Stage IV Rectal Cancer with Bone Metastis

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Stage IV Rectal Cancer with Bone Metastis

by nick5407 on Wed May 18, 2016 02:35 AM

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I am struggling with treatment opinions. I was diagnosed in Jan 2016.  I have FAP (grown to over 1,000 polyps in the colon and several on the rectum ) which one developed to stage IV cancer with bone metastis (spine, shoulder, arm, rib, hip) before I sought treatment. The initial plan was to undergo chemo radiation therapy (28 treatment days) and based on the results of treatment, determine which surgery was appropriate to remove the colon and/or  rectum( illeanal pouch or full colectomy with ileostomy) and  then systemic chemo after for the bone metastis. At the end of chemo radiation, I met with surgeon who advised just moving forward with ileostomy. This confused me as no additional tests or scans were done. I was told that it was because the initial plan was developed before they identified the metastis in the bone through a PET CT. I confirmed this with my Oncologist. This caused me seek a second opinion from another practice who feels systemic chemo to treat the metastis is the priority and surgery to remove colon later, which surgery would to be determined. I am hesitant to have full ileostomy unless totally necessary as I am only 27, husband and father of 2 (soon to be 3) and live a very active lifestyle which a colostomy would significantly impede. I am trying to decide what will give best quality of life with having a young family I need to support and can't decide which is more appropriate. My original oncologist is with a well respected practice, but second opinion is actually from a cancer treatment center, roswell park. Considering switching my treatment there instead. Thoughts? I appreciate any input!

RE: Stage IV Rectal Cancer with Bone Metastis

by nick5407 on Wed May 18, 2016 02:39 AM

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There are also directly conflicting opinions on the amount of time following each surgery until I could be administered the systemic chemotherapy. This is and the difference in opinion between the bine metastasis or colon being the priority to treat next I have been told are the driving factors in their differing opinions. 

RE: Stage IV Rectal Cancer with Bone Metastis

by antoinette_b on Fri Jun 03, 2016 02:56 AM

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Hi Nick,

First of all I'm so sorry that you're going through all of this, especially at such a young age. Just wanted to give you some positive feedback on the colostomy procedure decision you're struggling with. My Dad is 52, has Stage IV rectal and his doctor advised him to get the surgery in the case that the tumor swells during treatment or does not respond to treatment. The stoma was to prevent any long term damage in the case that a bowl obstruction would occur. Unfortunately, my Dad's tumor has since grown (found this out after 8 rounds of FOLFOX) ...but had he not had the colostomy he would've potentially had permanent damage to his body. The colostomy is temporary, and while he doesn't run like he used to (also doesn't have the strength after treatment, tired), he's not feeling any pain/pressure from the tumor and now he's emergency bowl obstruction free! 

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