Diagnosis

Please can you explain to me what the following means(taken from my surgeons letter to my GP) - 

Low anterior resection (I had a coloscopy in October, I thought a LAR was something different.)

pT2 pN2b

2/12 and three tumour deposits (I am aware that 2/12 refers to 12 lymph nodes examined but what is the difference between a tumour deposit and a tumour?)

R0

EMVI

MMR proficient

Thanks

Poz1

  • Hello Poz1,

    Thanks for getting in touch and welcome to our online community. I see from your profile that you’ve joined our bowel cancer forum. I hope you’ll find it a good source of support.

    My name is Carole and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    It can be difficult to understand some of the information that’s included in letters between doctors, especially when abbreviations and medical jargon are used.

    When a low anterior resection is carried out, part of the sigmoid colon and part of the rectum are removed. This is sometimes abbreviated to LAR.

    The stage of a cancer tells doctors how large a cancer is and whether it has gone anywhere else. There are a few different ways to stage bowel cancer. The TNM system is often used.

    When there’s a p in front, it means the staging was confirmed after surgery.

    After surgery, the bowel that’s been removed is examined under a microscope. The bowel is made up of layers containing blood vessels and nerves. A pathologist in the labs checks to see how far the cancer cells have grown into these layers as well as the blood vessels, lymph nodes and the nerves it contains.

    EMVI stands for Extramural vascular invasion and it means that the cancer cells have broken through to blood vessels found beyond the muscle layer.

    The pathologist also checks for certain characteristics within the cancer cells. Some bowel cancer cells have changes or mutations in sections of DNA called genes. One of the most common changes are in genes called mismatch repair (MMR) genes.

    They also check to see that there is a good margin between the cancer that has been removed and the healthy bowel that’s left. This is what the R0 is referring to.

    Unfortunately, I’m not able to explain what is meant by tumour deposits. This can refer to a group of tumour cells outside of the original tumour, but I’m not able to be any more specific.

    Your specialist hospital team are based placed to clarify what’s included in the letter and to explain how this information is used to determine the best treatment. We’d encourage you to speak to them for further information.

    It’s recommended that doctors follow a ‘please write to me’ approach when sending information to patients. It might be helpful to speak to them about this, as it can help to clear up confusions and reduce anxiety.

    I hope this is helpful. Please don’t hesitate to get back in touch if you have further questions.

    Sending best wishes,

    Carole

    Our ref: PW