T3NO pathology with perineural invasion

Hi Rd stage 3 

I have been looking for some up to date information and I think most of the literature around does not specifically address this in a patient friendly way but more research papers . I have noticed this coming through a lot and will raise it with Macmillan to see if it can be addressed in their publications going forward .

My limited understanding is it’s an independent predictive tool and part of the jigsaw pieces of information they use to decide the treatment pathway for a patient . That would also include lymph node involvement, tumour depth , cell type etc . 
This gives them an idea of increased risks and the benefit of  chemotherapy. 
In my limited  understanding being responsive to chemotherapy can change all of the above . I think my mum had every elevated risk plus a spread but incredibly responsive to Chemo. 
So part of the decision making process but not in isolation and many variables also affect the long term survival like good surgical margins with curative intent and possible chemo for belts and braces approach .

I think Gemmary  might have had it and may know more . I have tagged her in and will speak to Macmillan team too .

Take care ,

Court 

Can u please try to find someone similar I can talk to I’m freaking out

I will get Macmillan to get in touch as they may be able to get one of the nurses to help .

Take care ,

Court 

I have asked Macmillan to get someone to help you as I think I might have mixed it up anyway and is more pertaining to the nerve .

Best get more information for you .

Take care ,

Court 

Hi Rd stage 3,

I'm sorry to hear that you've been freaking out while looking for further information about your diagnosis. Waiting for further information when things are uncertain is always a challenge, and especially so when waiting on important appointments or test results. 

I just wanted to make sure you've seen that one of our qualified Cancer Information Nurse Specialists has now answered your question posted on the Ask a Nurse forum. You can view their reply by clicking on the link below:

• Ask a Nurse - Perineural invasion T3NO rectal cancer

Whenever you have a question about the medical side of things, our Ask a Nurse forum is the best place to get answers directly. If you need support with what a particular diagnosis or test result means specifically in your case, don't forget that your GP or hospital cancer care team will be in the best possible position to help, as they also have access to your medical records.

For any emotional support or practical tips, your fellow Online Community members are always here, and if you just want to talk to someone at Macmillan about how you are feeling, you can always contact our Information & Support Team by calling the Macmillan Support Line on freephone 0808 808 00 00. They're open from 8am to 8pm, 7 days a week. You can also request a call back by entering your details at the link below:

• Request a call back

I hope you're able to get the answers you need, and that you'll continue to get support from the good folks on our Online Community. Remember that you're not alone, and that we're all here for you. 

Hi, Rd stage 3 , I had vascular invasion rather than yours, so can't directly help, but happy to talk if that helps? Mine indicated cells present in the veins around the removed bit. My guess is yours indicated them in the nerves, but whether this was in the bit removed or at the margins , it might be worth you asking your team. It may be that adjuvant chemo will be required. Again, ask your team. ((Hugs))

Hi Rd stage 3.

I had extramural perineural invasion highlighted in histology from resection surgery for cancer in the sigmoid colon. You can read more on my user profile if interested.

My understanding is that reporting on invasions has only become standard practice relatively recently so there is not heaps of data available.

You are best asking your consultant regarding prognosis as it can depend on other factors such as other invasions and health conditions. It's also a conversation that is best dynamically held.

Not everyone wants or is comfortable with knowing prognosis. I did ask for mine and I was grateful for the honest discussion. You cannot undo what you learn, so if you are in any doubt, don't rush your decision.

I saw on your other post that you are N0 which is a very good aspect.

Would love to talk sometime