ileostomy or not?

Each case can be different, but each Dr has a different point of view also, the ileostomy is a protective measure and perhaps that physician is just not comfortable with taking that chance. I am 3 weeks post op, was able to lobby for a laparoscopic procedure, with no ileostomy, was very happy when I woke up to say the least. Am doing well to say the least!

Hi there, My tumor was stage T3bN1M0, and 13.3cm from the anal verge. Tumor was measured as 1.8cm on post treatment MRI, was 3.5 pre radiation and chemo. As far as the Lap and no ileostomy,  a lot depends on the experience and training of your surgeon. I was treated at a major university hospital with a great cancer center. My team, colorectal surgeon, chemo oncologist, and radiation oncologist met regularly to discuss my case at the tumor board meetings. Initially my surgeon was planning to do the open LAR with an ileostomy, after chemo. After much research on my part, I approached him with the Lap and initially he was opposed, but by the time I was done with chemo/radiation and ready for surgery he had a change of mind. He did caution me that if conditions were not perfect, he would need to change over to the open. Also agreed to omit the ileostomy, same caveat, things needed to look really good.  The Laparoscopy requires experience, skill and training and I was lucky my surgeon was very technically skilled. I am 73 and still working, I was able to work through chemo and radiation, 5 months, and am taking 8 weeks off to recover from the surgery. The Lap is a walk on the beach compared to the “big open surgery.” I feel great, TINY scars, no stoma. I am fit, 120 pounds, with no history of any other abdominal surgery.

It would be beneficial to your peace of mind regarding your decision to move forward with your surgeons’ plans, to get a second opinion. That should not bother your surgeon at all. Also ask him if he has ever done this surgery with the Laparoscopic approach. It is gaining popularity in the US, and common in Europe, we seem to be a bit behind with some things. There may be good reasons why you do not meet the criteria that he would need to hook you up with no ileostomy, and/or do the Lap. Like you I had time during chemo to think about the surgery. Remember, you have to advocate for yourself.

Hi There, Hope you are doing well! I wanted to check in with you since it sounds like you are getting ready to start chemotherapy, and then have surgery. I wanted to offer any support I can to you during chemo. I learned a lot of lessons, but in hindsight when it came to the chemo drugs. The aftereffects can be difficult, what chemo regimen are you having? Take care and best of luck!

You might want to take a look at whether taking cimetidine is appropriate at this point in time (old posts, or take a look at pubmed). Eating can be weird on Xeloda. Some people say not to eat your favorite foods on it, because you may never enjoy them again. . . For some, to keep your weight up, it makes sense to eat what you can tolerate (even if it is ice cream), but hopefully you will sail through without issues. Good luck.

Cimetidine? — Cancer Survivors Network

I also took Xeloda during radiation- 5 days a week for 28 sessions (as well as with my IV chemo, oxaliplatin). I tolerated the Xeloda very well and had no trouble eating. I didn't lose weight, darn it. Your mileage may vary, but Xeloda was a no big deal for me.

Oh no. How are you doing? Any complications? How long are you supposed to have the ileostomy? I’m already traumatized from radiation. I literally have no butt cheek where they zapped me on the daily anymore. It’s like a weird depression there now.

Hello BP, I am used to the ileostomy now. Not gonna lie, it's not fun, but it's doable. I had a lot of issues after surgery with it. I got an ileus the day after surgery. That took about 4-5 days to resolve and then I had swelling in the small intestine that caused a blockage that sent me to the emergency room and I was readmitted the same day that I got out.

The biggest long term issues for me are:

1. Staying hydrated.
2. I have to get up at night to dump it. I have very high out put, but that is getting better. Hopefully I can sleep through the night soon.

When they put it in, they believed I was stage 1 and they told me that it would come out in 8 weeks. Once they biopsied the lymph nodes, they realized I was actually 3b and that I would need chemo and radiation after my initial surgery heals up and there would not be time to do a reversal surgery. So now I need the ileostomy for 6 weeks while my surgery heals, 6 months of chemo/radiation and 1-2 months after that while my body recovers. I'm looking at 9.5 months in total.

Not exactly the news that I wanted, but it is my reality.

I hope you are feeling better and I hope the depressions go away. I also hope your friend is ok. I not looking forward to radiation and I was surprised they wanted to do that since the tumor and the lymph nodes are all gone in that area.

Are you going to do the chemo/radiation? I guess they want to be sure to get it all? There could b one cancer cell floating around the MRI doesn’t see I suppose. I get a new Ct scan Tuesday. Hoping for a miracle as we all are. Regardless of the results, I booked a vacation for September lol.

Hope they get it all. Keep me posted please if you remember since I will likely have a similar path. Let me know if you have any questions about the radiationchemo combo side effects you might get. Wish you the best.