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Can CT Colongraphy Detect Or Show If The Cancer Has Spread To Abdomen And Pelvis?

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Posted on Sun, 29 Dec 2013
Question: Hi can a ct colongraphy detect or show the andomen pelvis and lymph nodes to ser if cancer spread?
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Answered by Dr. Shoaib Khan (55 minutes later)
yah it it will show defnitely
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (8 minutes later)
Then why has my father been referred for a ct scan if lungs abdomen and pelvis? Does rhe ct colonography not just check indide the colon for tumours?
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Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer: CT visualizes structures that colonograph wouldnt Detailed Answer: Hello sir/ma'am and welcome. Thank you for writing to us. A CT colonography is usually ordered to visualize the large intestine mainly; but can also provide information on surrounding structures as well. It is especially helpful in diagnosing conditions like tumors, cancer, extra growths, structural abnormalities, etc; but in the large colon. So, the additional CT scan that was advised could most probably have been ordered because the CT colonography focuses primarily on the large colon and not on the surrounding structures. But a CT scan of the chest, abdomen and pelvic region would provide information on all structures present in these regions. I hope you found my response helpful. Please feel free to write back to me for any further clarifications, I would be more than happy to clear them for you. Hope there is nothing serious diagnosed in your father's case, and all is well from there on. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (3 minutes later)
So would a ct not visualize any masses in the abdomen, pelvis, liver etc?
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Answered by Dr. Shoaib Khan (15 minutes later)
Brief Answer: Normal CT would visualize all structures Detailed Answer: Hello once again sir/ma'am. A normal CT scan of the chest, abdomen and pelvis would visualize structures like liver, gall bladder, urinary bladder, and all the other organ and organ systems in the region; and whether or not they would have any masses. But, a CT colonography would concentrate mainly on the large intestine, and give a more detailed report on the large intestine, and not the other structures in the region. I hope this is clear ma'am. Please feel free to write back to me anytime for any further clarifications. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (4 hours later)
As my farher had anemia for about a year , the the cancer likely to be advanced? He has a right ascending colon tumour?
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Answered by Dr. Shoaib Khan (33 minutes later)
Brief Answer: Not a definite sign of prognosis Detailed Answer: Hello once again ma'am. Anemia is a sign of a poor prognosis, but it is also seen with tumors and not always with cancer. So, anemia may or not be a sign of a poor prognosis (i.e. advanced cancer). It would be a non-specific sign, based on which the degree or grade of cancer cannot be determined ma'am. Hope this is clear ma'am. Best wishes.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Shoaib Khan (1 hour later)
Would a crp not have dected an abnormality if theres a cancer in the body?
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Answered by Dr. Shoaib Khan (9 hours later)
Brief Answer: CRP would be non-specific Detailed Answer: Hi ma'am. A CRP (C-Reactive protein) test is a blood investigation that helps in detecting any infectious or inflammatory process in the body. It would be raised when cancer or a tumor would be present, but if it is raised that does not necessarily mean a cancer or tumor is present; it would thus be non-specific. I hope this answers your query ma'am. I look forward to being of assistance to you, so please do not hesitate to ask my anything. Best wishes.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Shoaib Khan (6 hours later)
My dad had been tild he has a maligant tumour but his crp was normal. If the cancer was advanced would the crp raise definatley? Thanks
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Answered by Dr. Shoaib Khan (2 hours later)
Brief Answer: CRP does not help to distinguish grade of cancer Detailed Answer: Hello once again ma'am. If the cancer had resulted in inflammation of a particular organ, then the CRP would be raise, but if it is isolated and has not caused any inflammation to any organs, then the CRP would be normal. So a normal CRP does not necessarily indicate the severity or grade of cancer. I hope this is clear ma'am. I am very sorry to hear about your father's diagnosis, my best wishes and prayers are with your father and your family. God bless.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Shoaib Khan (30 minutes later)
Thanks do much For your help its a very difficult time at the mo. When you mean cancer isolated does that mean not spread to organs and lymph nodes?If was spread would crp be raised ? I know crp not a diagnoses for cancer but would it increase to increase if spread to Organs?
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Answered by Dr. Shoaib Khan (20 minutes later)
Brief Answer: You are most welcome, it is my pleasure entirely Detailed Answer: Hello once again ma'am. I completely understand how this affects you individually as well as all the people around you ma'am, you need not thank me at all. Just let me know how I can be of assistance, and I would be more than happy to help. By isolated I meant it may have not resulted in the inflammation of the entire colon (which would raise the CRP). Like for example, a tumor or cancer in the liver would result in inflammation of the entire liver, and this would show a high CRP. If your father's cancer is malignant, then we will have to check whether it is metastatic or not (this means, whether it has spread to other organs or lymph nodes or not). Please check with your doctor regarding the same, as the result of the CT abdomen and pelvis or a PET scan would provide us with such information. If the cancer does spread to other organs, and result in that organ or organ systems inflammation, then the CRP would be raised ma'am. But, a normal CRP (like in your father's case does not mean the that a spread has not taken place. I hope this explanation is clear ma'am. May god bless your father and your family. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (3 minutes later)
Ok thank you very much
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Answered by Dr. Shoaib Khan (4 minutes later)
Brief Answer: You are most welcome ma'am Detailed Answer: Hi ma'am. You are most welcome ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (30 hours later)
Hi again My dad received the ct scan results of the pelvis, abdomen, lungs which seemed clear but clot in the artery found and he is on medication . The radiologist says poss stage 2, or 3. How will they know this and how will know for sure? He has a colonoscopy tuesday. Can a ct detect spread to lymph nodes and the blood vessels/tissue? They also want to do mri next week
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Answered by Dr. Shoaib Khan (6 hours later)
Brief Answer: Staging explained; CT will not visualize Detailed Answer: Hello once again ma'am. Well the stages has a very specifix classification, based on which we stage the patient. If the radiologist has placed a stage 2 or 3, it seems he is unsure about lynph node involvement. Let me explain: -Stage 2 means that the tumor/cancer has gone as deep as the subserosa or peicolic tissues or even invadede surrounding tissue or visceral peritoneum. But has not spread to the lymph nodes -Stage 3 means the tumor has gone as deep as the submucosa or even as deep as invading surrounding tissue; but has either less than 4 or more than 4 pericolic lymph nodes involved This clearly shows that the radiologist sure about the depth of tumor invasion but not sure about the lymph nodes; because if the lymph nodes were clearly visualized the radiologist would not be unsure about the stage. Which is why the answer to your next query would be no in this case. Although CT can at times visualize some normal lymph nodes. So I am sure the accurate staging will be done post-MRI. Hope this helps you ma'am. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (4 hours later)
Thanks so much Are both these stages curable?
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Answered by Dr. Shoaib Khan (26 minutes later)
Brief Answer: You are most welcome Detailed Answer: Hello once again ma'am. You are most welcome, and it is entirely my pleasure to be of assistance. Yes of course they are treatable, but depending on the stage they can hamper the quality of life. So once the stage is confimed, do write back to me and I shall list all the treatment options for the particular stage. I hope this information helps you. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (2 hours later)
The fact that they want to do mri would it suggest it t3? Why would they have not done mri first rather than ct?
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Answered by Dr. Shoaib Khan (2 hours later)
Brief Answer: Not necessarily ma'am Detailed Answer: Hello once again ma'am. No, the fact that they want to do an MRI is to confirm whether or not there is any lymph node involvement, it does not necessarily mean that they are suspecting stage 3. An MRI was not the first indication, as in most cases with such a presentation an investigation like MRI (which is more intense and expensive), is avoided. The initial clarification required was whether or not it was a tumor. But as the reports suspected that this was more than a tumor, the next indication is an MRI. I hope this makes things a little more clear for you ma'am. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (13 minutes later)
Would they not hav to take lymph node biopsies to confirm spread to lymph nodes ? I thought a ct would detect this. Is there more risk of the tumor re occuring at stage 3?
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Answered by Dr. Shoaib Khan (26 minutes later)
Brief Answer: Not helpful; No; Yes Detailed Answer: Hello XXXXXXX A lymph node biopsy can only be conducted once we know which lymph node is affected. Without knowing which lymph nodes are affected, a biopsy of a random node would yield us indefinite results. A CT is usually not used to detect lymph node involvement, but it can at times detect normal lymph nodes; but cannot really predict the involvement of lymph nodes in cancer spread. Yes, the risk of recurrence is higher with the 3rd stage XXXXXXX I hope I have explained this well enough. Please feel free to write to me anytime, and about anything. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (2 hours later)
Very helpfull you have been.can diet play a role in the cancer re occuring? My father drinks and smoke would it best to stop these?
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Answered by Dr. Shoaib Khan (5 minutes later)
Brief Answer: Yes; diet, smoking and alcohol are all important Detailed Answer: Hello XXXXXXX I am glad I could be of assistance. As this is colon cancer, yes, smoking, alcohol and a diet can increase the chances of a recurrence. So I would suggest a health diet, with reduction of fatty/oily/fried food. And of course, avoid both alcohol and smoking. Stress is also a contributing factor, so try to ask your father not to worry too much. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (3 hours later)
Thanks. So even if removed with surgery it can come bk? What are percentage of stage 2 and 3 re occuring ? Also would they give something to stop it re occuring? My father not keen to have chemotherapy if needed
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Answered by Dr. Shoaib Khan (7 hours later)
Brief Answer: Higher the stage, higher the chances of recurrence Detailed Answer: Hello XXXXXXX Recurrence depends on the stage as I mentioned earlier. Only if it has spread to lymph nodes or surrounding structures, there is a chance of recurrence. So I would say a stage 2 would have a 10-15% chance of recurrence, whereas, stage 3 would have more than 50% chance of recurrence. Radiotherapy and chemotherapy are usually advised during the course of treatment to prevent recurrences and to make treatment of the current tumor easier. Hope this is clear ma'am. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (9 hours later)
Hi my father had a call that a blood test has detected haemolytis and that a coombes test will be done. What is this and could it be linked to the colon cancer?
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Answered by Dr. Shoaib Khan (8 minutes later)
Brief Answer: Type of anemia; usually not related Detailed Answer: Hello XXXXXXX I am guessing you are talking about hemolytic anemia. This is a form of anemia in which the red blood cells either break down or are completely destroyed by the immune system; in simple words it is like the automatic destruction of healthy red blood cells. This is confirmed with the help of a Coombs test. There are various conditions that can cause Hemolytic anemia, and the Coombs test result will accordingly give the doctor an idea of the condition that could have caused hemolytic anemia in your father. Hemolytic anemia is a concern, because our body should naturally have a normal amount of red blood cells, and our body undergoes a natural process of cell birth and death. As the old cells die, new ones are formed. But if the body starts breaking down or destroying the healthy red blood cells also (like in hemolytic anemia), then this can result in serious complications. Usually not related to colon cancer, but has sir (your father) had any blood transfusions lately? I hope this is clear. I would advise you to go ahead with the Coombs test for your father ma'am. Hope this helps clear your query. Take care ma'am.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (4 minutes later)
Yes had a transfussion 2 months ago ? So could his anemia be related to hemolysis? Dr just said hemolysis.
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Answered by Dr. Shoaib Khan (12 minutes later)
Brief Answer: Yes, hemolysis is related to the anemia Detailed Answer: Hi XXXXXXX Yes, hemolysis is the breakdown of red blood cells (as mentioned in my previous response). This is usually seen in hemolytic anemia, which can be caused by various conditions. Blood transfusions are the most common cause for this condition, but I would still wait for the Coombs test result and a more detailed analysis to find the exact cause for this condition. Yes, hemolysis could be related to the anemia. Hope this helps XXXXXXX Please keep me updated and let me know if you have any clarifications. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (2 hours later)
He does have microcytic anemia . Is this different ? You havd been much helpful and you provide excellent service. At the mo we are all just too stressed and worried
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Answered by Dr. Shoaib Khan (13 minutes later)
Brief Answer: It is not the same ma'am, they are different Detailed Answer: Hello XXXXXXX No ma'am, microcytic anemia is a mild form of anemia where the red blood cells are smaller than the usual size. Whereas, hemolytic anemia is where the red blood cells breakdown or are destroyed by the immune system; this is a more serious form. I am glad I can be of assistance, and I completely understand the stress of having a loved one go through health issues. I recently had my 28 year-old brother suffer a heart attack and my mother a stroke, all within 3 months. So, I can understand the stress and sadness. Which is why I shall try my best to provide you with as much help and assistance as possible, I assure you that much ma'am. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (6 minutes later)
Sorry to hear that . Thx do much . U based in india? Ok i was assuming this form of anemia may b related to the cancer but may be its due to the blood transfussion . Could there be another serious reason for this ?
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Answered by Dr. Shoaib Khan (5 minutes later)
Brief Answer: Immune system related abnormalities Detailed Answer: Hi. Thank you for your empathy. I am currently based in Russia, but am from Bangalore, India. The anemia could have been caused due to the transfusion, but as I mentioned earlier, we cannot be sure right now. But according to me, the only cause that fits the XXXXXXX as of now is a recent blood transfusion; but this is just an assumption. Other serious reason for this could be the immune system dysfunction. Certain conditions can cause the immune system to stop functioning properly, which can at times be serious. This can result in the immune system attacking the body, resulting in various other conditions, out of which hemolytic anemia is one. Hope this is clear XXXXXXX Please do not ever hesitate to keep in touch or write to me, no matter what the question. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (5 minutes later)
Thanks il keep you updated
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Answered by Dr. Shoaib Khan (4 minutes later)
Brief Answer: Please do so Detailed Answer: You are most welcome. Please do that. My prayers are with your father.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (19 hours later)
Hi i have read the letter re ct scan. It says liver lesions found and liver mri needed. Does this mean spread to liver ?
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Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer: Unfortunately, it does suggest a possibility Detailed Answer: Hi XXXXXXX Sorry to say, but it does point in that direction, yes. Hoping for the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (1 hour later)
Even though all liver markers were clear ?
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Answered by Dr. Shoaib Khan (43 minutes later)
Brief Answer: At times liver markers may nor detect early stage Detailed Answer: Hi XXXXXXX In most cases liver markers are quite accurate, but at times they may not be able to detect a malignant lesion in its early stage, so it is better to conduct the MRI. In such a scenario, I would say it is also wise to just go ahead with a PET scan instead of repeating MRI scans on different parts of the body; as a PET scan would give us a more detailed picture of the entire body. Hope this helps. Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (1 minute later)
Ok
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Answered by Dr. Shoaib Khan (1 minute later)
Brief Answer: Discuss the PET scan option Detailed Answer: Yes ma'am. Discuss the PET scan suggestion with your doctor. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (3 minutes later)
From a ct can thet not tell what lesions they are ? Can they b unrelated ?
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Answered by Dr. Shoaib Khan (6 minutes later)
Brief Answer: MRI would be better; Yes they can be Detailed Answer: Hi XXXXXXX A CT may not be able to provide all the information required, an MRI would be more beneficial. Yes, they can be unrelated, especially as your father is aged. Which is why a detailed investigation will be required (Eg. MRI scan) to rule out other conditions and confirm or rule out spread of the cancer to the liver tissue. Hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (6 minutes later)
So the liver lesions dont mean they are mets ?
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Answered by Dr. Shoaib Khan (26 minutes later)
Brief Answer: Not necessary, but it needs to be ruled out Detailed Answer: Hello XXXXXXX It is not necessary that they should be due metastatis, but without the MRI scan the exact cause will be unclear. So as of now it would be a 50-50 % chance (metastasis versus a non-related condition), till the MRI scan is done. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (17 minutes later)
Thsnks
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Answered by Dr. Shoaib Khan (1 minute later)
Brief Answer: My pleasure entirely Detailed Answer: As mentioned earlier XXXXXXX you do not have to thank me. And my best wishes are with your father and your family always. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (36 minutes later)
Can i just ask if radiologist has put on ct report poss t2 or t3 what does that mean ? That does not indicate stage and spread right? Would a t2 or t3 still spread to liver
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Answered by Dr. Shoaib Khan (16 minutes later)
Brief Answer: T2 or T3 does not indicate spread to liver Detailed Answer: Hi XXXXXXX Sure. 'T' stands for tumor, and how deep it has grown or invaded. It is part of the TNM classification system, which helps in establishing the stage of any cancer. In colon cancer, the following is the classification of 'T': -T 1: Grown into muscle layer (muscularis mucosa) and extends to the submucosa -T 2: Grown through submucosa and extends to muscularis propria -T 3: Grown through muscularis propria and has reached to the outermost of colon or rectum; but has not extended through the colon and rectum (i.e. it has not grown through the outermost lining of the intestines) -T 4A: It has grown through the outermost lining of the intestines -T 4B: It has invaded surrounding tissues or organs As explained above, a T2 or T3 does not indicate a spread to surrounding tissues (eg. liver). Hope this is clear ma'am.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (6 minutes later)
But although does not indicate it , it still could have spread right? So a t2 or t3 is not that invasive? Sorry to be a pain have got worried re the lession Csn it ever be the cases where radiologist states a poss t2 or t3 and there can stil b a liver met?
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Answered by Dr. Shoaib Khan (13 minutes later)
Brief Answer: Could have; wrong only due to CT scans incapabilit Detailed Answer: Hi XXXXXXX Please do not hesitate to ask me anything, and I respect you for being a concerned daughter. Although the CT scan does not indicate an invasive spread/metastasis; this will still have to be confirmed with a more conclusive investigation like MRI or PET scans. In majority of cases, a radiologists prediction is not wrong, but we need to understand that a radiologist can only predict a stage based on what he/she can visualize. So due to the limitations of a CT scan, the radiologist's prediction could be inaccurate, but this would be only because the CT scan was not capable of showing the radiologist enough. But with investigations like MRI or PET, a radiologist's prediction is most accurate. Yes it could have still spread, and can be ruled out with MRI or PET. No, T2 or T3 is not that invasive. Hope this helps. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (11 minutes later)
Can a ultrasound detect liver mets as he had that friday too which appeared normal. Since i have come to know if this thats all think about
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Answered by Dr. Shoaib Khan (3 minutes later)
Brief Answer: No, ultrasound usually cannot detect metastasis Detailed Answer: Hi XXXXXXX I understand. An ultrasound is the mildest form of an investigation, and cannot be used to confirm or rule out any metastasis. Hope this helps.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Can CT Colongraphy Detect Or Show If The Cancer Has Spread To Abdomen And Pelvis?

yah it it will show defnitely