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Hello Dr, My Mother Recently Had A Rectal Cancer Surgery

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Posted on Tue, 19 Jan 2021
Question: Hello Dr,

My mother recently had a rectal cancer surgery. Everything went well with negative margins (even though she had some postive limph nodes, the CEA levels are almost at 0, the same for CA 19 and the tumor grade is =1, negative perinerual and limphovascular invasion and no tumoral deposits found). She has now a temporal ilestomy that should be reverted in February. In the 1st scanner she did after the surgery (2 months after) everything looked good except for adenopathy in the left iliac chain of 16mm x 12mm which worries me. The doctor said we have to follow it up. She had some infection in the internal wound after surgery and at the time of the scanner she still had pain the rectum zone. Do you think this limph node size should be considered a metastasis? or maybe it could be due to the surgery inflammation. Thanks!
doctor
Answered by Dr. Olgeta Xhufka (2 hours later)
Brief Answer:
Biopsy of lymph nodes can show it.

Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read your query and here is my advice.

I read the ct scan results and it is almost normal despite the adenopathy in the iliac chains 16.5- 12.9 mm.
I think that only the biopsy by laparoscopy can show if they are malignancy or just from any infection.
Taking count that she had infection at that time it can also be caused by infection .
Taking count that CEA levels are almost 0 is a good evidence.


Hope I have answered the question.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Olgeta Xhufka (2 hours later)
Thank you very much! Can I ask you what the recurrence risk is for her facts? Stage 3, 8 over 13 postive limph nodes CEA levels are almost at 0, the same for CA 19 and the tumor grade is =1, negative perinerual and limphovascular invasion and no tumoral deposits found.
She had 25 sessions of radiotherpy, 1 week of continuinng 5-FU quimo and capacetabine from february to may until she finished the radiotherapy. Everythingbefore the surgery. The tumor size was 5cm and there were 3 cm of free margins after surgery.

Thanks!
doctor
Answered by Dr. Olgeta Xhufka (10 minutes later)
Brief Answer:
The risk can't be estimated.

Detailed Answer:
Hello dear and thank you for asking again .
The fact that she has stage 3 cancer and 8 positive lymph nodes out of 13 means that reoccurrence risk exists but it can't be estimated.
The risk of reoccurrence depends on the effectiveness of the radiotherapy and chemotherapy and can't be exactly estimated but monitored .
This way the biopsy of the lymph nodes can show if it is related to cancer or not.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Olgeta Xhufka (44 minutes later)
Thank you! one last question. Is grade 1 of rectal cancer a low risk type? can it grow fast? I mean..like in 2 months?
doctor
Answered by Dr. Olgeta Xhufka (8 hours later)
Brief Answer:
Reoccurrence possibility is low.

Detailed Answer:
You are welcome.
The stage 1 rectal cancer means that it has grown in the intestinal wall but not evidence that may have spread to the lymph nodes or other organs.
In this case surgery can be successful on treating it and the reoccurrence possibility is very low.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
Dr.
Dr. Olgeta Xhufka

General & Family Physician

Practicing since :2011

Answered : 10113 Questions

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Hello Dr, My Mother Recently Had A Rectal Cancer Surgery

Brief Answer: Biopsy of lymph nodes can show it. Detailed Answer: Hello dear, welcome to Ask a doctor's service. I read your query and here is my advice. I read the ct scan results and it is almost normal despite the adenopathy in the iliac chains 16.5- 12.9 mm. I think that only the biopsy by laparoscopy can show if they are malignancy or just from any infection. Taking count that she had infection at that time it can also be caused by infection . Taking count that CEA levels are almost 0 is a good evidence. Hope I have answered the question. Let me know if I can assist you further.