Diagnosis query

Evalia 10 days ago

4 replies
127 subscribers
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Hi, I am new to the forum so am hoping someone can help. My mum has been informed she has bowel cancer but has never had a colonoscopy or biopsy. They have staged it as T3 N1 M0. The Colorectal team have been mainly unhelpful saying she is frail and they won't operate or offer any treatments other than management of symptoms. They also want to put her on a palliative pathway and want a DNAR in place. We have asked for a second opinion and they have also said they don't support this.

My question is, can bowel cancer be diagnosed and staged through a CT scan alone? Is this something we should just accept and let mum go? My mum is keen to get answers about what is creating issues but she doesn't have the typical bowel cancer symptoms either. Its all been very distressing and any ideas on next steps would be helpful.

Kareno62 9 days ago

Hi Evalia and I’m sorry to hear about your mum. Colonoscopies are usually the first line of investigation as it allows them to view the inside of the bowel and biopsy anything suspicious. If they suspect cancer and the biopsy confirms it then a CT scan gives a clearer picture, checks to see if there is spread to other organs and can indicate if there are any lymph nodes affected - in your mums case there is no spread to other organs and 1-3 lymph nodes affected.
I presume colonoscopies are used as the first stage as it doesn’t expose someone unnecessarily to the radiation risk of a ct scan? It’s hard to comment on their decision for your mum. Chemoradiotherapy is used to blast rectal tumours before surgery and can be very successful at shrinking a tumour but it’s whether she would be able to tolerate the daily sessions and then the chemo tablets alongside?

Sorry I’ve not been much help but you could ring the support desk on the number below for advice and guidance on a second opinion?

Take care

Karen x

Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

Evalia 9 days ago in reply to Kareno62

Thank you Karen, it’s much appreciated xx

Lucy1382 8 days ago

Hello Evalia- firstly, you are entitled to a second opinion and also entitled to move trust if that is what it takes. My mum had bowel cancer diagnosed during the pandemic, aged 84 (I have since had it myself) and it was T2 N0 M0 as far as I recall. They couldn't complete the colonoscopy due to diverticulitis so she was diagnosed on CT alone. I think they like to do colonoscopy as the primary diagnostic tool as they can also take out polyps/do biopsies etc, but as far as I am aware a CT scan can pick it up.

She was and remains frail but they operated and she came through fine- (not going to lie, that was a horrible worry and especially as we couldn't go in to see her during lockdown, but she made it). She is pretty much at the five year mark now and is 89. She does have bowel issues but these have got significantly better in the past couple of years (I don't think she paid enough attention to diet, to be honest!). She didn't have chemo or radiation.

Definitely worth pushing, but if you have an unhelfpul team, that is awful (been there with a surgeon lately!) and adds to the stress. Depending on travel times/where you live etc, it might be worth investigating a change?

Susan13 7 days ago

I would push for a second opinion and don't let them discourage you. It's incredibly hard to say if she is well enough to tolerate treatment but I think you owe it to her as well as for your own peace of mind.

The CT is enough to diagnose cancer. Mine was diagnosed through CT. I didn't get a colonoscopy until 6 weeks later. Many people do not have any symptoms so don't let that fool you. I'd trust the diagnosis but get a second opinion on treatment.