Choosing Abdominoperineal Resection APR surgery over watch and wait

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Hi, this is my first post.I hope to hear from people who have been in a similar situation or who have had an abdominoperineal resection. I am 46 and was diagnosed with rectal cancer on March 3rd. It was a massive shock, I thought I had IBS, never cancer. Even when my GP said she did not think it was cancer, but she was worried I had IBD. I had five weeks of radiotherapy with Capecitabine tablets, then four rounds of Oxaliplatin with more Capecitabine tablets. The tablets made me so poorly that I ended up in the hospital with dreadful diarrhea; they had to keep reducing the amount I could take. I felt very ill, but I made it through. After two MRI scans, a CT, and a flexible sigmoidoscopy, I was told the surgeon who carried out my sigmoidoscopy could see no signs of the original tumor. The CT scan showed no spreading, but the MRI scans are not clear; it could still be healing from the treatment and they cannot tell. I was left with the decision of "watch and wait" or APR surgery. I have been thinking long and hard; I keep going over the percentages of it coming back I have decided to go with the surgery. I am just so scared of it coming back and spreading; that has always been my fear right from the start. I was hopeful when I had the sigmoidoscopy that it could not be seen, but the thought of scans every three months and the possibility of it coming back and spreading I just dont want to take the risk. I have good support from my family and friends they understand why I have made this decision. I know no one can say it will not ever spread, but I feel this treatment will give me the best long-term chance. I am very nervous about surgery. Has anyone else made this choice? I have read up on the operation; I know it is major and the stoma will take some getting used to, but I just want to survive. I was very active before my diagnosis; I ran three to four times a week and went to the gym six days a week. I miss my old life and just want to feel I can get back to living even if it is different and takes some time. I do not have a surgery date yet, but I have had my CPET test and I have an appointment with the stoma nurse on Tuesday to go over questions, and she said they will work out and mark where my stoma will go and cover it with a waterproof dressing. Is there anyone who also chose surgery over watch and wait? Any advice on how you felt after surgery getting used to a stoma, or really anything? I just feel so alone. I am sure I have made the right decision for me, but it is still so hard. Sorry for the long message; it just helps to get it all out thank you for reading

  • Hi, 

    My experience was different, I had surgery first then chemo.  However I do have a permanent stoma and I can absolutely promise it’s much easier to live with than you think!  My stoma nurse said to me ‘it will affect your life as much as you let it’. I have found this to be completely true. Once a day I slap on a new bag and get on with my life. 

    I am also very physically active, it will take a while to get back to it and you will need to wear support underwear, but I’m back to the gym. 

    I totally understand your decision. Wishing you all the best for your surgery and recovery!

    cerysm

  • Thank you so much for your reply, It gives me hope that I will cope and with time get back to being active I just get back to living. Before my diagnosis, I didn't know much at all about stomas, and I don't know anyone with one. I've read up on them, but to hear from someone who has one really helps. 

  • Hi

    I had the same initial treatment plan for low rectal cancer. After achieving a near complete response to the chemoradiation and chemo I was offerred Papillon treatment followed by watch and wait surveillance. If I'm honest, due to my inital staging I was never really comfortable with the Papillon/watch and wait decision (over APR option) but felt this was the approach my medical team were leaning towards so I went with it.   I ended up having APR surgery after only 6 months when recurrence was confirmed.  I was cross with myself at the time because I knew I wasn't comfortable with the plan but had returned to work and started to get on with life again when I then had to undergo the APR which is a big surgery.

    I would go with what feels right for you. I'm now enjoying a full and active life with my stoma friend who is no bother at all.

  • Thank you so much for your reply it really helps to hear from people who know have been through it I am nervous about the surgery but deep down it I feel its the right decision just a big one to make but I'm staying positive and pleased I got the chance to choose thank you again again