Surgery Friday

Chrisswife

My 32 y/o husband was diagnosed with stage 2/3 rectal cancer in April. They gave him 5FU, Oxiplatin and Leucovorin, as well as 5 weeks of radiation. Treatment ended early June and he is finally having the tumor removed this Friday. Can anyone give me information on what to expect? His tumor is large and low toward the anus, we know he'll have an ostomy, but we don't know whether it will be permanent or temporary. He's extremely concerened about losing the ability to achieve an erection although the odds are low - 20%. I'm most concerned about the hotspots that showed up in his lymph nodes during both PET scans. How soon after surgery do the Dr.s know what we're dealing with in terms of the extent of his disease? Any information is appreciated sorry for the long message, the waiting has me a nervous wreck!

KrisS

I know how hard waiting can be. I had surgery for rectal ca in the middle part of my rectum. I had Stage IV disease In my case I had more extensive disease,and a hysterectomy, intraperitoneal chemotherapy etc. was done at the same time.

The surgeon gets additional information about the extent of the tumor at the time of surgery, since sometimes even the PET and CT scans are not perfect. That is why they are not certain about whether they will do a permanent or temporary ostomy until they get in there. I got a temporary ileostomy. There is a layer of fibrous tissue that surrounds the rectum and the adjacent lymph nodes. The surgeons take great care to try to remove the rectal mass still encased in this fibrous layer, so that the lymph nodes and mass are removed all in one step. That greatly reduces the risk of leaving tumor cells behide even if the lymph nodes are involved. They do that regardless of whether they suspect the lymph nodes have tumor in them.

Although the pathologists can frozen little sections of tissue and look at them at the time of surgery, this is not as good as the conventional method of thinly slicing the tissue after it has been preserved. That takes several days. In my case they took lots of additional samples of tissue because of the extent of my disease so it took an unusually long time, 2 weeks, for them to read out everything.

My oncologist told me he would not consider starting more chemotherapy until 4-6 weeks post op so that everything could heal and did not meet with me until then to discuss in more detail what to do.

As for recuperation, the pain medication they gave me worked pretty well. I was sore, but the whole experience was far better than I expected. I was up and about walking within a couple of days and back to work in about 6 weeks. My ostomy is comfortable and has given me no problems. My abdominal muscles around it were a bit sore after I overdid it a bit activity wise 4 wks post op, but that was about it.

I hope things go flawlessly. My prayers are with you.

Kris

Kris.

wildcat

So how did the surgery go?????

Chrisswife

Thanks KrisS for your informative response (and thanks Wildcat for your interest!). Over 10 days post-op, my husband still has pain but is getting a lot stronger each day. The path results look very good, the lymph nodes tested negative - hallelujah! We will meet with his oncologist to discuss possible follow up chemo but as you say - that will be a little while down the road.

He did have to have a permanent colostomy; the tumor was too close to the anus to get a good margin around it. We were disappointed but not surprised, the thing that matters is that for the first time since his diagnosis I am certain that he is going to be just fine.

KrisS

Chrisswife said:

Thanks KrisS for your informative response (and thanks Wildcat for your interest!). Over 10 days post-op, my husband still has pain but is getting a lot stronger each day. The path results look very good, the lymph nodes tested negative - hallelujah! We will meet with his oncologist to discuss possible follow up chemo but as you say - that will be a little while down the road.

He did have to have a permanent colostomy; the tumor was too close to the anus to get a good margin around it. We were disappointed but not surprised, the thing that matters is that for the first time since his diagnosis I am certain that he is going to be just fine.

I was wondering, and hoping that things went well for you guys. It is wonderful to hear that your husband is doing well and about the great path report!

Although it would be nice not to have an ostomy, they are quite managable. Lots more people have them than you think. My surgeon was kind but firm. When I said I was there to talk to him about tumor removal and sphincter sparing surgery he said "the goal is to get rid of the tumor, THEN we will see about the sphincter." I quickly realized what was really important.

My best to both of you.

Kris