Path Report/Question

[mary colleen]

My husband had his surgery back in October, but I just recently called and asked to have the path report sent to me. (Until reading some posts here, I had not realized that was even an option. Not too sharp sometimes...

Anyway, I noticed that the path report states his "M" status as 'MX' (mets unknown). The oncologist has always treated him as M0 (no mets), and he is staged as IIB, using that assumption.

Question: is it maybe just standard on path reports to indicate 'MX', since the pathologist is not looking at mets at the time of surgery, just looking at what has been resected?

As a side note, my husband did have all of the standard screens/scans prior to surgery. Though the radiologist told us that there were lesions on his liver, and a largeish lesion on his adrenal gland, the oncologist and surgeon told us at the time of surgery that they had decided to consider those all to be benign and call him a stage 2B.

Anyone else see this on a path report, or know the reason for it?

Thanks!

[blaze100]

Hi Mary, I double checked my pathology report from the surgery and it doesn't say anything about MX or my stage. Mostly it just describes the type of cancer cells found, tumor size, margins, and number and type of nodes that were tested.

I'm guessing you're right. The pathologist can not comment on mets really if they just are looking at a lung segment.

Looks like we are both stage IIB. Your hubby's tumor must have been a biggie too.

Were his margins OK. Is he going to follow up with chemo or radiation? What is the plan with the other spots?

Barb

[mary colleen]

Thanks for your response, Barb. I admit that the "MX" notation made me a little nervous, since I have never really felt 100% comfortable with the mets situation.

You have to understand that the when my husband went to see the radioligist prior to surgery being scheduled (by himself -I could kick myself for that one), he came home very shaken, and sure that the radiologist had told him that he had liver and adrenal spread.

When I circled back to the surgeon and oncologist they simply said that they were judging the lesions to be benign, and were not going to worry about them for now. So, seeing that "MX" on the report, rather than a nice "M0" made me a little worried that they weren't sure.

Yes, his margins were clean, he had 2 positive N1 nodes, some vascular and lymphatic invasion, and a tiny non-invasive second spot of cancer in the bronchi. He is mid-way through cisplatin/gemzar now, and going pretty well most of the time.

I guess upcoming scans will tell the story; none are scheduled, but I assume they will be done at the end of the 4 cycles of chemo (?)

Thanks!

[blaze100]

Hi Mary, Oh now I see his bio....I must have been spacing. Chemo brain!

T2N1MO...I think I was T2N0M0 so your hubby and I are very similar. But the way I figure, who knows anything for sure?

OMG, he talked with the radiologist alone? He has real guts. These guys are the biggest doom and gloomers on Earth! No lights on PET is usually good news. I would take the opinion of the lung doc or surgeon over a radiologist any day.

In fact, Mary, every radiologist report I get is so bad. So much scarring and radiologist thinks every spot is cancer. Then I usually have to make appt with lung doc. He reads the scans and tells me there has been no change and that radiologist is just a zealot.

I'm keeping my fingers crossed for your good hubby. Prayers for good scans after chemo, but you might be thinking of scheduling appts with lung doc or surgeon at that time so they can read them too.

Barb

[mary colleen]

Thanks, that helps a lot. I agree that the onc, surgeon, and pulmonologist acted as if they had heard these issues before after patients had seen the radiologist. For some reason, however, it seems to be the protocol at our cancer center to make new patients a one on one appointment with the radiologist in addition to the standard appointments. ...and you're probably right; no one knows anything for 100% certain. I am coming to view even the most careful cancer staging as an exercise in educated opinion. On to January and new scans!