Ct showed tumor but not on colonoscopy

[Dr105]

Hello all. So my father, who is in his late mkd60s, was having digestive symptoms- pain and trouble passing stool. After seeing his doctor several times he ended up in the er where a ct scan was done.

The ct scan showed a large (6 cm) ill defined mass at the junction of the descending and sigmoid colon in addition to a nodule on his lower lung which the report stated was suspicious for metastasis.

He was referred for a colonoscopy which did not find the tumor. They did take some polyps but they were biopsied and benign. He’s now being referred for another scan.

Anyone ever experienced something like this? We are somewhat dumbfounded. I live clear across the country so am not there to help with appts etc and interpret. We expected the colonoscopy to yield a cancer diagnosis.

[GCCA-Survivor Administrator]

Hi Dr105,

Thanks for posting with us. I have lynch syndrome and as a part of my surveillance I must get an annual CT scan and a colonoscopy. I would much rather just get a CT and be done with it, but the CT sees things the colonoscopy cannot and vice versa. Most colonoscopy sessions deal with polyp removal and CT could be completely clear while looking at the entire upper and lower abdominal area. If it's still in the wall lining of the colon, the CT will more than likely not detect it. I have not run into having a clean procedure and the next one is discovering something. But they tell me I need both given my cancer history.

It looks like you’re in one of those situations now. That 6 mm ill-defined mass may or may not be growing from the colon? I would think the colonoscopy would see something in that area if it were. It looks like it hasn't perforated the colon call. That does help the doctors narrow down the situation. It may have indeed metastasized from another area? I see there’s another scan scheduled. It would be interesting to see what that reveals. I would hope a biopsy is also being scheduled.

Is there a hereditary history of disease within the family? That would be good to know as well and may lead to some further necessary testing as well.

I do wish you well on getting your father on the path to being well soon. More tests are instore to get a better idea of what’s going on and a better direction for therapy. I do send positive vibz and wishes to you and your father for a speedy path to being well. Please let us know the direction this takes. That type of information can be helpful to others as well.

Thank you,

~Tom, GCCA Survivor - Colon Cancer Connected Site Administrator.

Just a reminder - this group is here to offer support, share experiences, and offer our thoughts - but this is not medical advice, and you should always consult your medical professional(s). Additionally, for all emergencies, seek urgent medical care, never delay.

[Dr105 in reply to GCCA-Survivor]

Thank you for your response. I will update once the second scan is complete. I thought it was strange they didn’t mention anything following the colonoscopy as I have known others who have had colon cancer and they both had the doctor tell them following the procedure. So I thought maybe they were waiting on the biopsy- but no, turns out they didn’t find it. I am hoping he will get a biopsy of both the mass (when they find it) and additionally the lesion on his lung. It seems like there’s been no attention given to the lesion at this point bc I guess they are focused on the primary. It’s now been three weeks and seems we know nothing or perhaps even less than when this started.

[GCCA-Survivor Administrator in reply to Dr105]

I do see where people wait weeks to find the results from a colonoscopy. It is quite amazing how long some things take. 3 weeks is a long time. A very long time. Is this a cancer center? The colonoscopy is the only way to get a biopsy and probably didn’t happen since they said they didn’t see anything. I would hope the next step after the CT is to go get a biopsy. And yes, the lesion on the lung is very important as well.

When I was first diagnosed, I didn’t realize how good my team was until I started to follow some on-line cancer groups and was appalled at the differences in care. Even here in the US. I have a colonoscopy and I’m talking with the doctor about it as soon as I wake up in recovery (I really thought that happens for everyone). I have a blood draw and CT scan at Duke at 11:00 am and I’m talking about it at 3:00 with the doctor and can discuss my colonoscopy there as well. I find that is not the norm, but believe it should be.

I pray it doesn't to this🙏, but I offer this as just information I know about now and have been through. If things do take a turn towards cancer, make sure your father gets genetic testing and the tumor gets sequenced. This will give you the information (biomarkers) targeted therapies are looking for.

Therapies are getting so targeted that you have to know as much about yourself as well. It’s no longer about the tumor type (lung, colon, pancreatic, etc.) but about the mutation. In my case I was included in a clinical trial for an immunotherapy approved for certain lung and melanoma cancers. I had stage 4 colon cancer. But it was the genetic testing that revealed I was MSI-high, and it was discovered I may find benefit in the same therapy. I did. It was quite miraculous. It’s now approved for people with my type of cancer. So you never know where a beneficial therapy may come from.👍

[kewl1 in reply to Dr105]

Not sure if this means anything but I knew somone whose colon cancer tumour was on the outside of his colon and therefore did not apear in a colonscopy.