Pathology results show evidence of cancer in blood vessels

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Hubby is just over 3 weeks post surgery now - had RAS lower anterior resection and anastomosis of colon at beginning of July. Tumour was removed with a good margin along with surrounding blood vessels and lymph nodes.

Today, he was called by colorectal nurse to say that pathology results had been discussed at MDT today. While the nurse said that the lymph nodes and margin area were thankfully clear, the blood vessels showed evidence of cancer within them. An oncology appointment is now being arranged and hubby has been told he will now need chemotherapy. We will know more once we actually see the oncologist face to face.

I’m just wondering if anyone else has been in this situation and if so, is there any advice or infomation that you can give us both. We’re quite shaken at the news. I know that there’s always the chance you’ll be told this while you’re waiting for staging results, but deep down you hope that you won’t and everything will be okay. 

Previous scans carried out before surgery showed no evidence of metastasis.


Thanks for reading,

Roses x

  • Hey Roses , sorry to hear about your news. 
    i didnt have this experience, but my dads had spread to blood vessels then liver. 
    It seems they have just caught your husbands Cancer before it has spread. 
    I assume he will have so many cycles of Chemotherapy now to kill the cancer cells in the vessels. 
    Hope you are both keeping ok

    Charlie 

  • Hi  ,

    I had no evidence of disease in either my lymph nodes or my bloods but they still recommended chemo as a belt and braces approach.  I finished round three yesterday (5 more to go), my advice would only be lots of rest when on chemo.  

    I hope it goes well!

    best wishes

    cerysm

  • Hi  

    From my own case, my understanding is that in recent years pathology are looking at 3 types of invasions when doing postop histology, in addition to the usual margins and lymph node involvement.

    The 3 types of invasions are lymphatic, venous and perineural. They can each be extramural or intramural, depending on whether it's penetrated walls.

    Invasions do not automatically mean there is metastatis but heightens risk of it, if not mitigated. I understood it that it means cancer cells are floating in those body's systems but they can be killed off before they settle somewhere.

    I'd suggest your hubby asks his oncologist to explain it directly so he can understand the risks and gains of his treatment choices.

    I would suspect you'll have an oncologist appointment swiftly with chemo options offered to start around 6-8 weeks post op to allow for recovery. I found writing questions down in readiness really helped me navigate any uncertainty and lots of new information.

  • Thanks for your words of support Charlie, we both really appreciate this. Hopefully we’ll have more info about the situation and hubby’s treatment options once we see the oncologist. It’s just the waiting in between…nurse said we should hear in a couple of weeks or so. 


    Take care,

    Roses x

  • Thanks for that Cerys.


    I’m so glad that your lymph nodes and bloods came back clear. It’s interesting to hear of your own experience of treatment offered. My hubby asked if the ‘belt and braces’ approach would be offered should everything come back clear. But the colorectal nurse told him it was not protocol to offer this in these circumstances (maybe it depends where in the UK you live?)

    Unfortunately, hubby now finds himself being put forward for chemo since they did find something.. Well know more once we see the oncologist, appointment is being arranged.

    Wishing you all the best with the rest of your treatment! I’ve passed on your advice about getting lots of rest to my hubby.

    Roses x

  • Thanks so much for explaining this to us CrumpetsOrToast. As we are entering a new area of hubby’s cancer journey, everything is new and unfamiliar.

    Yes, my hubby will ask his oncologist about this and also about the risks and gains of any treatment when he sees them. I’m glad that you mentioned about the post op recovery period being allowed for, that was something I hadn’t actually considered, but it will be important, since chemo is quite gruelling. We will start to make a list of questions in readiness too. Great advice and much appreciated by us both, thank you!

    Take care,

    Roses x

  • Hi Roses26,  

    They said it was because I was so young to have it. If I’d have been older they wouldn’t have offered it.  I’m 51 in case that helps and I’m in south wales.  It might be different between the different health trusts.  

    best wishes

    cerys

  • Hi Roses,

    Im sorry to hear about your husbands diagnosis- it’s a scary time for you both. 

    My mum has stage 3 bowel cancer and unfortunately cancer was found in her lymph nodes but also her blood vessels- not a lot of people have heard of this/maybe just not discussed as much. 

    She was diagnosed in March- she’s on round 3/12 for folfox. She was originally on Capox but it didn’t agree with her, she also got a picc line in which has been much better.

    She will get a CT at the end of her treatment to see if any very small pieces of disease (through blood vessels etc) has attached anywhere else.

    Wishing you both all the best x 

  • Hi Poppy, thanks so much for taking the time to reply.

    I'm really sorry to hear of your mum's recent diagnosis and hope that her treatment goes well. I've read about certain types of chemo not agreeing with people and they're then switched onto something different. 

    Thanks for also explaining the way your mum's treatment works, it helps us with what to expect. Once hubby has seen the oncologist things will hopefully be clearer. It's just a really scary time right now,but coming on here and asking things does help us.

    Wishing your mum all the very best, take care.

    Roses x

  •  My dad was diagnosed in May with a 64mm tumour which had spread to the liver 46mm. He has undergone 5 sessions of chemo and his 6th and final is this Friday. His CT and MRI taken this week show the chemo has shrunk the tumours to 22mm and 19mm. He’ll have surgery on the bowel and possibly ablation on the liver. Technically he is stage 4 but with bowel cancer this is slightly different and does not mean what is portrayed and thought of as stage 4 by lay people. Stage 4 just means that it has spread outside of the original site to another organ but it’s still very treatable!! Try not to focus on staging as every cancer and person is individual.