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What Does "t4 Tumor As Increased Contact Between Tumor On The Right" Mean?

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Posted on Fri, 4 Apr 2014
Question: Hi i need advice / my dad was diagnosef with colon cancer in nov. all ct scans done which showed no spread and that it was a t3 tumor. They were going to operate in 26 feb but postponed now for 2 weeks as he has a cough. Anyway they re did scans and now ct shows t4 tumor as increased contact between tumor on the right and right kidney-the fat plane is not seen. What this mean? Ct report attached
doctor
Answered by Dr. dr. Jawahar Ticku (1 hour later)
Brief Answer: colonic carcinoma Detailed Answer: Dear XXXX Thanks for posing this question on this site. Your dad's T4 colonic cancer with no nodal involvement or distant spread is a favourable situation. But in any case resection of the tumor (hemi-colectomy ) is needed along with clearance of the inflitrations on the kidney. This has to be followed by Adjuant chemotherapy which your oncologist will advise you. He should have full recovery but further delaying the surgery will not be fruitful. I hope he recovers soon from the current illness and gets to be treated successfully. Let me know if you need any more information. Truly, Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. dr. Jawahar Ticku (5 minutes later)
So does this mean the tumor has invaded kidney snd kidney will have to be removed ? From ct report u think There is lymph node involvement ?
doctor
Answered by Dr. dr. Jawahar Ticku (2 hours later)
Brief Answer: Unlikely... Detailed Answer: Dear XXXX Thank you for reverting. I do not think the kidney is involved to the extent of removal. It is only while doing the surgery you will know the extent of the disease. It may at all be the removal of fatty tissue over the kidney. Direct infiltration is hardly known and distant spread is very common which your dad has not. Normally in T4 Ca colon lymph node involvement is very common but as per your CT report it is not there. This can also be examined during surgery and some nodes are routinely removed for sampling. In the nutshell, surgery is going to play a pivotal role in determining the future course of management. However at this point his current condition needs to be treated. It looks positive as of now. I would like to follow him up after the surgery. Truly, Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. dr. Jawahar Ticku (36 minutes later)
Ok so what the radiologist has memtioned on report like small volume fat lymph Nodes noted etc .... Does not mean lymph nodes affected?
doctor
Answered by Dr. dr. Jawahar Ticku (2 hours later)
Brief Answer: colon carcinoma Detailed Answer: According to radiologists report it means there is suspicion of lymph node but even then sampling has to be done irrespective whether enlarged lymph nodes are there or not. The probability of lymph node positivity in T4 lesion is above 70 percent though radiologically they are detected or not. Dr. J.Ticku
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. dr. Jawahar Ticku (28 hours later)
Thx. I thought first you said no mention of lymph node involvement in ct report ? Also just in 2 months cam a t3 progress to t4?
doctor
Answered by Dr. dr. Jawahar Ticku (7 hours later)
Brief Answer: colonic malignancies Detailed Answer: Dear XXXXXXX The diseases are progressive in nature. if treatment is delayed the lower stage is likely advance to higher stage. As far as lymph nodes are concerned, they are normally present in the body. but whether or not they are involved in the cancer can be confirmed by biopsy only. Scans don't confirm lymph node involvement with cancers. Truly, Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. dr. Jawahar Ticku (2 days later)
Hi we had face to face meeting with consultant. My dads op for 26 march . He said from ct report they are of the opinion that the tumor is encroaching on the right kidney ? What this mean. Also may need to remove part or all kidney. Woulf this be a stage 4 then?
doctor
Answered by Dr. dr. Jawahar Ticku (2 hours later)
Brief Answer: Colonic Ca Detailed Answer: Dear XXXXXXX T4 tumor is not stage 4. Infiltration into kidney makes it stage 3. in any case the surgery has to be done and infiltration or invasion to the perirenal tissue has to be cleaned and separated. In any case surgery is must and it is good that he has been posted for surgery for 26th. March. Following the surgery actual details may be known and if required it may be followed by local radiation and chemotherapy. I wish him best of luck. Truly, Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. dr. Jawahar Ticku (56 minutes later)
The old ct report from december had n1 also.so do you think kudney removal not necessary? They are saying tumour encroaching the kidney
doctor
Answered by Dr. dr. Jawahar Ticku (12 hours later)
Brief Answer: Kidney removal is not necessary Detailed Answer: If it grossly involves kidney, it may need removal but if perirenal tissue is involved it may need its cleaning only and sparing the kidney. Dr. J. TickU
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. dr. Jawahar Ticku (1 hour later)
Thx alot . From The report u saw, u think removal will be nevessary ? Also what wound syrvucsl rates be like for a stage III cancer? As he had had a minor attack 8 months ago and has pulmonary embolism, would they still offer chemo?
doctor
Answered by Dr. dr. Jawahar Ticku (2 days later)
Brief Answer: Colon Cancer Detailed Answer: Dear XXXXXXX Old Pulmonary embolism is not a contraindication to chemotherapy if at all decided to be given. it may be a contraindication for surgery which your treating team will decide. Regarding survival in stage 3 it is fairly good after it is resected and followed by adjuant chemtherapy. Truly, Dr. j. Ticku
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. dr. Jawahar Ticku (4 hours later)
What do u think the liklihood is of it involving the kudney ?
doctor
Answered by Dr. dr. Jawahar Ticku (17 hours later)
Brief Answer: Colonic Cancer Detailed Answer: Dear XXXXXXX I already explained you that there is invasion of the tissues overlying the kidney. On surgery it may be dissected out or if the surgeon on visual examination feels the necessity of removal of the kidney might do so. Truly, Dr. J. Ticku
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. dr. Jawahar Ticku

Oncologist

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What Does "t4 Tumor As Increased Contact Between Tumor On The Right" Mean?

Brief Answer: colonic carcinoma Detailed Answer: Dear XXXX Thanks for posing this question on this site. Your dad's T4 colonic cancer with no nodal involvement or distant spread is a favourable situation. But in any case resection of the tumor (hemi-colectomy ) is needed along with clearance of the inflitrations on the kidney. This has to be followed by Adjuant chemotherapy which your oncologist will advise you. He should have full recovery but further delaying the surgery will not be fruitful. I hope he recovers soon from the current illness and gets to be treated successfully. Let me know if you need any more information. Truly, Dr. J. Ticku