Hello,
I am trying to understand the full extent of the terminology used in a recent clinic letter. I have tried googling it but I find this confusing and extremely concerned as I do not believe I am understanding it fully.
A recent surgery for an Ivor Lewis esopagectomy was preformed but what does T3 N3 M0 G3 P1 and R1 mean?
Thank you in advance.
Hello P_123
My name is Rae and I am a Cancer Information Nurse Specialist here at Macmillan Cancer support.
Understanding clinic letters can be confusing, as they are written from one medical doctor to another and not necessarily in a language easily understandable for the normal person. Your consultant and/or clinical nurse specialist should be able to help you understand it in everyday language, and you may well have an appointment in the near future to give you results. We can certainly help you to understand it more fully, but please do speak to your own team as well.
An Ivor Lewis oesophagostomy, otherwise known as a trans-thoracic oesophagostomy involves two main steps. Firstly, the surgeon makes an incision in the abdomen to mobilise the stomach. Then a second incision is made in the chest to remove the affection part of the oesophagus and create a new connection between the stomach and the remaining oesophagus. There is a recovery tracker which you may find useful as the surgery is recent.
TNM is a staging system used in many cancers. The T describes how far the tumour has grown into the oesophageal wall. N describes whether the cancer has spread to the lymph nodes, and M describes whether the cancer has spread to distant parts of the body (metastases).
Applying this to your results. T3 means the tumour has grown into the membrane covering the outside of the oesophagus. N3 means there are cancer cells in 7 or more nearby lymph nodes. There are no signs that the cancer has spread to other areas in your body, M0. There are further details and pictures here.
G stands for grading of the cancer. This is when the cancer cells are looked at under a microscope to see how similar or abnormal they look compared to normal, healthy cells. G3 means that the cancer is a grade 3, where the cells look very different from normal cells, may grow more quickly and are more likely to spread.
P refers to the pathological stage, which is determined by examining the tissue removed during surgery.
R stands for residual tumour, R0 means that no residual tumour was found, and R1 shows microscopic residual tumour, meaning that some cancer cells were found at the edges of the removed tissue.
Please do contact your oesophageal cancer team and ask what the next steps are in your treatment plan. The results should be discussed at the multi-disciplinary team (MDT) meeting and then a conversation with yourself should take place.
Having cancer and undergoing treatment can bring with it lots of emotions and it is important that you have support. We are available to talk via the Support Line, we have local cancer support In Your Area, and the online community has an oesophageal cancer forum. We also have all the ways we can help here.
Best wishes
Rae, Cancer Information Nurse Specialist
Ref/RH/LD
