1st post - Cancer: Colon Message Board

besteele · 10-13-2006, 01:28 PM

Hi everyone - This is my 1st post and to let you know I have been following this board for the last month and a half ever since I was diagnosed with rectal cancer. I find great comfort in reading from this health board.
This is my situation as I know it - my tumer is in the lower rectum just in reach of my surgeons finger, the test I have had are a sigmoidoscope to take a biopsy, a cat scan that showed my liver is normal,the abdomen is unremarkarkable, scans into the pelvis reveal eccentric thickening of the wall of the rectum along the distal half with a suspect lymph node in the prescral zone.
My surgeon wants to do the following - 5 days of radiation followed by surgery the following week . the surgery would include giving me a permanet colostomy.
I have a good friend that thinks I should get a second opion about the colostomy and I"am not sure if this treatment is the right way to go. The second treatment would be to have 6 weeks radiation and 6 weeks chemo.
I am not quite sure what to do at this point, so if you have any thoughts please let me know.

CancerDad · 10-13-2006, 01:59 PM

Hi and welcome to the board.

I am sorry for your diagnosis, but I am glad you found us. We all have experience and knowledge to share with you and support you as you go through this journey.

A week worth of radiation, and then surgery the following week is NOT standard in the treatment of rectal cancer. Nor is 6 weeks radiation followed by 6 weeks of chemo. Radiation is documented in studies to give better results when given WITH chemo usually for the first and last weeks of treatment. However, this DOES NOT mean that you have a bad radiation oncologist or oncologist.-- I just wanted to point out the norm. Maybe there are circumstances with your tumor that warrant this regimen.

I have a few questions... Did they tell you what stage you are, or exactly how big the tumor is? Also, how far has it grown into the rectal wall? Did they tell you what the differentiation of the tumor is-- poorly, moderate, or well-differentiated (histology from the biopsy/pathology report)? Lastly, what agent was your oncologist planning to use if you went the route of radiation and chemotherapy? The standard is 5FU and Leucovorin, although the oral agent Xeloda IS starting to become the norm.

I'm SORRY if I sound like I'm beating you up with questions!!! I'm just curious so we can all try to help and support you better!!!

Lastly, I just want to encourage you to get a second or even a third opinion on how best to handle your situation and whether a colostomy is necessary.

Warm Regards,
CancerDad

besteele · 10-13-2006, 02:32 PM

Thanks for your reply - I will try to answer most of your questions.
First to correct myself the 2nd treatment option would be 6weeks radiation combined with chemo followed by an operation.
The tumor size as I remember correctly from the catscan is 17mm in thickness from the bowel wall - I believe surgeon said it is fairly small.
Surgeon from feeling tumor doesn't think it has grown outside the rectal wall.
The differentaition of the tumor I have not been told.
Stage 3 is what the surgeon thinks it is.
I have not talked to anyone in respect to any angents that would be used.
I am meeting with my surgeon in 2 weeks - and need to prepare a list of questions.

Thanks again for your concern

gocatsgo · 10-14-2006, 05:52 AM

Have you had a transanal ultrasound? This will help the staging.

I think that the 5 days of rads followed by surgery is a from a NEW study. Google it to see. They tried to offer that to me as well. I think they are doing it in Europe now - maybe Norway, Netherlands or something. A study I just read the other day suggests it MAY become a new standard of care. My radiation oncologist was not willing to do it last year because I was 32 and she was not sure of the Long term effects based on the studies done at that time. Looks like there may be some new data to consider... Try googling the study and see what you think...I believe it was published just in September, and I forget which journal it was in.

Right now most people get the 6 weeks of chemoradiation followed by surgery six weeks later...

Good luck!
Cats

Jeni61 · 10-14-2006, 09:24 AM

Hello, welcome to our group, there are lots of knowledgeable folks here.

I also have rectal cancer, and had 6 weeks of radiation with the first and last weeks also having chemo.

My surgery is coming up on November 13th.

I have never heard or encountered a 5 day radiation regimen, but maybe your dr believes your case is such that that is fine.

Let us know how you proceed.

jeni