Marc:
This IS an option available to rectal cancer patients with State I 0r II cancer. Originally it recieved great debate in the medical literature, but I believe is becomming a little more acceptable. Especially depending on HOW they plan to remove the tumor. One of the criteria is it has to be within reach of the surgeon's instruments, and there should be no nodal involvement.
Do a search for Transanal Excision or Trans rectal excision of rectal tumor. There is also a technique where they can make an incision in the perineum and come up behind the rectum in order to remove some tissue and nodes to test for spread (mets).
Personally, I would be much more inclined to recommend this procedure if it were you, Marc, that were suffering. Men have MUCH smaller pelvises to get into to transect and reattach tissue. Also, there are MANY nerves that run around the rectum that are responsible for sexual functioning and urination. Men have a much greater chance of erectile dysfunction...etc, as well as urination difficulties as do women... though women may experience a slower time emptying the bladder, typically, her chance of NOT being able to pee (as I have suffered) is much greater for a male patient. This is REALLY A TOUGH CALL. If she were stage 3 there would be no question for me, I would say go with Abdominal resection... If she were stage 1, no question, go for a Transrectal excision.
I don't AT ALL intend to sound sexist... that's not it at all. It is simply a matter of anatomy. You could argue statistics though too... She did receive radiation, the surgeon is correct, and she will receive adjuvant chemo... All this evens out a Stage 2 to have the SAME CHANCE OF RECURRENCE for TRE versus a more traditional abdominal resection approach. Also, there are chances of nicking/nerves, and increased complication rates by her going through an abdominal resection which is MAJOR PELVIC/ABDOMINAL surgery.
You two need to look at the studies and decide for yourselves. If you are looking for someone to give his/her opinion--I am somebody who has been through an abdominal approach, I would have chosen the transrectal approach had I been eligible, and had my surgeon suggested it though. Unfortunately I was a 3C with extensive nodal involvement, and could not go with the Trans Rectal Excision. If I were your wife I would do the Trans Rectal Approach, but be darn sure that this surgeon specialize in colorectal surgery utilizing the Trans rectal approach, and has done MANY of these procedures before. There is nothing wrong with sitting down with him/her and asking for numbers.
GOOD LUCK!
CancerDad
PS I'M SORRY. I hope you didn't read this before I edited my post... colostomy bag troubles... I didn't have time to proof, and just posted it!
