Surgery or Radiotherapy

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Hi all,

it has been some time since i posted on the forums. I am a 33 year old male and was diagnosed with stage 4 bowel cancer in November last year and have been having chemotherapy (FOLFOX) treatment since (currently on round 11). My latest scans show a complete radiological response, but I'm told this does not mean an absence of microscopic disease. Obviously i am thrilled with the results thus far, but am now facing a difficult decision - major surgery or targeted radiotherapy.

I am told that surgery (APR, strip para-aortic lymph nodes and liver resection) offers greater long term outcomes, but i would definitely be left with a permanent stoma, and potentially other impacts, such as impotence or bladder issues.

Radiotherapy offers a non-surgical option, but the stats show that likelihood of nil recurrence of cancer is not terribly high - that said, there are no guarantees with surgery either! Also lifelong surveillance will be more frequent than with the surgical option.

I wanted to know if anyone faced this dilemma and what they chose to do. Whilst i couldn't have hoped for a better outcome, the choice is difficult to comprehend.

Thanks

FormerMember over 4 years ago

Hi,

I think the most important thing you said is "nothing is guaranteed". Similar to you I was diagnosed 2and a half years ago with stage 4 bowel that had spread to my liver. I have undergone bowel resection with permanent stoma and 2 liver resections. I was "clear" briefly for a few months despite surgery. There is no certainty with any of it, I went with surgery because it seemed to offer the best possible outcome, I have no regrets with my choices.

We live with uncertainty all the time, I am currently having chemo for my liver and lungs but remain pretty healthy otherwise. Like you long term surveillance is a constant and I take each step at a time. I have a permanent stoma and my bowel remains cancer free and the stoma seems a normal part of my life.

They're very difficult decisions and choices, keep asking questions to your oncologist and specialist nurses and trust in your decisions, it's your body after all!

I hope that helps.

Best wishes

Martin

Loliver over 4 years ago in reply to FormerMember

Thanks Martin,

Very useful insight. Did you have the choice of a non surgical option at the time?

I am sorry surgery wasn’t the golden bullet for you. Sending positivity!

FormerMember over 4 years ago in reply to Loliver

At the beginning I was inoperable as the tumours were to large. 3 months of chemo and then 5 weeks of radiotherapy shrunk everything and I was then operable. For me I felt a massive relief that I was able to have the surgery after being initially told it was palliative. Mentally having it physically removed was a positive for me.