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Stage 3 Treatment-Fistula

Posts: 21
Joined: Sep 2016

My 38 year old sister was diagnosed with Stage 3, Rectal Cancer last week. The tumor is rather large, and she has 2 swollen lymph nodes that were detected near the rectal area during the MRI. Also she has a fistula and partial blockage. We met with the Oncologist, who is at our local Cancer Center, and he recommended surgery to repair bloackage, then 6 weeks of chemo (pill form) and radiation, then surgery for removal, followed by more chemo and radiation. We met with the surgeon at the James Cancer Center at OSU. The surgeon recommended no surgery prior to treatment, 3 months of "aggressive" intravenous chemo, surgery to remove tumor and fistula after treatment, followed by chemo and radiation. I am confused and scared of their different approaches. How were you treated and what do you recommend?

Trubrit's picture
Posts: 5512
Joined: Jan 2013

So sorry to hear of your sister's diagnosis. 

It is rather frustrating, getting two different opinoins and then having to make a disicion. 

I was never offered a choice, as my tumour was large enough to be blocking the rectum, so it had to come out immedietely.  

The likely reason they are leaving the tumour (just in case you wern't told) is because removing a tumour opens up the chance of Cancer cells escaping and running riot in the system. They like to shrink the tumour with chemo and in some cases follow that up with radiation, and then remove the tumour. 

I cannot recommend what treatment your sister should do. But I can wish her, and all of those who love her, the best as she moves forward. It is not an easy road, but you will see, there are many survivors, especially Stage III.

There are others here on the forum who are more qualified to give you advice and hopfully they will be popping in over the next few days. 


Posts: 21
Joined: Sep 2016

Thank you so much for your words of encouragement! It's definitely a roller coaster of emotions.

Posts: 1282
Joined: Apr 2012

I have been NED(no evidence of disease) for last 6 yrs! Read my file and draw your own conclusions.  Best of luck to you.

Posts: 21
Joined: Sep 2016

Did you experience weight loss prior to your diagnosis?

Posts: 21
Joined: Sep 2016

Thank you! I will check out your file.

Posts: 506
Joined: Apr 2013

My husband required emergency surgery to remove his tumor which had completely blocked his colon so he did not have any choice, like Sue.

How does your sister feel about this?  Is she feeling OK?  Due to my husband's total blockage, he could not eat or drink anything and had a nasty NG tube.  The colon resection surgery he had opened things back up so he could eat and drink normally.  He had a few more blockages during treatment, which are no fun.  Not being in the medical field or having this decision to make, I can't say which choice is better for your sister.  Looking back on my husband's case, I would recommend any treatment or surgery to help her feel better immediately.  She may be losing weight if she's not eating much or having diarrhea due to her issues.  It may be hard for her to go through treatment if she has a partial blockage or fistula.  Good luck


Posts: 21
Joined: Sep 2016

At this point, she and our family are ready to start the process of getting rid of it! More than likely, the more aggressive approach is our best option. It just scares me not knowing why the want to go outside of the standard protocol for Stage III.

She is in a lot of pain and fatigue. Her iron is very low (8.2) and anything she eats, goes right through her. However, she is forcing herself to eat nutrional food every 2 hours, despite the pain that is causes.

It truly appreciate you taking the time to respond to me!

Kazenmax's picture
Posts: 453
Joined: Feb 2016

I was diagnosed stage III tumor close to the sphincter with 1 possible involved lymph node. I had 3 weeks of radiation/chemo and developed a fistula. I had to wait for surgery because I needed to heal from the radiation. 

They really want to shrink the tumor prior to surgery.  I can't say what's best for your sister, I only tell you what I did. It's been rough but I'm almost done. I have 3 more adjuvant chemo and I'm done. My doctors say they don't get to say the word, cure, that often but they believe I will be cured and I have to believe them.

DD3's picture
Posts: 134
Joined: May 2013

Sorry about the diagnosis.  My wife's tumor was located down by the rectum and was basically blocking any "movement."  The surgeon didn't want to do surgery prior to shrinking the tumor.  So, my wife has a stent installed to allow things to pass.  It worked.  Then off to chemo/radiation to shrink the tumor and target the lympnodes.  Then onto surgery and adjavent chemo.... 

funshine's picture
Posts: 26
Joined: Aug 2016

I would even get a third opinion. Im not sure eating every two hours is necessary. It might even be bad at this point if she has a blockage, good food or not. Juicing might be helpful.

I didnt have a choice when I had a blockage. I had to eat less until they operated because if my colon burst it would have been way worse. I do know that the pill form of chemo per my doctor doesnt have a good success rate, but it depends on the doctor opinion. He still had me try it because it was the next thing to try. it did nothing for me as he predicted.

Intervenous chemo is more intense but needed sometimes. If it is aggessive I would want the intense version quicker rather than later to find that she went from stage 3 to 4 because she didnt do the intervenous.

just a suggestion.

thoughts and prayers.


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