I'm wondering the pros and cons of doing the chemo and radiation before surgery or after for rectal cancer.

God Bless
Brad

Brad, I was diagnosed with rectal cancer in late July and have one last radiation appt. I have had presurgery chemo/radiation, with bookended chemo, meaning 24/7 infusion pump the first week and last week of about 6 weeks of the protocol.

Initially, my surgeon was going to go right to surgery, but the radiation oncologist advised doing the presurgery treatment first.

The presurgery treatment has value in that it downsizes the tumor and makes its removal easier, which is an issue in rectal cancer. Rectal cancer also has a higher local recurrence rate than colon cancer, and pre-surgery chemo/radiation cuts its incidence by about half of what it might be if done after.

I have just completed this -- well, with one radiation zap left -- and tolerated it well, altho everyone is different. If you are having any discomfort, the nice thing is, you will likely get comfy right away, as the treatment definitely shrinks the tumor.

Best of luck to you, let us know how you are doing.

Jeni

Brad,

I concur with Jeni 100%. I was diagnosed 2 1/2 yrs ago with rectal cancer. I too was concerned about putting off the surgery for chemo/radiation treatments. I got a verbal 2nd opinion with Mayo clinic and learned this is the standard form of treatment for rectal cancer.

Lee

Though it is standard to do chemo/rad before surgery, if I had it to do again I'd do the surgery first. The burns from the chemo and radiation combo were horrible - I never could have imagined how painful it would be. I ended up having eight weeks of radiation because they were not successful in shrinking some inguinal lymph nodes so they kept on firing.

The radiation damage made recovery from surgery much more difficult. I ended up getting an infection in my rectal incision - pretty common because irradiated tissue doesn't recover well. The incision had to be opened and was constantly draining. It was quite painful for several months after surgery and I still deal with some degree of pain and drainage from that area six months after surgery. The doctor also found a mass in my pelvis that was likely cancerous but he could not remove it because of the severity of tissue damage due to radiation.

And after all was said and done, by cancer kept metastasizing throughout my treatments. One month after surgery it had spread to my liver.

Given the chance for a "do over" I'd likely never do radiation again. I so wish we'd gone directly to surgery. Hindsight is 20/20. I have no hard feelings toward my surgeon. He was following protocol. This is just one story. I wish you the very best!

I think that you will find that having radiation w/continuous 5FU infusion is standard of care for rectal cancer. My understanding is that it decreases the chance of recurrence. Also, if you have any hope of restoring function (ie pooping out your bum) you should do the radiation first, in my opinion. This way, the doc cuts out the radiated section and gives you a better chance of having some bowel control - if you are able to have a sphincter sparing surgery.

Good luck,
Cats