The pathologist (me) signed it out: 'Moderately differentiated adenocarcinoma of the colon, with lymphovascular invasion, metastatic to liver.'
That single cell grew into a 2 cm metastasis in the right lobe of the liver. That’s when Margaret’s alkaline phosphatase rose. That’s why she felt fatigue—cytokines from the tumor causing systemic inflammation. Cachexia began. Her body started breaking down its own fat and muscle, not because she wasn’t eating, but because the tumor released TNF-alpha and IL-6." pathology lecture
The professor collects her papers.
Dr. Voss nods slowly. "She knew. She asked me once, over the phone, 'Is it the bad kind?' I told her the truth. She thanked me and said, 'Then I’ll make the most of the time left.'" Cachexia began
Stage IV. Incurable."
"At this point, Margaret felt nothing. The polyp was a tiny mushroom growing in the dark. But on a colonoscopy, it would have looked like a raised red bump. If we had caught it then, we would have snip-snipped it out. Case closed. We didn't." Part 2: The Invasion (Breaking the Basement Membrane) An animation shows cells piling up, pushing through a thin blue line (the basement membrane). Voss nods slowly