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Question regarding temporary Colostomy

jemy91
Posts: 29
Joined: Mar 2007

Hello everyone. Quick summary, My dad was dxed with Colon cancer end of March. His surgery is scheduled for May 17. He has had a CT and blood all normal. He had his appt with the surgeon yesterday and he mentioned that he would be trying to do the surgery using the laproscopic (sp) method (if possible as my Dad has a spare tire ;) The surgeon also mentioned that once the surgery is complete they will fill the colon with air and if there is any leakage that my Father would require a temporary colostomy that would later be reversed. I am wondering what the likelihood of this is. Also how many Stage 2 have had Chemo? We have been told (we live in Canada) that Chemo is only offered when the cancer hits the lymph nodes? Any input is greatly appreciated.
Thanks.
Paula

chynabear's picture
chynabear
Posts: 483
Joined: Jul 2005

I was told before my surgery that I would only have a temp or permanent ostomy would be if the cancer was so low or the tissue damaged so badly that they couldn't sew it back together. I think it happens more when the tumor/cancer is very low. Otherwise, I would probably say that he has a great chance of not having one.

In the US, I think the standard is moving to give more Stage II chemo. When I was diagnosed in 2004, chemo wasn't generally offered to Stage II or below. I had one positive node, so I received 6 months of chemo.

If I knew then what I know now and being diagnosed all over again, I would really take a strong look at pro's and con's of having chemo especially for a Stage II. You are generally not told about the long-term side effects of chemo and I would have to weigh the decision heavily.

My prayers are with you and your family. Know that you are doing a great service by learning as much as you can to make the best decisions possible.

Patricia

vinny1
Posts: 10
Joined: Nov 2006

I am also in Canada (Toronto). Where are you? My husband was diagnosed with rectal cancer last August. In December he had surgery and has a temporary illiostemy which will be reversed in May so that the colon could heal - this prevents leaks etc. The illiostomy was only because his tumour was so low down. As for chemo, his pathology came back T2 NO MO and he still has had chemo. Originally when we were going through the initial staging the endorectal ultrasound and CT staged it at a definate T2 a possible T3 with no lymph nodes. We were told that if he was a T2 he could skip chemo but the option was there to take the chemo if we wanted. We said that we did and the radiologist said that we were on the same wave length as him. My husband then had an MRI to try and get a more accurate staging and the MRI showed it was a definate T3 with suspicious lymph nodes - we were then told that not having chemo. was not an option. As I said pathology came back T2 NO MO and we were told that yes he still had to have the chemo. Because it was rectal cancer my husband had to have radiation for 5 weeks 5x week and he had chemo during this time as well, this was mainly to help the radiation do its job, we called it chemo light! So the pathology report was good but it may have been because the radiation did its job and the chemo he is receiving now is to kill any cells that may or may not be floating around and killed any cancer in the lymph nodes if in fact they did contain cancer, we will never know, I have been told many times one can have enlarged lymph nodes just because. Chemo is 5 days a week every 3 weeks for 4 months. He is at Princess Margaret in Toronto. Hope this helps.

nudgie's picture
nudgie
Posts: 1483
Joined: Sep 2006

First off I live in the U.S. (West Virginia). I was DX with Stage II colon cancer (no lymph nodes or spreading) in July 06. Had tumor removed on 10 July 06 and was left with a temp colostomy. My tumor was a total obstruction of my colon. After path report was read by surgeon he stated that I should see an Onc Doc even though I was Stage II there were no signs of spreading because he was NOT an Onc Doc, so I did. My Onc Doc stated that the industry standard for Stage II now was adjuvant chemotherapy using FLOFOX which consisted on 5FU, Lecovorin and Oxy given every other week for 6 months = 12 treatments.

Both my surgeon and Onc Doc stated that I should do this as insurance and a precuationary measure because of the chance of a microscopic cancer cell somewhere that could not been seen, so after speaking to all doctors, family and friends I agreed to due the chemo.

My recommendation would be to speak to the surgeon and Onc Doc about the path report to determine if the tumor cut through the wall of the colon, how many lymph nodes were taken out and tested and chances of a microscopic cell floating around somewhere.

Taking charge of your own health and body is the most important thing that can happen right now. Doctors are here to help, give advice and treat, but you are the only one that nows how your body is functioning and performing.

Please keep us posted.

kmygil
Posts: 881
Joined: Feb 2007

Hi Paula. Last August I was diagnosed w/Stage II no nodes no mets, and my onc said that it is now the standard in the US to do 12 rounds of chemo after surgery, usually Folfox5 (with Avastin if you are want to be in on that trial.) I opted not to do the Avastin, but I completed 9 of 12 rounds of the Folfox5. The side effects are lingering, but I feel better about things--like if there were any stray cells out there we nabbed them. So I would definitely discuss chemo with your onc and do your research regarding the chemicals and their side effects.

My thoughts & prayers are with your dad, you and your family.

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vinny3
Posts: 933
Joined: Jun 2006

As far as the colostomy or ileostomy question it depends upon where the tumor lies and the particular circumstances found at the time of surgery. Your father should be prepared to have one and if he doesn't get one that will be an added bonus. As far as the question of chemo for Stage II there is not a definite answer. I recommend that you consult with at least one oncologist there and preferably with several. Do as much questioning and research as you can. There are survivors on this site, Stage IV, who have done little or no chemo but changed lifestyle and diet and who are NED now and there are others who were Stage II who did not have chemo and have had recurrance or spread. You have to get as much info as possible and then your father has to make the decision that is most comfortable for him and go with that. I would recommend checking the information at the National Cancer Institute website (www.cancer.gov) for one. There is no one right answer, just the best answer for him.

Dick

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