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Colon Cancer.

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My dad has his pathology report verbally following Colon cancer surgery.

It's a t3 tumor

Dukes stage c1
28 lymph nodes removed and 10 affected . But ones affected were near tumor only not elsewhere .

What are the prospects ? Is c1 equivalent to
A stage 3c as 10 lymph nodes were affected?

Category: Oncologist

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Category: Hematologist
 32 Doctors Online


Your father seems to have advanced disease for which surgery has been successfully completed. Since lymph nodes were also involved, he may also require chemotherapy now for 6 cycles. Based on his general post-surgery health condition, his cardiac, kidney and liver status, your oncologist will decide on the chemotherapy drugs required. He needs to be constantly following your oncologist's advice in this regard.

Dukes Stage C is roughly equivalent to TNM Stage 3C, but what you should know is that TNM staging is the recommended and better way of staging Colon Cancer. The Dukes Classification is outdated and not recommended in practice.

He will do better with chemotherapy which will usually control disseminated disease and give him better quality of life and good survival advantage.

Hope this clears your doubts.

Kind regards.

Patient replied :

Hi thank you

The problem is he does not wNt chemo. He saw his oncologist and she told him all the worse side effects . He has had a minor attack last year and had also pulmonary embolism . Also after surgery lost too much weight due to lack of food. He dropped to 53 kg n now has increased to 56.6 kg.

Is there anything else instead of chemo he can do like immunotherapy I read on?

Is he likely to get mets/ spread with a c1 ? How long to mets take to appear?


It is the duty of the Oncologist to keep you well informed about all the side effects of chemotherapy before starting the treatment. The fact is that all patients do not experience all side effects. Few patients may have fewer side effects but it varies from each person and each cycle. So it would be better that you discuss with your oncologist again, trust him and go ahead with your chemotherapy.

Regarding your query on immunotherapy, as of now we do not recommend immunotherapy in colon cancer per current guidelines for adjuvant setting.

There are high chances of getting dissemination if chemotherapy is not given, but the time cannot be determined by anyone.

Talk with your oncologist and trust him.

Hope this clears your doubt. Please feel free to discuss further.
Kind regards

Patient replied :

So if he refuses chemo and it is a stage 3c, would he defiantly
Get mets at some point ?

Even with chemo he can still get mets right?

Chemotherapy will give a chance of cure when administered which cannot be achieved if treatment is not given. Also the chance of dissemination (spread) is less with Chemotherapy and the probability is high without it.

The best option is to proceed with the Chemotherapy given its major advantage of disease control, rather than waiting to develop metastases sooner without Chemotherapy.

I hope that answers your questions.

Thank you.

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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