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New Rectal Squamous Cell Carcanoma Patient

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Subject: New Rectal Squamous Cell Carcanoma Patient
Date: 11/21/2007

I've just been diagnosed with SCC of the rectum.  The tumor is small, only 2 cm, so the surgeon is calling it stage I, but we won't know for sure until I get the transrectal ultrasound next week.   The bad news is, the tumor is too close to the anus for a simple operation, so the only surgical option offered is APR.  I don't have a problem with having a permanent colostomy if it's going to eliminate the problem once and for all.

However, my surgeon does not want to go the colostomy route on a stage I tumor and is recommending External Beam Radiation Therapy (EBRT) and chemo.   I am not sold on chemo, I've done my research and the 5 year survival rate is only improved 0.1% over those who do EBRT alone.   The  only advantage  of adding chemo to the EBRT is better local shrinkage of the tumor.

Another option that I have discovered through my own research is EBRT combined with endocavity (contact) radiation treatment  According to the journal articles I have read, success rate at five years with this combination is 100% for uT1N0 tumors and 85% for uT2N0. This study was done on adenocarcinoma patients, so it may not directly apply, however, the sample space is so small for SCC of the rectum that this study is the best I can go on.

My question for the group.  Has anyone used EBRT and endocavity radiation treatments for their rectal cancer?  If so, how long was the recovery and how bad was the pain during the recovery period?

Of course, I will be getting a 2nd and perhaps 3rd opinion before embarking on a course of treatment.

 

Subject: RE: New Rectal Squamous Cell Carcanoma Patient
Date: 11/21/2007
Oops!  Transposed some figures.  Second sentence of second paragraph should read "I am not sold on chemo, I've
done my research and the 5 year survival rate is only improved 1.0%
over those who do EBRT alone."  See New England Journal of Medicine Sept 13, 2006 issue for details.  IMHO, a one percent improvement is not worth the side effects and the risk of permanent liver, kidney or bone marrow damage (depending on the agent used), but that is for each individual to decide for themselves.
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