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What Does "metastases In A Aortocaval Node Of 10 Mm" Mean?
Question: What can a metastases in a aortocaval node of 10 mm mean for treatment purpose and prognosis in a person who had colon cancer surgery this year and was dukes c. ?
Brief Answer:
Chemotherapy is necessary.
Detailed Answer:
Hi,
Welcome to HCM and thanks for asking.
For Duke C stage, I would advise to my patient as follows:
1. To undergo chemotherapy.
2. Prognosis would be good. Atleast 50% of patients will survive till 5 years, if patients respond well to chemotherapy.
If you have any further queries, do get back to me.
Take care.
Dr. Prakash HM
Chemotherapy is necessary.
Detailed Answer:
Hi,
Welcome to HCM and thanks for asking.
For Duke C stage, I would advise to my patient as follows:
1. To undergo chemotherapy.
2. Prognosis would be good. Atleast 50% of patients will survive till 5 years, if patients respond well to chemotherapy.
If you have any further queries, do get back to me.
Take care.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thx
Surgery was done march and tumor removed with nodes .
Xeloda was started 11 weeks after ( bit late as first my dad was reluctant to have chemo ).
On 4 th cycle it was stopped , as cea was going up and scans were ordered .
Pet scan showed 1 16 mm liver lesion and 1 aortocaval node with metastases. Node is 10 mm
His cea was as-
May 3 XXXXXXX 4
July 6
Sept 9.8
Oct 8
Bit confussed why a bit of a cea drop in October as chemo was stopped .
He is due to start folfori today .
Surgery was done march and tumor removed with nodes .
Xeloda was started 11 weeks after ( bit late as first my dad was reluctant to have chemo ).
On 4 th cycle it was stopped , as cea was going up and scans were ordered .
Pet scan showed 1 16 mm liver lesion and 1 aortocaval node with metastases. Node is 10 mm
His cea was as-
May 3 XXXXXXX 4
July 6
Sept 9.8
Oct 8
Bit confussed why a bit of a cea drop in October as chemo was stopped .
He is due to start folfori today .
Brief Answer:
Possible "CEA surge" which normalized.
Detailed Answer:
Hi,
Thanks for replying.
Difficult to explain a drop of CEA. A drop in CEA is usually thought of as a good response.
Chemotherapy is known to cause surges in CEA level during initial treatment and this is called as "CEA surge" possibly due to increase tumor marker expression by cancer cells and possible tumor lysis. Its more commonly seen after first chemo.
Later on as the it reduced, the CEA level could have fallen down.
Estimation method, nutrition and immunity can all affect CEA level in varying effects.
However, CEA cannot be used as an absolute marker. Correlation with CT or PET scan is essential.
Let him start with Folfori. It is known to be helpful.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Possible "CEA surge" which normalized.
Detailed Answer:
Hi,
Thanks for replying.
Difficult to explain a drop of CEA. A drop in CEA is usually thought of as a good response.
Chemotherapy is known to cause surges in CEA level during initial treatment and this is called as "CEA surge" possibly due to increase tumor marker expression by cancer cells and possible tumor lysis. Its more commonly seen after first chemo.
Later on as the it reduced, the CEA level could have fallen down.
Estimation method, nutrition and immunity can all affect CEA level in varying effects.
However, CEA cannot be used as an absolute marker. Correlation with CT or PET scan is essential.
Let him start with Folfori. It is known to be helpful.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Is it a bad sign with this node involved ,?
Y must they not be doing surgery/ablation with only 1 liver met involved which is
Small at 16 mm?
Y must they not be doing surgery/ablation with only 1 liver met involved which is
Small at 16 mm?
Brief Answer:
Node involvement - poor prognosis.
Detailed Answer:
Hi XXXXXXX
Thanks for replying.
At present a metastases has happened. If it has moved to liver, it could have moved to other organs at distant locations. Node presence, would indicate other areas involved. Its similar to having a liver mets. If it responds to Folfori, its good.
I would not say its a bad sign, but metastasis indicates a poor prognosis.
Excising a single mets would not serve any purpose.
Better to destroy all cells through chemotherapy.
Surgery also has its own complications at this age. I am not saying chemotherapy at this age would be better, but thats a better option.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Node involvement - poor prognosis.
Detailed Answer:
Hi XXXXXXX
Thanks for replying.
At present a metastases has happened. If it has moved to liver, it could have moved to other organs at distant locations. Node presence, would indicate other areas involved. Its similar to having a liver mets. If it responds to Folfori, its good.
I would not say its a bad sign, but metastasis indicates a poor prognosis.
Excising a single mets would not serve any purpose.
Better to destroy all cells through chemotherapy.
Surgery also has its own complications at this age. I am not saying chemotherapy at this age would be better, but thats a better option.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Can the node still get larger with folfori ?
Brief Answer:
No, it should not.
Detailed Answer:
Hi,
Thanks for asking.
If its a mets node, it should not get larger with folori.
If its inflammation, decreasing tumor and improving immunity will reduce its size.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
No, it should not.
Detailed Answer:
Hi,
Thanks for asking.
If its a mets node, it should not get larger with folori.
If its inflammation, decreasing tumor and improving immunity will reduce its size.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Brief Answer:
Radiation - not for small mets
Detailed Answer:
Hi,
Thanks for asking again.
Radiation therapy is usually given for large tumors before surgery to reduce the size and excise the tumor.
Or its given, when patient cannot tolerate chemotherapy and surgery cannot be done to reduce any symptoms due to the tumor size (obstruction, compression, etc).
Radiating the node which is very much deep is riskier given that the tissue surrounding it will also get destroyed. For eg: its a aortocaval node - very near to aorta and venacava - If the blood vessels were to get damaged, it will lead to immediate internal bleeding.
Radiation therapy is difficult to control. It could cause further mutations in the tumor cells or even in normal cells giving rise to new tumors or more aggressive present tumor.
Radiation for mets is not usually a choice. Only complicated cases, it will be used to relieve symptoms.
Chemo, if it works could get rid of the mets. Partial or complete remission may occur depending on the sensitivity of the tumor to chemotherapy.
Hope this answers your query.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Radiation - not for small mets
Detailed Answer:
Hi,
Thanks for asking again.
Radiation therapy is usually given for large tumors before surgery to reduce the size and excise the tumor.
Or its given, when patient cannot tolerate chemotherapy and surgery cannot be done to reduce any symptoms due to the tumor size (obstruction, compression, etc).
Radiating the node which is very much deep is riskier given that the tissue surrounding it will also get destroyed. For eg: its a aortocaval node - very near to aorta and venacava - If the blood vessels were to get damaged, it will lead to immediate internal bleeding.
Radiation therapy is difficult to control. It could cause further mutations in the tumor cells or even in normal cells giving rise to new tumors or more aggressive present tumor.
Radiation for mets is not usually a choice. Only complicated cases, it will be used to relieve symptoms.
Chemo, if it works could get rid of the mets. Partial or complete remission may occur depending on the sensitivity of the tumor to chemotherapy.
Hope this answers your query.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Raju A.T
Ok . What if chemo does not work on the node ? Can this happen with folfori ?
Brief Answer:
Folfori should work
Detailed Answer:
Hi!
Thanks for asking again.
Being positive and hopeful is important.
Possibility of Folfori working is high.
If chemo works on liver and not node, node is possibly not tumor.
We will come to know after a cycle or two.
Importantly, he should be able to tolerate it.
Any further queries, happy to help again.
Dr. Prakash HM
Folfori should work
Detailed Answer:
Hi!
Thanks for asking again.
Being positive and hopeful is important.
Possibility of Folfori working is high.
If chemo works on liver and not node, node is possibly not tumor.
We will come to know after a cycle or two.
Importantly, he should be able to tolerate it.
Any further queries, happy to help again.
Dr. Prakash HM
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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