Surgery Decision

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Hello, I've recently been diagnosed with a T1/T2 2.5cm rectal tumour. The MRI scans say no lymph node involvement. My doctor says there is a 10 - 20% chance that there is and will not know for definite without removing them. He is offering TME surgery with a temporary ileostomy. I am very keen not to have the large surgery, he also said I could have the much smaller ESD procedure to remove the tumour, but will not know if there is lymph node involvement. I thought the MRI scans could see lymph nodes, but would seem not definitively. To have such big surgery for T1 N0 seems like smashing a pea with a sledge hammer and I'm reluctant to do it. I think the doctor saw how distressed I was and suggested that I need to be emotionally and psychologically on board before he does the big operation (easy for him to say!)   Maybe, I just need to reframe my thinking, has anyone else had to make this type of decision? The TME surgery and ileostomy really scares me.  

  • Hi ,

      Sorry to hear of your news.  I wasn't offered the two - I was just told I needed the big surgery as a result of which they were able to tell me that there was no lymph node involvement and that I also had no signs in my blood which was a huge relief.  I am on chemo but as a belt and braces approach.  I did not need an ileostomy though.

      Obviously I cannot advise one way or another (not being a medical person and not knowing your circumstances), but I will say that having the surgery is not as bad as it is in your head. I personally had no pain at all even after they removed the pain relief, it can be sore now if I do too much, but only in the same way as if I'd done a session of sit-ups.  It is a big surgery and, like you, I was terrified before it happened, but it's more about the recovery time that it takes and not how much discomfort you'll be in.

    Good luck in your decision and hopefully that helps to reassure you a little. 

    Best wishes

    Cerysm

  • Hello Jelly29,

    I agree with CerysM. Not knowing what to expect was the worst bit but after a 6 1/2 hour op the recovery was painless, although I took things easy for a month or so. I had a loop ileostomy prior to chemoradiotherapy to control severe diarrhoea. That worked and the op for it was relatively minor - back at home less than 48 hours later - and treatment started a week after. The ileostomy works so well I decided to keep it, despite reversal being an option.

    Place your trust in the colorectal team; they will do their best for you to resolve this current problem.

    Best Wishes,

    Dulac

  • Thank you for your kind replies. 

  • so sorry to hear your news!
     the same offered to me, however I was 24 at diagnosis and wanted to ensure I did everything tk remove the cancer. I didn’t want it coming back in a few years and me regret my decision. I had temporary ileostomy and reversal, now almost 2 years on. however the more minor surgery can be successful too! If you have any questions let me know x

  • The very best of luck Leigh xxJan