Questions, questions, questions!

cal79
cal79 Member Posts: 57
edited March 2014 in Colorectal Cancer #1
Hope everyone is doing well. I have a few questions that I was hoping someone may be able to help me out with!

To refresh, I had an ultra low anterior resection with colonic j-pouch construction for rectal ca (stage 1) in April. They created a temporary ileostomy which is going to be reversed in about 6 weeks. I have had some wildly varying opinions on the outcome of the reversal, but my stomal therapist seems convinced that in my case I should have no problems whatsoever (with control or anything) and I should be back at work in a couple of weeks.

This is a little contrary to most other info that I have uncovered - I have heard that people have some quite severe difficulties following this surgery. Can anyone hazard a guess as to why they are expecting such a good outcome, and is this likely? The reasons I had considered were that I am young (26), no complications like chemo or radiation, and a strong pelvic floor (I hope!).

My other question is about aggressiveness of the tumours. I had an adenocarcinoma, which I believe is the most common type of tumour. Does anyone know if you can get varying levels of aggressiveness within adenocarcinomas (my surgeon has been a little cagey about discussing this as he wants me to go for hnpcc testing).

Thank you!
Cal

Comments

  • HisJoy
    HisJoy Member Posts: 113
    #2
    Good morning! There are two main types of adenocarcinomas in the colon, depending on how they look under a microscope: mucinous and signet ring cell. Before you could know how aggressive the tumour is, you need to find out what type of cells were present, whether the tumour is high or low grade, and whether it was poorly differentiated or highly differentiated. All of this should be in your pathology report. The most aggressive type that is most difficult to treat would be poorly differentiated, high grade, signet ring cell. Those little buggers are very aggressive and move very quickly. (that's the kind I have) However, that particular type is pretty rare, so check your path report and see what kind you had. The mucinous type generally starts as a polyp and takes a long time to develop and spread.

    Hang in there!
    BB
  • spongebob
    spongebob Member Posts: 2,565 Member
    #3
    Ahoy, Cal -

    I can't really speak to the ostomy reversal, but you might drop "stacygleaso" a note and ask her opinion. She is a stage 4 survivor with what sounds like a similar ostomy situation who had a completely successful reversal. She's probably in an excellent position to talk to you about it.

    I will speak to the HNPCC testing... Cal, I urge you not to do it. As one who has had the genetic testing on himself and three generations of the familial tree, I have had a lot of time to consider it and develop a definite philosophical position. I'd be happy to share it with you if you'd like.

    - SpongeBob
  • shmurciakova
    shmurciakova Member Posts: 906 Member
    #4
    Hey there Cal,
    All I can say concerning the agressiveness of the tumor, is that they caught it in Stage I and now it is gone! That is awesome. I feel that gives you an excellent chance at being cured and that if I were you I would not concern myself w/ the agressiveness w/ the tumor (which is now gone!). As for the iliostomy, I do not have any experience w/ this myself. I hope that someone w/ personal experience responds about that.
    I would presume that the reason they think you will recover well is because of your age and activity level, and also probably the way that your surgery to remove the tumor went?
    Anyway,
    Best of luck,
    Susan.
  • goldfinch
    goldfinch Member Posts: 735
    #5
    Regarding an ileostomy reversal. I imagine they feel you will do well because you had no radiation to the area.
    I had radiation, chemo and a tumor that was very close to the sphincter muscle. I had the rectum removed and a temporary ileostomy. I've had difficulty, but that's most likely due to radiation damage and the fact that I had to return to chemo 2 months after the reversal.
    I don't know how much dietary info they will give you after the reversal, but MD Anderson site has a terrific info sheet for those who are recovering from colo surgery. I wish I had found it 9-10 months ago!
    Mary
  • cal79
    cal79 Member Posts: 57
    #6
    Thank you for all your advice, it is very helpful :) As I work in research, I always want to know everything!

    Spongebob, would love to hear your ideas on HNPCC testing, could you possibly email me? (Not sure how this works, but I think I registered my email address??).

    Thanks once again :)

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