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surgery to remove tumor in rectum and lymph nodes close-by scheduled for Jan. '05

4law's picture
4law
Posts: 112
Joined: Dec 2004

I was diagnosed with rectal cancer in Sept. 2004. I was told a 4-5 cm tumor approx. 8-10 inches from anus. CT scan did not show spread anywhere else. Not sure of technical stagging, but I was told everything showed no signs of anything advanced.
I completed 6 weeks of continuous 5F chemo infusion through porta cath and radiation 2 weeks ago. During exam in surgeon's office the other day, he says most of tumor is gone with what looks to him to be small ulcer-like remains. Surgery is scheduled in Jan. to remove remains of tumor and lymph nodes close-by. He will remove approx. 10-12 inches of rectum/colon. He was pleased with what he saw and feels chances for permanent bag is slight, although depending on what condition my rectum/colon is at time of surgery will determine if a temporary bag is needed. Pathology results following surgery will determine what kind of chemo (I was told to expect about 6 months) I will have post-surgery.
On the one hand, I am extremely happy with the progress and results so far. However, I am extremely nervous about upcoming surgery. I realize that there is no other choice but surgery and that is the best way of getting rid of this damn cancer so I can go on with my life. I will be cut from near belly button to public area, be in hospital for about 5 days and then expect to be home 2-3 weeks. Catheter will be put in penis once I am asleep, but will remain for a few days. I am trying to be upbeat and do realize that I am lucky in a lot of ways, but I must admit to being scarred.
I just turned 60, male, married with teen-age daughter.
Can someone in network reply with first-hand experience on what to expect? Thanks!

Tomoco
Posts: 3
Joined: Dec 2004

Hi 4law-
I was diagnosed with stage II rectal cancer on 10/19/04. I had surgery to remove the tumor on 11/9. they removed about 7" of my lower intestine. They were successful with getting all of the tumor out. The CAT scan showed no evidence of it spreading in the lymph nodes or wall. I did have some complications after surgery, and was in the hospital a total of 25 days. an abcess formed in me and I had to have another surgery to have 3 drain tubes inserted. I was only in the hospital about a week after the second surgery. The docs told me that this happens in about 5-10% of the cases. also, I had a minor bout with pneumonia, so be sure to do your breathing exercises--no matter how much they hurt.

The incision isn't as bad as I had anticipated, and healed rather quickly.

I will be starting chemo in Jan; which will last 6 months.
I know that you are scared and worried about this, but you have to trust in your surgeon, and the higher power.

Good luck.

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

You are fortunate to have found the tumor early, and
that it had not penetrated the colon wall. As long as you are comfortable with your surgeon, relax and let him do his magic. Your description of the surgery and recovery time sounds accurate. Complete healing will probably be a little longer than 2-3 weeks. I spent 7 days in hosp, but also underwent two surgeries, one to try and preserve the anus, and another two days later to remove the
tumor and install a permanent colostomy. (The tumor was further down and too close to the anus to save ..) Either way, you'll be up and running
in a few weeks. Your recovery time will depend on your physical condition when you go in for surgery, so use the time you have to get in as good a physical condition as you can. Good Luck, Bud

taraHK
Posts: 1961
Joined: Aug 2003

Hi. I was diagnosed with a low rectal tumour December 2003. Like you, I had 6 weeks of chemoradiation before surgery. Although my tumour shrunk a lot during the radiation, in the end I did have to have a permanent colostomy (and removal of the rectum), as my tumour was just too low. Of course everyone hopes to avoid this but I do want to let you know that, if it happens to you, it ain't that bad. I had chemo after surgery.

It is normal to be nervous about surgery! But, it sounds like you are in excellent hands. I had an incision from belly-button to pubis (and also incision around my butt). One piece of advise: keep a pillow close to hand after the surgery. If you feel you are going to laugh or cough, push the pillow firmly against the incision. The nurses will probably encourage you to get up and start walking very soon after the surgery. Do it! My 3rd piece of advice: make sure you get good pain relief. I think this can really help with recovery. After I got home from the hospital, I tried to walk every day. I think this helped my recovery, which was without complications. I'm surprised they are saying you'll be home for only 2-3 weeks after the surgery. I would expect a longer recovery time.
Thinking of you and wishing you all the best.
Tara

jana11
Posts: 708
Joined: May 2004

Hi. I also had rectal cancer. Pre-op chemo/rad and post-op chemo for 4 months. Like Tara, colostomy for life, and it ain't so bad.

Surgery tips:
1.) Exercise now. Just walk, bike, run; whatever you like. Get in the best shape you can to help heal later.
2.) I had my surgery at age 32 and in great shape. I was told I couldn't work for at least 6 weeks. I went back, part-time after 6 weeks. It takes a while to heal.
3.) Get a donut pillow to sit on. Helps a lot, especially for car rides.
4.) Get a removable shower head to help wash all areas easily once you go home.
5.) Get a wedge pillow in case your abdomen isn't comfortable laying flat.
6.) Get button down pajamas that can be easily removed in hospital. And bring slippers and bathrobe to walk around in.
7.) Bring some underwear that is 1-2 sizes too big. You will have swelling after surgery and it will help.
8.) Bring music and pictures/cards to make your hospital stay more "homelike"
9.) You will be fine. Definately use pain meds!!!!!! I had an epidural and was grateful to have it post-op.. Ask for one. Walk around ASAP after surgery and do all the breathing exercises.
Hang in there. The Foley catheter (urine cath) is a piece of cake, don't even worry about it!!
If you have any questions... just ask. Have wonderful holidays. jana

spongebob's picture
spongebob
Posts: 2600
Joined: Apr 2003

4law -

Sounds to me like you have a pretty good handle on what to expect already!

Understand that it will take some time for the colon to adjust to it new "trimmed-down" status. You will probably find you have a lot more gas and you have to go more often. 5+ times a day is not uncommon. That will improve with time, but may never completely go away.

Now, here's the really tough part for the married guys (I'm divorced so it's not as bad for me)...

The chicks really dig the scar - they hit on you and make passes at you all the time. You will feel like such a piece of meat. Your career as a swimsuit model may be over, but - if your wife is kind, understanding, and realizes that it's ONLY for rehabilitative purposes - you can have a new career as a gigolo. Now, in my case, I'm rather furry so my scar isn't too evident and I don't get nearly as much action as Nanuk or Kanga, so when I go to the beach, I put a yellow post-it note on my belly with an arrow pointing at it - usually works well until I apply sun screen.

Seriously, though, keep a good attitude. Welcome to semi-colons - we're always here (except Kanga, who is often AWOL). Don't let the dragon get ya down - cut his head off!

- SpongeBob

jsabol's picture
jsabol
Posts: 1156
Joined: Dec 2003

Hi 4law,
Welcome to our club. Sounds like things are going well for you...continued good luck with the surgery.
I had a colon resection last December, and it went really smoothly. I was in the hospital for 5 days, and I heartily endorse good pain control. I also had an epidural inserted just before the general anesthesia, left in for 3 days post op...numbed the lower belly, but I could walk and move just fine. It worked really well for me. Don't worry about the catheter...a bit of an inconvenience, but only for a short while.
While in the pre-op area, you will get some pre-op meds. Be sure to let the anesthesiologist know at your initial meeting that you are a bit nervous about surgery. Once you are "pre-medicated", the nervousness slips away and you will relax a bit (or a LOT more, in my case)
I was 53 at the time of surgery, in good physical condition, and the recovery was closer to 5 to 6 weeks. I guess I could have pushed it, but facing chemo also meant I wanted to heal as much as possible.
Good luck to you; surgeons do this all the time, but hopefully we only experience surgery infrequently. Keep us posted. Judy

johnom's picture
johnom
Posts: 86
Joined: Jul 2004

Dear 4law,
Everyone's advice is excellent. Print it out for reference if you have to. I went through almost exactly what you describe starting in Feb. instead of Sept.
The 2 days of prep for the surgery were ugly, but survivable. DO GET AN EPIDURAL...YOU WILL BE GLAD YOU DID, TAKE OUR WORD FOR IT.
As was pointed out, the first 2-3 months after surgery are a little rough, in that your colon is missing some parts. I and some others would experience a sort of "spastic colon" where we would have as many as 35 BM's in a couple of hours. Not diarrhea, but actual stools. It's going to introduce you to the "ring of fire", which is best fought with Desitin (diaper cream). Like the rest of us, you will always look for ther restroom where ever you go. Accidents are not uncommon. I carry spare undershorts in my car, along with Desitin, aloe wipes, preparation H, and always an O-ring to sit on when needed.
Immediately after surgery they want everything to keep moving through your bowels, but as time goes on after 6 weeks or so, I suggest you begin to increase your use of Metamucil or its equivalent until you feel comfortable and get some relief from the contstant BM's.
Psychologically understand you will probably not be the same person again. The scars are a symbol of bravery for all of us, like the flag of a country displayed in their annual parade. The other scars that are not visible...fear, shame, guilt, etc. can be displayed here on this site, where everyone else knows exactly where you are coming from and going.
I know your surgery will go well. Remember, the NG tube, the very worst of it all for me, does get removed finally and forever. The catheter is actually no biggee...they put it in while you are asleep, and it takes about 3 seconds to remove it. I was back at work in 5 weeks, part time.
I encourage you to read everything you can and include this website in your reading.
Good luck and know that many prayers go with you.

steved
Posts: 836
Joined: Apr 2004

As you can tell form the replies above you are far from alone in having this. I had the exact same treatments this year and had my resection done in June. I won't lie - it was the hardest thing I have ever done but it is short lived. I had the anterior resection with a temporary ileostomy which I am keeping till the end of chemo to control problems of diarrhoea on chemo.

The op itself is a physicallly hard thing. I was in hospital two weeks total as it took a while for my bowels to restart. They give morphine like drugs which control the pain well and the main thing is just to rest and sleep and allow th e body to recover. I was up and walking after a day and fully mobile within a week. you may have a central line in- a tube into the kneck to give fluids and drugs and drains around the belly to let out the fluid that collects after an op. These come out after a few days.
I had two onths off work afterwards as I was too tired and sore to go back earlier. The bag isn't too bad and you just get used to that- amazing what becomes normal after a while.
Overall it is rough but doesn't last forever and it is the most important aspect of treatment when deciding your future prognosis- so make sure you have an experienced surgeon who specialises in colorectal operations and not a general surgeon.

if you want any further questions answered do feel free to email me. Otherwise best of luck and let us know how it all goes,
Steve

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