Final Pathology

Hi ellen93. I’ve attached a link to the Macmillan page about staging

https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer/staging-and-grading-of-bowel-cancer

EMVI means the histology has detected some spread into blood vessels and PNI (perineural invasion) means there is some detected in the nerve or nerve sheath. Successful resection with clear margins is good news but you’ll probably have follow up chemo as the belt and braces.

Please don’t google! Ring your colorectal support nurse for a chat or the nurses on here on 0808 808 00 00 for reassurance

Take care

Karen x

Kareno62 Thanks Karen..I have stopped googling..I'm not medically trained so I could so easily misinterpret something or the info is out of date..I am focusing on the fact they got it all out with clear margins and chemo will kill any nasties we can't see...

Hi ellen93, it's really positive that your husband had a successful resection and it is moderately differentiated (so not particularly aggressive).

I don't think there's ever a 'perfect' pathology report at stage 3 and 4 (stage 3 in your husbands case) tbh. The pathology report identifies risk factors to help guide treatment and monitoring post-surgery. You'll have some people who are EMVI and PNI negative but they have a really aggressive cancer, so it's all about knowing how to tackle follow up treatment for different tumour types. 

The problem with Google is that it's so misleading. You'll read studies where they claim something is a negative prognostic marker...and then you see the study only involved about 40 ppl and had no statistical significance whatsoever. 

IJPThank you..that has made me feel much better..yes I know the Oncologist said there is a high risk of it returning  but chemo will reduce that and as my friend said they can say for sure it won't but they can't say for sure it will either...

Exactly, the only thing we know for certain is that cancer is very unpredictable! 

But chemo will help a lot. Plus regular monitoring will mean IF any recurrence occurs it should be able to be stopped in it's tracks pretty quickly. 

@kareno62 @IJP Can I ask does the EMVI and PNI positive mean S4...as I noticed the oncologist left this off the staging..

Still stage 3 ellen93. Only stage 4 if it has spread to another organ (e.g lungs) or to distant lymph nodes that can't be removed. I don't either of those apply to your husband?