Expert: Claes-Gustaf Nordquist, M.D. - 8/18/2004

Question
My mother is a 62 yr old woman who has been in excellent health. She was scheduled to have a complete hysterectomy on May 21 for removal of a 10 cm pelvic mass that appeard to be on her left ovary. During the week before her scheduled surgery she began to have inc abdominal pain, swelling and intolerance of food. Upon admission her sodium was 120 and her potassium was 2.9. During the examination under anesthesia, she had a large amt of bleeding coming from her cervical os. The cervix was otherwise free ov evidence of tumor.The mass was greater than 10cm and her peritoneal cavity was full of bloody ascites (5 liters) and tumor debris. The large mass was rising out of the pelvic cavity and appears to have burst. It was determined that the tumor had been bleeding from within and had burst. In exploring her pelvis further, it was found that she had a lesion in the mid sigmoid colon. It was the primary tumor and malignant. It was an endometrial type of adenocarcinoma with some mucinous feature. The rest of the peritoneal cavity and liver appeared to be free of visible signs of tumor. Liver was palpated as was the diaphragm and rest of small bowel  and colon. The omentum was suspicious but the chart says that it was free of cancer. It was removed. The colon is the primary cancer. Findings about the lymph nodes are ambibiguous.The surgical notes stated that  there were no palpable or visibly large nodes in the mesentery.There is no information on actul nodes removed or results of tests run. When I pressed him specifically as to whether the nodes were involved, he answered yes but was vague as to how many or how he got that information, it is not in the chart.
This is my question: The surgery was three months ago and we are just in the process of testing and "restaging" for the purposes of tailoring treatment. Am in justified in being anxious to proceed with treatment? The Dr. should have the ct scan results as well as blood test results but insurance had denied a pet scan.We are fighting it but in the meantime my mom doesn" want to know anything until all tests are in. This will take weeks. Her colonocopy "consult " is not scheduled until Sept 7. (She's never had one) I'm wondering what the heck is going on! Isn't the cancer growing daily? This relaxed approach is feeding my mom's denial. What is an average recommended time to wait until treatment starts?

Answer
I'm sorry to read about your mother's problems! Of course her therapy should be proceeded with  A MINIMUM of dealays, in fact as quickly as possible! What is also of interest here is at what point in time was any tumour suspected and how long did it take until surgery was performed? Please do keep me posted!