Alternative treatment for rectal cancer

hi i didnt even know there was an alternative option. can anyone have it or does it depend on individual cases. please let me know as im due to have op in four weeks time

Hi - I am awaiting surgery for a T1/2N0M0 rectal tumour and initially my surgeon said that he would do a keyhole resection with a temporary stoma.  However, when he then did a digital exam he said that the tumour was more accessible than it looked on the MRI and CT scans, and suggested that he try a trans anal resection instead.  He did warn me that he may need to go back in and do the standard keyhole procedure once they examine the tumour, but I am keen to at least try the trans anal surgery as it would mean no stoma and no external wounds. 

I have read that the down side of this procedure is that there is no option to remove any lymph nodes, but he is confident that my cancer has not spread and he will monitor me closely afterwards.  I am waiting for a date now and hope to have the procedure within the next week or so.

I would be interested too to know of any experiences as the literature is not very extensive on this procedure.

I was only offered it after refusing conventional treatment. It is not standard treatment in the uk  and is for rectal cancers only (I believe) . It is the same treatment given to T1 tumors and those too old of an age to survive a major operation. Mine was a T2 tumor but the treatment has also been used on T3 tumors.

A Guy called Mark Davies has wrote a book about it called 'Saving My Arse: Bowel Cancer: A Survivers Story.

www.savingmyarse.co.uk

You can read about the treatment on the Clatterbridge hospital wedsite

www.clatterbridgecc.nhs.uk/patients/treatment/papillon/ 

Hi Anita,

I am not sure how close the initial CRT that I had is to the treatments that you have mentioned, but I had pre-adjuvant chemo-radiotherapy for low rectal cancer - which had spread to the lymph nodes - which was so succesful that the tumour disappeared.  I thus qualified for Diana Tait's Deferral of Surgery Trial which I elected to join, and so was put onto a "watch and see" regime in the hope that I could get by without needing surgery at all.  After a few months I continued with the normal post-surgery chemo (12 cycles FOLFOX).

However, at the conclusion of this chemo it was found that the cancer hed returned and I immediately went for surgery - complete removal of the rectum.  My surgeon was able to reverse the iliostomy and I am now making progress with adapting to life with a less than optimal internal plumbing.

I do know of at least one other participant in the trial whose experience has been more successful than mine, and who is still doing well without surgery, but I am not sure what his initial pre-surgery regime was.

Regards,

David.

Hi Claire

I have had Transanal endoscopic micro-surgery (TEMS) for a T2 rectal tumour. At the time of surgery it was hoped it would be a T1 but turned out to be a T2. Have followed up with Chemoradiotherapy and Papillon radiotherapy. 

Had no problems with the surgery although i spent 10 days in hospital mainly because my surgeon would not let me leave until i had had a bm and i was not allowed to eat fully for a couple of days. That said it took me about 6 weeks to recover as i picked an infection up.  

Thanks Anita - I live in Spain and my surgeon said that I should only be in hospital for about 2 days - fingers crossed.  Sorry to hear you had to be in for so long and then had to deal with an infection too.

I assume that if mine turns out to be T2 then I will either have more surgery or chemo, but will have to wait and see. Will let you know how it goes.

Claire 

Thanks for that info my tumour is a T4 so im assuming i wont be able to have the alternative option. Oh well Abdominal Perineal Resection it is then.   x

Hi Anita,

I did the same thing as you after being diagnosed in March 2012. Really did not want the surgery and the permanent stoma so stumbled across Papillon and had standard Chemoradiotherapy and had 3 sessions of Papillon with Prof Myint at the Clatterbridge, I did not require any TEMs surgery.

Regards

Richard.

Hi Matt,

I was recently diagnosed with T2 rectal cancer. A CT scan of my trunk and MRI of my pelvic area indicated that the cancer has not spread beyond the rectum. The tumour is mobile, or so I was told. My consultant said the Trust policy is complete removal of the rectum, lymph nodes and anus, with a permanent colostomy, as this radical surgery gives the best long-term outcomes. He mentioned radiotherapy, as an alternative elsewhere, but didn't mention any other possible treatments.

I wonder what he'll say when I ask him about IMRT outcomes.