Pre op radiotherapy for low (2cm above anus) T3 N1 M0 Rectal Cancer.

Hi ChrisMB, I had the same diagnosis back in 2019, aged 73. I had the long session so 25 doses of radiotherapy, 5 days a week, with Capecitabine tablets 7 days a week for 5 weeks. Neither radiotherapy or Cape caused me any real problem and it shrunk the tumour to a point where the surgeon almost didn't operate. However, he did and it was the right decision. I then waited for a couple of months as the radiotherapy carries on working. (The cape is a 'low' dose that helps the radiotherapy work.) I then had a Lower Anterior Resection  followed by Capox as a mop up. At the moment I am clear

I have read people saying that the shorter intensive course is harder to take but no doubt you will hear from people who have experience of it.

All the best with the treatment whichever way you decide to go

John

Hi ChrisMB. I was diagnosed with rectal cancer in February 2019 aged 59. I had the long course. The same as John, 25 sessions of radiotherapy alongside Capacetibine. I also had no real problems. Had AP resection 17th July, 2 years ago this Saturday. Followed by 6 months of mop up Capacetibine. I have my 2 year CT scan tomorrow morning. Also have a permanent colostomy. I have no problem with it. You get used to it quite quickly. Good luck with your treatment.

Kim x

Many thanks for sharing your experience, John.....much appreciated.

That's good to hear, Kim....thank you so much...hope your CT Scan is ok...with best wishes, Chris x.

Hi Blackstuff, Kim. How did the 2 year colonoscopy go? I hope it was all clear for you.

Cheers, John 

Hi John. It was a CT scan I had on Friday. I won't know until I get the results. Keeping my fingers crossed as last year I had to have an MRI scan as they had seen something on my liver which turned out to be a cyst which didn't need any further treatment. Thanks for asking. 

Take care 

Kim

Hi ChrisMB

I am 62 and my diagnosis was a 4.5 cm tumour, T3N2M0, 1 cm from anus. I had a permanent colostomy first, then 4 cycles of Capox, because they wanted shrinkage before operating. One week after my last cycle I had an mri where the lymph nodes looked clear and the tumour had disappeared. The original plan was to have 5 weeks of chemoradiation after the chemo, but because of the good response they changed it to just one week of radiation only, ie no more chemo. Last week I had a Pet scan and tomorrow I am having a sigmoidoscopy. If they still can’t find anything (fingers crossed!) then I will not need an op after all and will go onto close monitoring.
So, despite worrying at the beginning that I should have an op first because I just wanted it out, I am now an advocate for chemo and radiation first! But I know we are all different and everyone reacts differently to treatment. Best of luck, you will have an excellent team doing their very best for you.

Many thanks for sharing your experiences....I saw the oncologist on Thursday & it looks like I'll be having the 5w course of combined chemo/radio therapy with repeat scans 12w after with another MDT meeting review & probably surgery...at first I did think "get the b****** out", but I now accept that the outcome is likely to be better with the chemo/radio therapy first.

Thanks again to you all.

I am on this course of treatment too...diagnosed with mid rectal cancer 3cm last March....I too wanted an op and be rid of it...but was told to have capox....4 cycles.  Of oxaliplatin with capecitabine tablets ....but taking that and steroids and anti sickness and laxatives.....it was all too much.....so had to stop after 2 cycles of the poxy oxy....too many side effects.....I then went on the 5 1/2 weeks of radiotherapy and crappy capy tablets again...hard going...but managed it....finished last week...and now having to wait about 8 weeks before scans...and then some sort of op....I don't know what that will be.....or whether I'll have an illeostamy...colostomy or any other ostomy!!! I have no idea what any of them means....have no idea what a stoma or a pouch is...i try looking up these things....but can't understand any of it....I just hope I can cope with whatever it's going to be !!!!

Chris 

I great stuff on the thread but I would recommend you check that your tumour isn’t a Signet Ring Variant (1% chance) as per-op radio may adversely impact and may spread the tumour. 

I had similar diagnosis and was initially advised the same treatment but luckily got a 2nd opinion and it was determined it was the signet ring variant so we went for surgery first (full removal of large bowel/intestine) and now have a permanent ileostomy. 

I’ve just finished cycle 2 of a 4 cycle chemo course which will be followed but 5 weeks of 5 days of Radio which should pop up any rouge cells (hopefully ).

Good luck but it’s worth checking as I’m glad I did.