Rectal cancer

Hi CRG001

I am very sorry to hear about your son’s diagnosis. What a shock for you all !

Thats great news though that there is no spread as bowel cancer caught early has many treatment options !This explains the different reference points from the anal verge round to the appendix area !

From what you have said they have located his in the Rectosigmoid  area and roughly ten cm from the anal verge which you can locate at the bottom of the diagram!

My understanding is the rest is basically a description of the appearance they had visually of the tumour ! Bit ulcerated etc and around 5 cm ! These are standard terminology to describe what they are seeing Transversable  I think just means things can pass over . Is he still able to go to the toilet ?

Our helpline staff would be happy to chat this through with you just to make sure this is roughly correct ! Definitely not a Doctor !. 0808 808 0000.

In terms of a colostomy etc . The surgeons will assess and advise as it’s all a bit tricky ! Some are told they may need one but if able to reconnect they will . Others have a temporary stoma that after a period of time once the bowel has healed go for a resection and some have permanent stomas but most are able to think and be informed about it before surgery ! 
This part is very tough as they gather the information together to get the best treatment plan for him but it does get better !

Take care ,

Court 

Thank you so much for the information.  Yes, he is still able to go to the toliet.  On Tuesday, he will go for another MRI body scan to confirm the depth of the mass.  He will meet with the surgeon, oncologist and get his chemo port put in next week.  He is only 38 years old and cancer does not run in the family so it has been a shock to everyone.  I will be glad when a treatment plan is in place and we know what he will be dealing with.

I have read your journey with  your mum and it's sounds like you have been through alot but have come out of it with great news.  Wishing her (and you) a long healthy life.

Thanks again and take care.

I honestly don’t know what’s changed in the last ten years but more and more younger people are getting diagnosed! 
I read in the bbc of a 21 year old yesterday being diagnosed! Particularly when there is no family history!

Sounds As though they have caught it in time and can get it resolved and back on with his life with this firmly in the rear view mirror!

You will feel much better when treatment starts psychologically as it feels something is being done to tackle it !

Hard on them going through treatment but a good team around him!

My mum is built for endurance that’s for sure ! 
We are here for you too when it overwhelms you from time to time !

Hope you have some support too ! A coffee with understanding friends means the world !

Take care ,

Court 

Hi, CRG001this sounds like me from what I understand. Mine was 80% circumferential about 10 - 18cm from anal verge, in the rectosigmoid junction to the distal sigmoid . After scans, I went straight to surgery, a month after diagnosis. The bowel was almost blocked at that stage. I didn't need a stoma and it hadn't spread outside of the bowel, just! Vascular invasion meant chemo. I am now nearly 2 years clear, awaiting another CT in Dec. So I hope this gives you both some hope! It is treatable . Any questions and I'll try and answer them. Take care

Thank you for your response.  The situations do sound very similar.  I am praying next weeks body scan confirms it hasn't spread to any other organs.  He is a very active person and this has definitely slowed him down.  He was first admitted to the hospital because he was severely anemic.  They gave him 3 liters of blood and 2 iron infusions which has really helped.  Strange part is he hasn't saw any blood since his colonscopy.  They think he might have ulcerative colitis too. They had gave him medicine to help coat his stomach so we are wondering if the blood was coming from the colitis and not the cancer.   So happy to hear you are nearly 2 years clear and definitely give me hope for him.  This forum is a blessing to everyone that is dealing with cancer.  It helps to know you aren't alone.

UPDATE:  My son had two body scans today and below are the results.  I'm not sure what all of this means.  Has anyone had antything similar and can give me some insight to what might be next for him.

Unenhanced MRI of the Pelvis (Rectal Protocol)

Overall MRI stage: T3c, N2, Mid rectal cancer
MRF: involved (tumor elements margin within 1 mm of MRF).
Right posterior mesorectal tumor deposit involves the MRF. Left mesorectal lymph node abuts the MRF.
Sphincter involvement: No
Suspicious extra mesorectal lymph nodes:Yes, right internal iliac
EMVI: Yes

For the purpose of radiation therapy planning, series 7 would be most useful

MRF means Mesorectal fascia ! 
EmviI think roughly they have the images back from the scan which gives them a better picture of how far the tumour has affected the side walls of the rectum, surrounding blood vessels and what is the best way to approach the radiotherapy to target it ! 
I will tag in Gemmary  as I think she might know a bit more about EMVI . 
I have to say though I don’t know much about rectal cancer as my mum’s was higher up and I don’t have the right degree . ( no dr) ! However our helpline staff have nurses who would be happy to chat through the clinical aspects and help you understand it ! 0808 808 0000.

This is purely my guess from what I have read other patients say ! The image is just to show you roughly the locations of the side walls . They all have clinical names the drs refer to so they can rescan post treatment and pay attention to areas previously affected with cancer deposit! 

Take care and hopefully the radiotherapy will also downstage it ! That’s the good thing about radiotherapy !

Court 

Hi CRG001 and court both pictures taken from the Macmillan book, understanding rectal cancer . I was given this at my first consultant meeting.

The T stages are explained by

And the MRF is the mesorectal fascia, which is a fatty tissue surrounding, and contains blood vessels and lymph nodes.

So in my case the bit in the black dotted line was removed, probably a bit larger as they got 40 lymph nodes and about 15" of bowel.

The sphincter means the bowel control muscles, so they are not involved. It may mean that the bowel can be reconnected at some point. My tumour was about 10 -18cm, and they left what rectum they could, and although warned, and marked up for stomas, they managed to reconnect! I do have limited poo capacity now! You are marked for stomas before the op so the nurses can ask what type of clothing etc you normally wear, as they can tweak the position slightly so as to not clash with waistbands  etc.

The bit removed is biopsied and in my case they changed the N1 to N0 after looking at 40! But they said it was in the blood vessels, hence EMVI 

So before the op I was T3N1M0 and after T3N0 V1M0 

You don't find much info on EMVI but particularly for rectal cancer, as it is more 'contained' in the body, it probably has more significance than node involvement. So the recommendation will probably be chemo after. Mine was low dose 5FU for 30 weeks. See my profile for more details.

If there is treatment before I can't help, as they decided to go straight to the operation before the bowel totally blocked. Reading since, people seem to have pre treatment of some kind. I can only think that they decided the best course of action was to get mine out ASAP, the op was brought forward by a week, and I'm grateful. I think it shortened the overall process.

I tell things straight, so sorry if I've upset you, but cancer is a bu***r!! To put things straight, if I get a clear scan in Dec that will be 2 years clear after all the treatment finished. So there is plenty of hope.

If you've got this far well done! Any other questions I will try and help.

Thank you for the information.  I will be glad when the week is over and he has a definite treatment plan.  Take care.

Hi, did your son get any treatment plan yet, or are you still waiting?