Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical
Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine.
M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
I also answer questions in these other categories: General History,
Military History,
Brain Tumors,
Breast Cancer,
Colon Cancer
I recently had trans anal excision of a invasive moderately differentiated adenocarcinoma extending into the submucos. focal lympovascular invasion was present. Normal mucosal margin was identified as negative for carcinoma, however fragments of tubulovillous adenoma were present. The carcinoma was 0.8 cm in greatest dimension, pathologic stage: pT1 pNx PMx.
The Microscropic description reads: The rectal mass in three levels on three slides is fragments of colonic mucosa with central invasive moderately differentiated adenocarcinoma. The neoplasm extends into superficial subbmucosa but is not present at the deep cauterized margin, or ata the lateral margin that can be identified. There appears to be an adenocarcinoma centrally. There are at least two foci of circumscribed tumor nests in the submucosa. One of these, on level two, appears to be a vascular structure, apparently a thin walled vein or a lymphatic.
My question is: Is there any cancer still present beyond the deep margin that the surgeon made, and what would be the normal follow up treatment with the onocologist. I will be seeing an onocologist on Tuesday but was wondering if radiation, chemotherapy, or both would be normal courses of treatment? Thanks in advance for your help in this matter, and thanks for participating with your expertise answering questions on the web.
God Bless,
Mike
Answer This is a rather small cancer and it SEEMS to have been radically removed. However I can not guarantee that - and most probably nobody else can either. Personally I would have prefered to give you radiation therapy before surgery. But I think you should in order to try to increase your chances have it as soon as possible. It is much more debatable if also chemo therapy is needed but if you want to try to improve your chances as much as possible and side effects of the treatment (also the radiation therapy has such(!))are not much of a concern to you maybe you should have that too. But that is something you have to decide with your dr. But I do see some advantages of a combination of radiation therapy and chemo therapy. Unfortunately the side effects may be rather tough!
