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One Mistake Led to Another (Part V) – Colon Cancer Stage III

In Stage 0 colon cancer, there are abnormal cells in the mucosa of the colon wall.
In Stage 0 colon cancer, there are abnormal cells in the mucosa of the colon wall.
National Cancer Institute

When you think that you have food poisoning, but the doctor tells you that you have Colon cancer, you suddenly start asking yourself different questions.

TJM
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  • How bad is the cancer?
  • How far has it spread?
  • How long do I have to live?

But the questions changes once you start looking at the cancer statistics online at places like the American Cancer Society and the National Cancer Institute.

Then the question becomes; what stage is my Cancer in? The answer to that question answers all three of the questions that I had been asking.

The National Cancer Institute divides Colon Cancer into five distinct stages.

The stages are important, because the five-year survival rates are calculated based on the stage of the Colon Cancer when treatment begins.

Stage 0
In Stage 0 Colon Cancer, abnormal cells are found in the mucosa, which is the innermost layer of the colon wall. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ.

Stage I
In stage I Colon Cancer, cancer has formed in the mucosa, the innermost layer of the colon wall. and has already spread to the submucosa, the layer of tissue under the mucosa. Cancer may have spread to the muscle layer of the colon wall.

Stage II
Stage II Colon Cancer is divided into Stage IIA, Stage IIB, and Stage IIC.

  • In Stage IIA, the Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall.
  • Stage IIB, the Cancer has spread through the serosa (outermost layer) of the colon wall but has not spread to nearby organs.
  • Stage IIC, the Cancer has spread through the serosa (outermost layer) of the colon wall to nearby organs.

Stage III
Stage III Colon Cancer is divided into Stage IIIA, Stage IIIB, and Stage IIIC.

In Stage IIIA:

  • The cancer may have spread through the mucosa (innermost layer of the colon wall) to the submucosa, the layer of tissue under the mucosa, and may have spread to the muscle layer of the colon wall. The cancer has spread to at least one, but not more than 3, nearby lymph nodes, or cancer cells have formed in tissues near the lymph nodes; or
  • The cancer has spread through the mucosa (the innermost layer of the colon wall) to the submucosa (layer of tissue under the mucosa). The cancer has spread to at least 4 but not more than 6 nearby lymph nodes.

In Stage IIIB:

  • The cancer has spread through the muscle layer of the colon wall to the serosa (the outermost layer of the colon wall) or has spread through the serosa but not to nearby organs. The Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; or
  • The cancer has spread to the muscle layer of the colon wall or to the serosa (outermost layer of the colon wall). Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or
  • Cancer has spread through the mucosa (innermost layer of the colon wall) to the submucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the colon wall. Cancer has spread to 7 or more nearby lymph nodes.

In Stage IIIC:

  • Cancer has spread through the serosa (outermost layer of the colon wall) but has not spread to nearby organs. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or
  • Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer of the colon wall) or has spread through the serosa but has not spread to nearby organs. Cancer has spread to 7 or more nearby lymph nodes; or
  • Cancer has spread through the serosa (outermost layer of the colon wall) and has spread to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes.

Stage IV
Stage IV colon cancer, the most serious stage, is divided into Stage IVA and Stage IVB.

  • Stage IVA: The cancer may have spread through the colon wall and may have spread to nearby organs or lymph nodes. The cancer has spread to one organ that is not near the colon, such as the liver, lung, or ovary, or to a distant lymph node.
  • Stage IVB: The cancer may have spread through the colon wall and may have spread to nearby organs or lymph nodes. The cancer has spread to more than one organ that is not near the colon or into the lining of the abdominal wall.

In my case, the cancer seems to be in Stage IIIB: The cancer has spread through the muscle layer of the colon wall to the serosa (the outermost layer of the colon wall) or has spread through the serosa but not to nearby organs. The Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes.

According to the American Cancer Society, this means I have “resectable (operable) stage III colon cancer”, and the treatment is to remove the cancerous mass, do a biopsy on the mass, then treat the affected area with 5-fluoroucil-based adjuvant chemotherapy.

The 5-fluoroucil-based adjuvant chemotherapy treatment program was introduced in the late 1980s, and since then mortality from resectable (operable) stage III colon cancer has dropped by as much as 30%

That’s the good news.

The bad news is that according to the American Cancer Society, Cancer Facts & Figures 2010, the 5-year relative survival rate for colon cancer cases diagnosed in 1999-2006 is only 67%.

On the other hand, the 5-year relative survival rate for Stage II Cancer is 90%.

I thought I had Stage II Colon cancer, so I am suddenly faced with a 23% drop in the probability that I will be alive in 5 years. That’s a tough pill to swallow. There’s a big difference between a 1 in 10 chance and a 3 in 10 chance.

For example, LA Weekly reports that newborn babies, who are born poor in L.A., only have 1 in 10 Chance of Achieving Wealth.

While, According to the Albany County Bar Association; "A black male with a high school degree will still have a 3 in 10 chance of spending time in prison.”

According to WSB – TV 2 in Atlanta, Children have 1 in 10 chance of having their identity stolen.

An insurance agent may tell you that you need disability insurance because, "you actually have a 3 in 10 chance of suffering a disabling illness or injury during your career that would keep you out of work for three months or more."

Which would you be more concerned about: having your child’s identity stolen or having disability insurance?

It’s a whole new ballgame.

To Be Continued in One Mistake Led to Another (Part VI).