hi all

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Denise1966
Denise1966 Member Posts: 90
edited March 2014 in Colorectal Cancer #1
Well, I met with the surgeon today. He is having me do a endoscopic ultrasound on wed. and he says we may then do the surgery the following day, if we don't have to do chemo and rad before to shrink the tumor since it is borderline rectum and sigmoid. Has anyone had any of this before? If so, what can I expect? Please let me know as I have again managed to make myself crazy. Thanks!

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  • KathiM
    KathiM Member Posts: 8,028 Member
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    Yes, I have had this done. The prep is similar to the colonoscopy prep. I had no aftereffects. One question (remember, I am NOT a doctor...), have you been told what kind of cancer it is? If it is squamous cell, my 2" tumor COMPLETELY resolved with just chemo/rads. (This is anal cancer treatment). I went ahead with the surgery, because it was so unknown to my treating doctors, but all tissue removed was cancer free. What kind of surgery is the doctor recommending? A resection can be a bit of time to recover from.

    Hugs, Kathi
  • Denise1966
    Denise1966 Member Posts: 90
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    KathiM said:

    Yes, I have had this done. The prep is similar to the colonoscopy prep. I had no aftereffects. One question (remember, I am NOT a doctor...), have you been told what kind of cancer it is? If it is squamous cell, my 2" tumor COMPLETELY resolved with just chemo/rads. (This is anal cancer treatment). I went ahead with the surgery, because it was so unknown to my treating doctors, but all tissue removed was cancer free. What kind of surgery is the doctor recommending? A resection can be a bit of time to recover from.

    Hugs, Kathi

    Hi Kathi, well it is in the rectum/sigmoid area. He's thinking of shrinking the tumor because it is so low. he has not told me what kind it is and he says th EUS will tell him the extent and lymph node involvement. Did yours tell you about any lymph nodes? How was the chemo/rad treatment, that is really freaking me out now.
  • pamness
    pamness Member Posts: 524 Member
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    Hi Kathi, well it is in the rectum/sigmoid area. He's thinking of shrinking the tumor because it is so low. he has not told me what kind it is and he says th EUS will tell him the extent and lymph node involvement. Did yours tell you about any lymph nodes? How was the chemo/rad treatment, that is really freaking me out now.

    my colon cancer was in the colorectal area - as I said last night they did the colon resection and them chemo and radiation because I had 2 positive lymph nodes. I had very standard colon cancer. What else have they told you? When they do the endoscopy/ultrasound what are they looking for exactly. I am not a doctor, but if they find lymph nodes they will probably go the chemo rad route - I did it and the surgery. It's not fun, but could be worse. You need to see what they say befor you freak out totally.
  • rmap59
    rmap59 Member Posts: 266
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    Hi Denise,
    I had the ultrasound too. It was painless, the prep was not as bad as the colonoscopy prep. They found that my tumor had grown into the fatty tissue a little so I had surgery first and then chemo/radiation. I got through it as many here have. Just let your Doctors know your concerns and get educated as much as possible. I pray you will have little or no side effects.
    Robin
  • Denise1966
    Denise1966 Member Posts: 90
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    pamness said:

    my colon cancer was in the colorectal area - as I said last night they did the colon resection and them chemo and radiation because I had 2 positive lymph nodes. I had very standard colon cancer. What else have they told you? When they do the endoscopy/ultrasound what are they looking for exactly. I am not a doctor, but if they find lymph nodes they will probably go the chemo rad route - I did it and the surgery. It's not fun, but could be worse. You need to see what they say befor you freak out totally.

    Pamness, He told me he wants to do the eus for staging purposes and lymph node involvement. How long did you do the chem/rad before surgery for? Was it horrible?
  • vinny3
    vinny3 Member Posts: 928 Member
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    Hi Denise,
    It's a very tough decision and there is alot of anxiety until a course of treatment is really decided upon. I will tell you my course.
    I was diagnosed with rectal cancer in April 2005. It was very low (close to the opening) so if I just had surgery it would be for a permanent colostomy. I am a physician and did alot of reading so when my oncologist recommended doing the radiation/chemo to shrink it and my surgeon agreed as then he could do a simple excision I was all for that as I could avoid the colostomy. Two other surgeons had recommended the bigger surgery. Unfortunately 8 months later the cancer came back and I ended up with a colostomy and then more chemo after that.

    The chemo/radiation done to shrink the tumor is not pleasant but tolerable. For the first two weeks you don't notice too much. Then the effects of the radiation kick in and there is some burning around the bottom and you get fatigued. However, I was able to continue work throughout except for the hours I was in chemo. The main effect I noticed from that chemo was some rash as if you have some precancerous skin spots, which I did, it makes them get red and sometimes blister. The good part of that is that when it is over your skin heals and the spots disappear.

    If I had to do it over again I would probably opt to just do the big surgery to begin with. With the location of your tumor it is unlikely that a colostomy would be needed. At most, if needed, perhaps a temporary ileostomy. I'm not convinced that doing the preop chemo/radiation gains that much for survivability but may be necessary, in some cases, to shrink the tumor to make the surgery easier and safer to complete. The drawback of the radiation is that it shrinks the lymph nodes too so that when you have the surgery, less lymph nodes are removed and it is harder to tell what stage you are in. The ultrasound gives them an idea if a lymph node is obviously involved (quite large) but it is possible to have an affected lymph node that is a normal size and that can only be told then when it is removed.

    I'm sorry to have written a book. I would recommend taking just a little extra time, if you can stand it, to get at least one other opinion.

    Let us know what you decide. We are all praying for you and whatever decision you do make is the right one.

    ****
  • dancininrain
    dancininrain Member Posts: 4
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    Hi there. My mom's oncologist suggested that she have the endoscopic ultrasound so that he would be able to stage her cancer immediately instead of waiting until after surgery. My mom has rectal cancer, and the oncologist told her that if the cancer were fully contained in the rectal wall and no lymph nodes were involved that immediate surgery would be an option without having to go through chemo and radiation first. He told her that even if the cancer had gone through some layers of the rectum but had not perforated through the rectal wall, and no lymph nodes were involved, he would be happy with chemo and radiation and surgery without any follow up chemotherapy. If her cancer had spread to her lymph nodes, then he would want to continue with chemotherapy after surgery. He told her that without being able to stage the cancer before surgery she would have to undergo chemo, radiation, surgery, and follow-up chemotherapy because even if no lymph nodes showed up positive in the tissue sample following surgery, this could be a false negative given the prior chemo and radiation. During the edoscopic ultrasound, the doctor was able to biopsy several of Mom's lymph nodes (a painless procedure) and received pathology on them in a matter of minutes. Unfortunately, mom's lymph nodes were positive, and a small portion of the tumor had grown beyond the rectal wall. Even though the news was not great, at least Mom knows how important the treatments she is going through are, and that she is not going through them needlessly. The procedure itself was a bit like a colonoscopy with an easier prep (Magnesium citrate instead of colyte), and she was lightly sedated. She said that there was no pain involved.
    My mom started with Xeloda (an oral form of the chemo drug 5-FU) and radiation for six weeks. She felt really good the first two weeks, the second two weeks felt a bit tired, and the last two weeks had many days where she was happy just to lay on the couch and rest. She did lose her appetite for a few days at the end, but she has only been done with chemo and radiation for a few days and her appetite has already returned.
    Just know that this is an information gathering procedure that will tell the doctor what he needs to know about your tumor to most effectively treat it. My prayers are with you as you start this journey.

    Hugs,
    Ardlie
  • KathiM
    KathiM Member Posts: 8,028 Member
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    Hi Kathi, well it is in the rectum/sigmoid area. He's thinking of shrinking the tumor because it is so low. he has not told me what kind it is and he says th EUS will tell him the extent and lymph node involvement. Did yours tell you about any lymph nodes? How was the chemo/rad treatment, that is really freaking me out now.

    I'm sorry, don't mean to freak you....just listen to what the results of the EUS is. Sounds like this guy is on it....
    My tumor was in the first rectal fold, and was, as I said, pretty large. The decision was made to do pre-surgical chemo/rads to try to shrink the thing...Then, it worked so well, as I said, that there was nothing left...
    I had one lymph node positive, found earlier during a CT scan....**** is right, because of the sequence, when the surgery came around, it was a bit tougher to tell of the involvement.

    Listen to the results. The EUS is not bad...I guess I was sedated more than most...maybe because this was done after rads, when tissue was still healing, and they didn't want me participating...

    Hugs, Kathi