How long between LARS, stoma and reversal for you?

Posted by michaelfromsf @michaelfromsf, 6 days ago

I am expecting to have LAR surgery soon and the plan is to remove my sigmoid, part of rectum, lymph nodes and install ostomy, then hopefully reverse. I presented stage 4 10cm tumor but with no metastatic spread. Had FolFox through port, then 25 rounds CRT, last radiation in Feb. all tests show CR or near CR. wondering if anyone like me can share this long it was between your initial LAR and healed enough for reversal. I am Pretty nervous! Thanks.

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Did they do genetic testing on your tumor? If you are one of the lucky people who are MMR deficient, immunotherapy may be a good option.
See: https://www.mskcc.org/news/rectal-cancer-clinical-trial-msk-changed-everything-its-patients
Good Luck

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@tgoz

Did they do genetic testing on your tumor? If you are one of the lucky people who are MMR deficient, immunotherapy may be a good option.
See: https://www.mskcc.org/news/rectal-cancer-clinical-trial-msk-changed-everything-its-patients
Good Luck

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They did test and I my cancer is not the type that responds to immunotherapy. Thanks for your reply but I am really hoping someone can share there reversal experience in terms of how much time between LARS, stoma and reversal? I have heard anything from 7 weeks to 7 months or a year.

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@michaelfromsf, I'm tagging @cjay @lou3 @happygrandpa @pjebp @verol65, who may have experiences to share with you regarding the timeline low anterior resection (LARS), stoma and ostomy reversal.

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Hi, @michaelfromsf , I'm glad you didn't have any metastasis!

I had a type of LAR that did not involve a stoma/ostomy of anykind. To remove my whole rectum, sigmoid and mesorectum (lymphnodes), my surgeon used a technique called a two-step Turnbull-Cutait pullthrough with coloanal anastomosis. This means I underwent two surgeries:
* a long one (mine was 5 hours due to a couple of complications; usually it takes 3 to 4 hours between 2 surgeons) to resect the whole thing and pull the colon through the anus, about 5 to 8 cm.
* after staying in the hospital for one week (in some hospitals they send people home), a short operation (1 hour) for the coloanalanastomosis: they cut the bit of colon that was hanging out and handsuture the colon to whatever they left you with of rectum (in my case, it was next to nothing).
This is a complex procedure, but it avoids the temporary ostomy. You might want to discuss this option with your medical team.

Whether you have this surgery or a LAR with temporary ostomy or reversal, you have to be prepared to suffer from LARS because you will no longer have the holding places that the rectum and sigmoid are. Your way of going to the bathroom to defecate will change. I find this video to be a good explanation without being morbid: https://www.youtube.com/watch?v=rL7YJC_F-yg. And you might want to join LARS support groups on Facebook. You could listen to this podcast: https://my.clevelandclinic.org/podcasts/butts-and-guts/low-anterior-resection-syndrome. You could visit this site for information and tips on nutrition and other aspects of living with LARS: https://livingwithlars.com/. Some people fare better than others. Usually it seems that those of us who didn't get an ostomy tend to fare better than those who did, but it's a very individual thing.

If you're interested in the FB support groups, I can send you the links.

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