Another treatment option offered

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Hi everyone 

Im new here - my husband was diagnosed last month with rectal cancer which we were told hadn’t spread. 

forgive me I’m still learning all the correct terms, but basically he has a large 6cm tumour low down in his rectum . At consultation with surgeon he advised that treatment would be five sessions of radiotherapy( combined with oral chemo) per week for five weeks 

A ten week break 

Then the big op (APR) and permanent stoma 

However we met the oncologist yesterday. worryingly he told that my husband has an ‘advanced’ tumour - we hadn’t heard that word before, which had spread to ( or through) the the muscle of the bowel , and  affected lymph nodes 

so that was the first shock 

the second shock was that he offered a different treatment option 

which was after the five weeks chemo/ radiotherapy, no ten week break but straight into full IV chemo for three months.

He said that this approach has a 50% chance of shrinking the tumour completely ( so no op and no stoma) 

he explained that it’s a very tough regime and not everyone can tolerate it.

I’ve searched on here but can’t find anyone who’s documented this , can anyone help? Have you had this approach and was it successful?

many thanks x

  • Hi  and welcome to the board. The 2 types of treatment that you mention are both acceptable forms of treatment. The first one you mention is the traditional one that has been used for a good few years whereby chemoradiotherapy is used to shrink the tumour, then a 10 week wait while it carries on working, then the op and then chemo to zap the lymph nodes. A recent trial called the Rapido trial has shown that it is just as effective (if not a bit more) to have the chemo before surgery.

    Chemoradiotherapy is very effective at shrinking a tumour but not always enough to avoid surgery which is the gold standard treatment. From a patient point of view I’m not sure which is ‘easier’. Chemo is tough at anytime - some people find the chemoradiotherapy ok but others have struggled and are still suffering with fatigue and diarrhoea for several weeks after finishing - add IV chemo on top of that and it will be tough going. On the other hand it can take several weeks to recover after the op and this could delay the start of any post op chemo (if you click on my name you can see my treatment to date)

    If you type rapido in the search box at the top of the screen then it will bring up previous posts - here’s a link to 1 below and also 1 about the Rapido trial

    https://community.macmillan.org.uk/cancer_types/bowel-colon-rectum-cancer-forum/f/diagnosis/240709/tumour-removal-and-having-a-temporary-stoma?pifragment-13906=2#1742059

    https://community.macmillan.org.uk/cancer_types/bowel-colon-rectum-cancer-forum/f/general/236512/research-from-rapido-trail

    The APR op is a big op but it ensures the complete removal. There’s a lot of people on here with stomas both temporary and permanent and lots of advice available. There’s people who have had a complete response to chemoradiotherapy and are still cancer free but there are also others who have had a recurrence and had to have the op anyway.

    Hope this hadn’t been too much doom and gloom and hopefully some of the members going through the new regime will pop in shortly

    Take care

    Karen x

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm