Has anyone with upper stage 3 rectal cancer T3bN1c been sent for a second opinion about having an extended margin operation and then chosen to have the standard resection operation. I am just on the crossover point and been told that they only send a small percentage of people every year. The risks are so much greater with the extended margin but the area of concern is not 100% cancer and could be scarring from the chemoradiotheraphy treatment. I could put myself through an operation that is not required but the smaller op may spread the cancer cells if this area is cancer. Really don’t know which one to go for. Any advice please ?
That is a very difficult decision and I can see why you would want to be 100% certain of your choice if there is such a thing with cancer .
I have sat through a few difficult meetings with my mum where the consequences were laid on the table to allow her to be fully informed . She had one criteria. The option that gave her the chance of a cure . Now she was a stage 4 patient so working her way back if you like but her choices were troublesome and not for the faint hearted .
One question I would want to know if there was evidence of cancer remaining is it possible to operate again or does that mean you would be reliant on chemo ? If it was the case it might tip your decision.
Would the extended procedure leave you with life long implications ? Or do you know the name of it as some people may have had it and give you better insight ?
Thank you for your reply and kind words. I would be looking at having a standard LAR operation v Exenterative procedure which I could potentially go through and not require. I would most probably have a permanent stoma with the exenterative op but could wake up far worse minus my bladder, a kidney, reconstruction of areas, nerve damage etc and it terrifies me that I would be a completely different person to what I am today. The LAR would hopefully long term not require a stoma at all as my rectal cancer is high enough to do the reconnection afterwards. My tumour is in an awkward place to operate and didn’t respond as well to the 5 weeks of chemo and radiotherapy as they had hoped for, although did reduce in size quite considerably. The tumour remains with a small margin around for operation so I was sent to see Prof Mirnezami in Southampton to consider the extended margin choice. Yes they could operate again on me although would be more difficult after I have had the LAR because of scar tissue. The decision is left with me and I really can’t decide, my heart is telling me LAR to give myself a chance of not having a stoma, but deep down if the area they are concerned is cancer I fear that could be dispersed to other areas with this op, but it could be dead cells from the treatment, they just can’t tell until they operate. The bigger op just terrifies me.
Well I can totally understand your dilemma . Two completely different procedures and outcomes . There are a few threads discussing the larger operation just now and I know they would be more than happy to discuss it with you in terms of quality of life after such a procedure . I can hear what your saying though if you do the larger operation but it may be dead tissue then you have to live with the consequences. Did they discuss being able to send tissue off to pathology during the operation to see if the margins are clear ? Not sure if it’s technically possible with the pelvic region but you could send an email to the surgeon .
