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How to test lymph nodes after TEM removal procedure for T1

Posted by melw @melw, Oct 17, 2022

A mass identified from colonoscopy in September as part of a regular check up. size 3cm, 7 cm from anus. Shocked and scared. Initial biopsy from colonoscopy shows cancer in situ. Had a TEM removal as opposed to cutting out part of the colon, as my surgeon thought it did not warrant that because MR report says it did not go into colon wall. then biopsy concludes cancer gone into submucosa, Grade 1-2, negative resection margins. Could not biopsy lymph nodes because of the TEM procedure. Surgeon advice is no other procedure is needed except for a PET scan and regular follow-up visits. MR report before removal showed engagement of some lymph nodes around colon area, with larger ones 0.78cm. Any other way to test the lymph nodes? Would PET scan be able to tell? I am 43 yrs old with a young kid. So scared. Any info or advice would be appreciated.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 18, 2022

Welcome @melw. I can imagine that you are shocked and scared to find out that you have stage 1 or 2 rectal cancer after the transanal endoscopic microsurgery (TEM). In stage 1 and 2, it has been determined that the cancer has not spread beyond the colon or rectal wall. But, if I understand you correctly, you are questioning how they would know since no lymph nodes were removed or tested at the time of surgery. Is that correct?

Here is some information about typical followup care.
- Colorectal Cancer: Follow-Up Care https://www.cancer.net/cancer-types/colorectal-cancer/follow-care

Do you think that a second opinion might be warranted?

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1 reply
melw | @melw | Oct 18, 2022
In reply to @colleenyoung "Welcome @melw. I can imagine that you are shocked and scared to find out that you..." + (show)
@colleenyoung

Welcome @melw. I can imagine that you are shocked and scared to find out that you have stage 1 or 2 rectal cancer after the transanal endoscopic microsurgery (TEM). In stage 1 and 2, it has been determined that the cancer has not spread beyond the colon or rectal wall. But, if I understand you correctly, you are questioning how they would know since no lymph nodes were removed or tested at the time of surgery. Is that correct?

Here is some information about typical followup care.
- Colorectal Cancer: Follow-Up Care https://www.cancer.net/cancer-types/colorectal-cancer/follow-care

Do you think that a second opinion might be warranted?

Jump to this post

Thanks Colleen! Yes I am wondering if there is a way to know whether it's spread to lymph nodes without removing them for biopsy. And a second opinion would be helpful. I am outside of the US. Would a consultation with Mayo be possible?

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1 reply
Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 19, 2022
In reply to @melw "Thanks Colleen! Yes I am wondering if there is a way to know whether it's spread..." + (show)
@melw

Thanks Colleen! Yes I am wondering if there is a way to know whether it's spread to lymph nodes without removing them for biopsy. And a second opinion would be helpful. I am outside of the US. Would a consultation with Mayo be possible?

Jump to this post

You can certainly contact Mayo Clinic to ask about options for consultation as an international patient. Here's how to submit a request http://mayocl.in/1mtmR63

Mayo Clinic has a location in London, UK and associated facilities worldwide through the Mayo Clinic Care Network. See international locations available here: https://www.mayoclinic.org/about-mayo-clinic/care-network/network-members

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