Preparing for Appointment: Dr. Maloney Patel

Tomorrow is my appointment with Dr. Maloney Patel, who is a colon-rectal surgeon at RWJ. Hopefully, some of our questions will be answered:

First, starting with what I do know:

Cancer Type: Gastrointestinal Carcinoid Tumor aka Neuroendocrine Tumor (NET)

Date of Diagnosis: April 21, 2010

Tumor Size: 3cm

Primary Origin: Appendix

Now, what I don't know:

What stage is my cancer in?

Stage Determination based on Point of Origin and TNM

T - size (cm)

N - extent spread (regional)

M - extent spread (distant)

Staging for Appendiceal Carcinoid Tumor according ACS:

Stage I: (only for tumors less than 2cm)

Stage II: T2 or T3, N0, M0: the tumor is either larger than 2 cm OR it has grown into the cerum (T2) or ileum (T3). The cancer has not spread to nearby lymph nodes (N0) or to distant sites (M0).

Stage III: either
T4, N0, M0: The tumor has grown into nearby organs or tissues. The cancer has not spread to nearby lymph ndoes (N0) or to distant sites (M0).
OR
Any T, N1, M0: The tumor can be any size and may or may not have grown into nearby structures (any T). It has spread to nearby lymph nodes (N1), but not to distant sites (M0).

Stage IV: Any T, any N, M1: The tumor can be any size and may or may not have grown into nearby structures (any T). It may or may not have spread to nearby lymph nodes (any N). The cancer has spread to distant sites (most often the liver).

5-year Survival Rates, by Stage and Primary Site (Appendix):
Stage II: 88%
Stage III: 78%
Stage IV: 25%

How do we determine if it has spread (regional or distant)?

How do the treatment options differ for Stage 2,3,4?