Options other than transection of rectum

Hi, yes was diagnosed with a T3 mid to lower tumor, stage IIa in October. I was referred to oral chemo and radiation for 6 weeks that I finished at the end of January. An MRI in mid-February showed that the tumor was completely gone, an unusual outcome for a T3 tumor. A sigmoidoscopy this Friday is needed to see what if any visible disease remains. If there is residual disease, I will likely proceed to systemic chemo then a reevaluation to see if surgery is necessary. While my outcome from radiation was unusually complete, I believe chemo and radiation are becoming the standard protocol prior to surgery to at least shrink the tumor. Worth another conversation at least. Sorry for the worry and concern. Hope this helps.

I was diagnosed with rectal/anal cancer stage 3 at the end of 2022. I have had 8 chemotherapy sessions (no surgery), which has shrunk the tumor by 2,5 cm. I am now on oral chemo with radiation and had my 3rd treatment today. I have a total of 6 weeks with a session every day. It only takes 10 minutes and is painless so far. I take 3 chemo tablets in the morning and 3 in the evening. I can only hope for a positive outcome, but the pain of the cancer has definitely subsided dramatically.

Hi, I am from Australia, diagnosed with 5.8cm ano rectal cancer (stage 3) just before Christmas. The best option treatment offered time was combined radiation & chemo. Due to risk of obstruction, I had a loop colostomy 2 weeks prior to commencement of treatment. I am 14 out of 28 treatments done with 5 days off treatment due to severe diarrhoea. Thank goodness for the Colostomy as I wouldn't have managed any treatment with the 2 weeks diarrhoea otherwise. This has been my main issue along with colitis & gastritis which has settled somewhat with medication. I have also been unable to eat much, but I guess that's from all the abdominal spasms that come with diarrhoea. Food has become my new medicine. I know that all cancers are different & some rectal cancers can be surgically removed with reconnection of bowel later on. Unfortunately this was not the case for me as my tumour went from anus into rectum & surgical removal would have meant a permenant colostomy. You need to talk to your oncologist & ask questions, after all, your future depends on it. Hope this helps

This is the regime I am on, without the initial chemo. 3 chemo tabs in morning & night on days of radiation & 6 weeks daily radiation except weekends. I have had to have a break due to severe diarrhoea (see previous comment) but wander if this is colostomy related as surgery only 2 weeks before treatment. I have found any symptoms you have will be assumed to be from the treatment & I am on a push to have bowel scans done to discount surgical issues such as adhesions or strictures.

yes i have the same thing and im on 5th chemo session i think chemo is the safer way even though chemo isnt easy - im getting chemo then radiation then maybe surgery but i guess everyone is different - id like to get surgery but they recommended the other route

id get a second and third opinion

I will be staring this treatment chemotherapy with radiation on Monday for a stage IV anorectal cancer. Am very nervous about it. I had 4 courses of chemotherapy followed by 28 radiation treatments in 2021 for a ureter cancer. Not excited about doing it again. I’ve been told if this doesn’t work, APR surgery with a permanent colostomy is the only option. I’m not open to that with metastatic cancer. Fingers crossed it works.

@202007jack
What did your husband get as treatment after all?
I had a polyp that was between 3 and 4 cm from the anus and which we though pre-cancerous (from the colonoscopy's biopsy) removed transanally last December. The biopsy said there were positive margins, so I got a long-course of low-dose radiotherapy + 3 pills of chemo on the days of RT, to avoid a new surgery that could put the sphincter at risk. The RT provoked a rectovaginal fistula at 3.2 cm from the anus (very rare secondary effect) and a recent colonoscopy revealed a ¿new? polyp right across from the fistula. Therefore I'm getting a full rectum and mesorectum resection with a coloanal anastomosis at the end of the month. I have no doubts that it's the right thing to do, but I have so many questions about the post-op period and addaping to the colon having to do the job of the rectum.

My concern with not having the surgery first would be the possible involvement of lymph nodes.
I was diagnosed in February with stage 3 CRC, T3N2, and the tumor had grown into the walls of the sigmoid, but was just high enough to plan a lower anterior resection, followed by a temporary ileostomy. My surgeon believed (correctly thank heaven) that the tumor would never shrink to the point of not needing the surgery, so (going against the advice of the oncologist) we moved ahead with a short course of radiation (5 sessions), followed quickly by the surgery, which I had in April. She removed the large tumor, 26 lymph nodes, along with 2/3’s of my rectum and a portion of my sigmoid.
After the pathology came back, 16 of the 26 lymph nodes removed were cancerous. Had I not had the surgery as quickly as I did, there would have been a very high chance of the cancer spreading via the lymphatic and blood system, and spreading to other organs.
I had the ileostomy for almost 6 months, during which time I had adjunct chemotherapy with FOLFOX for 4 months. The ileostomy reversal was done at the end of September, 1 month after my chemo ended. I returned to work December 1, after 11 months on medical leave, and I’m still learning about my new plumbing and how I now digest differently.
I am more than grateful that my cancer has not been detected through 3 Signatera blood tests. My first scan is next month. She definitely saved my life.

Sorry it has taken so long to reply. He has two thirds of his rectum removed… no chemo or radiation. He has had to adjust to new patterns in digestion and modified diet that is not too strict. He is very fortunate that he is cancer free. We are lucky to have such wonderful cancer care in our area.