need advise on surgery method for rectal cancer

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need advise on surgery method for rectal cancer

by petdearly on Fri Sep 07, 2012 02:35 AM

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Hello all,

I am the caregiver for my husband who has T4N1MO rectal cancer. Tumor size is 4.5cm located at 2.3cm from the anal verge.

He has gone thru chemo (Xeloda) and radiotherapy for 25 session in Aug '12. There's good progress from the scans recently but we are still waiting for another week for MRI scan. He is now wearing a colostomy bag.

I just need advise from whoever has gone thru the surgery, was it from the open abdomen or from the anus? Our hope is to save his anal sphincter so that the colostomy can be reversible. He will be 31 years old this November and a very active person.

Thank you in advance for all the advice and suggestion. 

RE: need advise on surgery method for rectal cancer

by wandalein on Mon Sep 10, 2012 09:19 PM

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My husband was diagnoised stage 3 with tumour as T31NM0, one out of 16 lymph nodes involved.  He was diagnoised March 6, 2012 and had the surgery to remove the tumour on March 23, 2012.  His surgery was abdomonal.  It was in the upper part of his rectum.  He had apx 14 inches of bowel removed.  He just had the reversal of the temporary illiostomy and the take down seems to be a sucess his spinchter seems to be working in that he can hold it for a short period of time during this adjustment period.  He had the surgery 3 weeks ago and it seems to be progressing forward in the stools are being more formed and the urgency is less each day.

RE: need advise on surgery method for rectal cancer

by petdearly on Tue Sep 11, 2012 10:43 AM

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Hello wandalein,

Thank you for your kind advise. May i know where is the tumor located? how come he had to cut 14 inches of the colon? was it polyps is located at several places in between the 14 inches?

My hubby is using the colostomy as his bladder is functioning very well. but his tumor is too near to the anus, and it is blocking from the stool to come out. 

if you have anything to advise me, please do...before i discuss with the surgeon on how his surgery will be like. am not so sure to have open abdomen as the tumor is very near the anus...i've read about some surgery was done from the bottom (anus) and the surgeon will remove the tumor and save the anal spinchter. thank you for your feedback on this and please take care both of you.

~petdearly~ 

malaysia

Thank you so much for y

RE: need advise on surgery method for rectal cancer

by Super01Mom on Mon Sep 17, 2012 04:01 AM

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Hello,

I was diagnosed with  T31NM0 June 2008, my cancer was very near the anus as well, I had a LAR done thru the abdomen with a colostomy. My take down was performed Oct. 2011, and since then I have experienced bowel incotinence. I had tests done recently and it showed severe nerve damage and nearly no muscle control around the spincter muscle. Would the damage of happened if they went thru the anus instead according to the surgeon when you have a low tumor, your chances of nerve damage and muscle damage is very common no matter what route you take. I am trying a new treatment which is a nerve stimiluator hopefully it is successful because my alternative is having the colostomy placed back to avoid the issues I am having. I would discuss all the pros and cons with the surgeon and make sure you have a colon/rectal specialist and not just a general surgeon. Good luck and let us know how it turned out.

Sheryl

RE: need advise on surgery method for rectal cancer

by wandalein on Thu Sep 20, 2012 05:21 PM

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Hi; in reply my husband's was in the upper rectum chamber, he had apx. 14 inches of colon and 4 inches of rectum removed.  His pinchter was saved, I think that is the most important thing.  My husband had his surgery through the abdomen.  I am not sure what options you have but I have read that in the rectum there is more chance of reoccurrence than in the colon itself and for that reason (I have also read) is why it is better performed by abdomenal surgery than through the anus, just to make sure they get it all.  I want you to know that it is a very major operation and there is a lot of recovery time but it does get better.  My husband had his surgery on March 23rd and had a temporary ileostomy bag until Aug. 22nd.  The reversal was a much easier surgery on him and he is getting better ever day.

RE: need advise on surgery method for rectal cancer

by petdearly on Fri Sep 21, 2012 07:38 AM

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Hi Wandalein,

Thank you for sharing your experience with me. My husband surgeon now doesnt want to operate on my husband as yesterday we had another news that he needs to do few more rounds of chemo since the tumor is not shrinking to the certain degrees that they expected and also now the cells has spread to the prostate. There is no more fat muscle between the rectum and prostate.

The MRI report also says that there is a poorly demarcated lymph node measuring approximately 2cm of the right internal iliac group.

If there's anyone who can advise me on the next chemo details, that would be very good.

Pray for everyone good health! take care!!  

RE: need advise on surgery method for rectal cancer

by wandalein on Mon Sep 24, 2012 05:43 PM

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I am sorry to hear that your husband's surgery is delayed and there is a problem with his prostate.  I know everything is so close in that region.  That is why my husband's surgeon told him to re-think the standard treatment of radiation because of the prostate being so close.  My husband did say no to the radiation, the risk seemed to outweigh the benefit and the possibility of the radiation damaging the prostate and causing prostate cancer.  Good luck.  I know it really sucks to be going through so much.

RE: need advise on surgery method for rectal cancer

by TERRY1957 on Wed Sep 26, 2012 11:31 PM

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I had surgery in Sept 2011 for colon cancer.  My tumor was at the joint of the rectum and colon.  They entered through the anus and removed the tumor with no incision through the skin and no recession of the bowel.  The surgery went extremely well and was one day stay in hospital.  Hope this is an option for your husband.  Side effects are common after this type of surgery but can be successfully treated with viagra and such.  This is due to  the proximity of the nerves.  Of course radiation and chemo also cause these issues.  Just want to make sure you know everything up front.  Good Luck and God Bless.  Terry

RE: need advise on surgery method for rectal cancer

by petdearly on Fri Sep 28, 2012 08:45 AM

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Hi Terry,

Thank you for sharing info on the surgery option. I will speak to my colorectal surgeon on this. From the MRI scan the tumor is to near to the anus, but i just keep positive with the 2nd line treatment where my onco will give my husband Avastin (targeted theraphy) plus irenotecan + 5FU for 4 cycles.

With this, i hope the tumor will shrink and the surgeon can operate out the tumor. My husband is very concerned on the anal spincther saving, therefore we have to be positive that this time is a success.

About radiotherapy, i also very-very frustrated because they assured us with the Tomotherapy machine, the result will be better, but it doesnt turn out good for my beloved hubby. Sometimes, when we dont have much info about the disease, we tend to follow whatever the specialist recommeds, therefore it's it sometimes Trial & Error situation :(

I just wish everyone All the Best and be Strong!!! 

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