Colon Resection, cancer found in one lymph node: Treatment options?

I think referring you to an oncologist is proper. They can discuss the various treatment options with you and make a recommendation.

They may do surveillance scans to see if there are more potential cancer spots and to set a baseline. There are some blood tests which indicate the activity level of the cancer. All that is used to determine a treatment plan.

In my case, surgeons took the entire colon and 108 lynch nodes of which a dozen were malignant after a colonoscopy detected it. Scans showed about a dozen unidentifiable suspicious spots in liver, kidneys, lungs and thyroid. While the surgeons thought they got it all, the oncologists recommended chemo, which I did, although they did give me the option to opt out.

Scans every 3 months showed that those 12 spots were not growing and thus were likely not cancer. The scans also can show the effectiveness of the cancer. There was one spot in the area of the surgery which was shrinking during chemo, then grew after chemo, and has since stabilized.

Thank you for sharing your experience. I am looking for some alternate options other than chemotherapy. I should know more options when I see an oncologist with more testings. They took 17 lymph nodes and one was positive so far.

I’m glad that chemo therapy worked for you and stabilized it.

Thank you again!

I think your questions are best answered by the oncologist. I had 0 lymph node involvement and still attempted chemo, because it gave me peace of mind knowing I did everything possible. My oncologist gave me the option as well. I made it through half the treatments. I’m almost 5 years NED

@sos2000 What part of your colon is affected?

Most of my colon is clean. I have a new pre-cancerous polyp around the same place of my rectum, close to the sphincter, where I already had one that was resected last December, with a biopsy indicated that there were positive edges/rims. Earlier this year, I had radiotherapy with light oral chemo I had to take on the days of the RT sessions. The new surgeon I consulted said that given the positive edges, I should have had a second surgery last December or January. I had and still have 0 lymph nodes affected according to the CAT scans and MRIs I have had throughout the year.

Now with the return of a pre-cancerous polyp and with a wide rectovaginal fistula close to the sphincter, the surgeon, the oncologist and a cancer investigator have all separately told me that the right thing to do is a two-stage Turnbull-Cutait pull-through with coloanal anastomosis. They all point out that we need to do something radical: resection of the rectum and mesorectum to take out the 25 or so lymphnodes of that area. At the same time, the sphincter is preserved and the anastomosis allows avoiding a colostomy.

After discussing this with my husband and reading about the intervention, I have agreed to that intervention. Given the holidays are coming and I want to travel before facing the post-op period and the whole adaptation due to the resection, I will have my surgery in late January or early February.

I had a cancerous tumor removed from my sigmoid colon this year. Surgery was also robotic. 2 of 52 lymph nodes studied indicated cancer activity. No other organs involved. I am in my third month on oral chemo. I am doing very well, good blood results, working out every day. I suggest you explore oral chemo if available to you.
My best to you.

Thank you for sharing your experience. It really helps me understand more options to consider. Congratulations on NED.

Sigmoid.
About 10cm of sigmoid of rectum was removed where carcinoma polyp with positive margin at 17cm was.

My CT with iv contrast was all clear except one small module in lung in August, 2023 But after colon resection with 17 lymph nodes they found a cancer in one lymph node in December, 2023. My colorectal surgeon was surprised to this pathology result and I was in disbelief…

Thank you for sharing your experience. Praying for successful operation and have a wonderful holiday season!

Thank you for sharing your experience. Always learning new options from others.

Do they actually removed 52 lymph nodes during surgery?
I read 13 lymph nodes removal is a standard guideline.

So happy to hear your oral chemo is working for you!

It's so good to hear you are doing well. When you say "oral Chemo" would that be the pill Capecitabine? I just met with Oncologist yesterday and I asked about taking a chemo pill (that's all I'd heard of) the side affects he went over from that pill seemed to be worse than the Oxaliplatin & Fluorouracil Pump, which he suggested. I'm recovering from a colon resection, and pathology report showed 6 of the 22 lymph nodes removed were positive. He said I'm cancer free but recommends 6 month of chemo because of the positive lymph nodes .

I took three pills of Capecitabine from Monday to Friday (with a couple of exceptions for holidays and maintenance of the radiotherapy machine) on the days I had an RT session. I had to stop the Capecitabine after 22 sessions because I started feeling intermittent parestesias in my left limbs.