Low rectal cancer

Sorry I can't help but send a ((hug))

Hi . I’m sorry that you seem to be in the dark a bit so I’m going to tag court with her knowledge to see if she can offer any advice? Hope you get your scan results soon

Take care

Karen x

Welcome  ,

Its complicated isn’t it . I take it you have been having chemo and doing very well shrinkage wise .

I am happy to share what I have absorbed from too many consultations however it may or may not now be accurate . My understanding is location and volume matter when it comes to a spread to the liver and lungs . Clinically the main aim is to stabilise the cancer  in the world of oncology that is a big deal and if they have achieved that they will consider that a big win . They then have a very delicate balance on deciding if they should take a break from something that is working to introduce some other intervention and if they have surgical complications etc can’t get back to chemo in a timely manner they could then loose the stability they have achieved . This concerns them greatly . They also  have concerns if the cancer is in more than one organ at a time due to the spread through the lymphatic system so want to allow the chemo to keep doing it’s amazing job of pulling in any micro disease it has been working on . If you read my mum’s bio you will see she has had mets to her liver first then to her lung after a few years she did not have them together . It may not be that individually your tumours are not surgically removable but they are concerned that other micro disease could surface off treatment .

They only removed my mum’s primary bowel tumour when they thought they had a chance to remove all cancer at once and she had a combined operation on her liver and bowel .  The result of that was an immediate recurrence in her liver with a further five tumours . It was a bit soul destroying . However like you she was very chemo responsive and a further year of treatment (2 in total) they decided she was stable enough to go back in .

My mum’s oncologist was not supportive of her initially having liver surgery the second time . There was no way she would have been strong enough for chemo for about six months after her second big surgery as she had 73% removed . Thankfully she did not have a recurrence but it was a gamble she was fully informed about .

The other aspect they focus in on is volume of cancer and the location . My mum had significant spread to her liver but had three clear sections from segment one to three that remained Clear so they could remove the rest but leave the first three segments to regenerate . If they had any cancer in the first three they could not have gone ahead .

Also with the lung , location and size matters again . My mum’s was near the surface , less than a cm and easy for the lung surgeon to access .

Do you know how many mets and the size of them ?

It is sometimes hard on forums to know what is achievable from a surgeons point of view . However you are entitled to a second opinion . Some teams are using treatments like Radio frequency ablation . It used to have a clear set of guidelines for the criteria but that seems to have disappeared. I will link in a booklet which explains it better that I can .

Whilst surgery is the gold standard for the cure there has been some great effort to living with cancer like a chronic condition . I think it sounds as though they would consider you a person who is responding very well to treatment . 
My mum only ever heard cured after 12 years . Which came as a surprise. They did mention curative intent for surgery but also told her to expect to have more cancer in the future . It was tough to hear .

Her approach was to focus on reducing the tumour burden . Each time she had less than her point at diagnosis. Slowly but surely she chipped away at it .

Sounds as though you are having some great scan results .

Our helpline staff would probably give you a much more informed opinion on 0808 808 0000 and would be happy to chat .

It is so hard  to grasp some of the complexities around surgery . But that does not mean you are not a top responder to your current plan and I do credit chemo with turning my mum’s situation around .

Sorry for the novel . It’s a hard subject to condense .

Court 

https://bowelcancerorguk.s3.amazonaws.com/Publications/TreatingAdvancedBowelCancer_BowelCancerUK.pdf
This is the link to the booklet . It covers other approaches too which you might find interesting.

Take care ,

Court 

Thank you so much Court for this.  I have read the booklet which is very informative and helpful.  I feel much less stressed now.

That’s great . It takes a while to piece it all together doesn’t it but it helps when you have more insight into how they manage it .

Hope you have a good evening ,

Court