Thoughts on LAR surgery

AndyLe

I was recently diagnosed with rectal cancer. A large polyp was removed during my colonoscopy but came back with cancer still located along the margins. All other tests have looked good (MRI, CT). My surgeon is recommending LAR w/ileostomy to remove my rectum and surrounding lymph nodes to make sure it has not spread. She did give another option of excision of the area only. The second option is only viable if the cancer did not spread to deeply into the wall and would require more follow-up with a greater chance of the cancer returning.

I am leaning toward LAR but am terrified of LAR syndrome. I am in my mid 40's, active, have children, and a job that is not possible to do with incontinence issues or multiple bathroom breaks.

I'd love to hear from people who have gone through this and if they regretted getting one surgery over the other. And if you decided for LAR, how has the quality of life been?

Thank you for insight on this matter.

airborne72

My experience included a large rectal tumor discovered during a colonoscopy in 2017. I underwent radiation and oral chemo for 5 1/2 weeks to shrink it. Then I underwent the LAR and had an ileostomy for another 5 months while I underwent IV chemotherapy. After three sessions of IV chemo I tapped out. The cure was killing me. I accepted the risk. Now, 5 years later I remain NED (no evidence of disease).

During one of my semi annual visits with my oncologist he mentioned that for patients that he sees today with the symptoms I had he does not recommend the follow-up chemo and in some cases does not even recommend the LAR. The science and art of oncology is rapidly improving.

In my situation, the chemo had significant immediate impact on my health and quality of life, but it eventually dissipated. On the other hand, the LAR also had a significant impact on my quality of life but even after reversal my quality of life is less than it was before the LAR.

Get a second opinion. Your relative youth will greatly assist you in whatever route you take but your life is changing regardless. We refer to it as the new normal. Hang tough and continue to monitor this forum.

Jim

Tara1772

At 48, my 6mm rectal tumor was discovered on colonoscopy and thought to be benign. I took the trans-anal surgery to remove just the tumor, which went well. My bowel problems were resolved and I celebrated. UNTIL....the pathology on the tumor showed to be cancerous and I subsequently had LAR. I staged up and required 6 months chemo, so I had to keep the ileostomy for 9 months total. I've been reversed now since Sep 2021 and most of the time I am in control of my bowels. I found that a probiotic was the game-changer for me. I keep Depends around for the other times. If your journey happens to take a similar path, don't get discouraged. It really does get better with time and you learn to recognize different sensations appropriately. Good luck Andy!

Green20171

https://csn.cancer.org/discussion/comment/1702863#Comment_1702863

It is very rare for a 6mm polyp become cancerous. I thought polyp larger than 1cm can possibly turn to cancer.

BGNor

https://csn.cancer.org/discussion/326000/thoughts-on-lar-surgery

I had LAR surgery, in Jan 2016, for a malign tumor located in the transition between the colon and rectum. Categorized as rectum cancer. Removed with LAR surgery after which I got an anastomosis(staples), i.e no ileostomy. I quickly regained full bowel function and have not had any trouble with it after that. So my experience with LAR is nothing but positive. Safe and quick recovery for me, but no ileostomy - so not quite the same maybe.