What Lies Ahead?

I would appreciate some knowledgeable opinions as to what lies ahead for my father-in-law. Two months ago he had surgery for rectal cancer. Part of his rectum was removed along with over 10 inches of his colon. A colonostomy was not require because the doctor was able to reattach what was left. They also removed 44 lymph nodes of which 34 were cancerous. (adenocarcinoma) These nodes were not just local some were quite a distance from the primary tumor. The surgeon has recomended radiation and chemo. The Oncologists do not think my father-in-law can tolerate either because he is 84 years old. Plus he witnessed what chemo and radiation did to me for my stage IV squamous cell carcinoma at the base of my tongue and has opted not to have any treatment, but that is another story. His family is under the impression that he is cancer free because the doctor told them that he removed all of the cancer. Well, with my experience with cancer, the doctor may have removed all of the cancer he could see but with 34 cancerous nodes I am sure there are microscopic cells just about anywhere and everywhere in his body and without radiation and/or chemo it is just a matter of time before these cells become bonifide tumors. I would like to know how aggressive adenocarcinoma is and what you think of my father-in-law's prognosis. Any response would be appreciated.
Paul

This sounds like stage 3 rectal cancer. Following surgery 60-70% of patients will have recurrance of their cancer for the reasons you mentioned. The recommendation is chemo and radiation to prevent this. Studies have shown that you can double your 5 year survival by using chemo/radiation after surgery, from 25% to 50%. On the other hand your FIL is 84 and has lived a long life. The chemo/radiation will have an adverse effect on him.

Michael,
Thank you for your response. You are correct, it is Stage 3 Rectal Cancer. Do you know how aggressive adenocarcinoma is? Also, what the average time for recurrence is without radiation and/or chemo? Prior to surgery, the surgeon told me that the cancer was rated as a grade three which is on the aggressive side.(as far as I know)Again, thank you for your response.
Paul

I would think thats hard to say. Time to recurrance after surgery would depend on how effective the surgery was. Were there good surgical margins? Were there any micro mets that escaped detection? If I were to guess, I'd say rucurrance could occur anywhere from a few months to a few years.

 

On 9/26/2006 Oncrx wrote:

I would think thats hard to say. Time to recurrance after surgery would depend on how effective the surgery was. Were there good surgical margins? Were there any micro mets that escaped detection? If I were to guess, I'd say rucurrance could occur anywhere from a few months to a few years.

Hi,

I am new to this forum, and you sound very informed.  My wife has been diagnosed with stage II  uT3 N0 M0 rectal cancer, just inside the anus.  She is one week into chemo and radiation.  Facing surgery and likely colostomy in March, then more chemo.  What are the chances for recurrence after that?  Can you direct me to other sources with such information? 

Thanks,

Francisco 

 

stage II cancer is fairly cureable since she has no nodes involved and no mets.  Surgery alone should give a 60% or so chance of cure and with chemo the 5 yr survival rate can approach 85%.  The ACS has some good info if you wish to read more.  Just Google "rectal cancer".