with side effects such as nausea, diarrhea, pain, neuropathy and others too numerous to mention.

Surgery to remove the mass, if indicated, may or may not include an ostomy (usually temporary).  The experience can be very different to that of a patient with diverticulitis, particularly if the tumor is a discreet mass, so do not rely on accounts of diverticulitis surgery patients.  Cancer is different to diverticulitis in a number of ways, and the aftereffects of chemo and radiation raise issues that no diverticulitis patient faces.

Your mother will be very busy having "small procedures" (haha, small unless they are doing it to YOU) and waiting for test results and the decision of the tumor board.  There's a lot of hurry-up-and-wait between diagnosis and treatment.  The good news is that they can do a lot for colorectal cancer.

The Lance Armstrong foundation has a great website with lots of information and support.  Also, they will provide your mother, free of charge, with a Survivors Notebook.  This is a very helpful tool, containing useful information and a place to keep and organize information regarding her treatment.  livestrong.org or laf.org will get you to the website.

My cancer was discovered during colonoscopy and like you mother's, was diagnosed without a biopsy.  I had stage 3 cancer and underwent all the treatments mentioned above.  Next week I will celebrate 4 years cancer free.

Good luck to your mother.  Please keep posting with her questions and progress reports.  I will keep a good thought for you and your mother.

jd

[Morecambe]

Hi - I am really sorry that you have received this diagnosis.  I suggest that you type in colon cancer to google/yahoo and study some of the postings so that you are in possession of maximum information.

I think you should make sure that during your discussion with your surgeon you understand whether oncology will cure the cancer or whether surgery is more effective.

I underwent a total colectomy for diverticular bleeding but I believe that the procedure is the same for my complaint as it would be for colon cancer.

I placed my experience on a previous posting:-

http://www.medhelp.org/posts/show/523166

You might like to find this posting, print it off and show it to your surgeon and ask "is this - more or less - how you would expect my own experience to unfold".  Then you can decide whether you are prepared to undergo the surgery - if suggested - or whether you prefer the chemo/radiation etc.

Colon cancer is curabele as long as the diagnosis is made early.

Good luck
Morecambe