Here's some more information that you will need to be aware of. If it is rectal cancer, you will be given a clinical
stage. I realize that your doctor said stage III but there are differentiations in the stage III setting. There is a stage IIIA, IIIB & a stage IIIC. The staging is based on the "T", "N" & "M" factors. The terminology can get confusing until you get accustomed to it. Basically, the "T" stage refers to how deeply your tumor invades the wall of your colon/rectum. The "N" designation refers to how many nodes are affected and the "M" designation refers to how many, if any, distant mets (metasteses) you have. Mets can be either or both distant organs or distant lymph nodes involved. The other difficult part to discern is that there is a "T" stage
and an overall stage.....don't confuse the two. Your "T" stage will always be referred to as a T1, T2, T3, etc. To get your final overall stage, the patient has to know all of the components. Here's a link that better explains it.http://www.cancer.org/Cancer/ColonandRe ... cer-staged
If you do indeed have a diagnosis of rectal cancer, you will undoubtedly be undergoing more tests. The first would be a rectal ultrasound.....not exactly a pleasant test, but one that is necessary. This test allows the doctor to diagnosis the "T" stage of the tumor and to see any local lymph node involvement and is important to be done prior to any treatments. (Keep in mind that although you may have had a CT scan, the rectal ultrasound is much more sensitive to assess the pelvic lymph nodes than the CT is.) Usually with rectal cancer stage II and higher, the first treatment is neoadjuvant (presurgery) chemoradiation. These treatments are done to help shrink the tumor and to 'sterilize' the lymph node field in the pelvis. Rectal cancer has a higher rate of local recurrence than colon cancer and the chemorad treatments help to minimize this risk.
stage in rectal cancer is important because when surgery is undertaken, there is a fairly substantial probability that the tumor will have shrunk significantly and/or the affected nodes will be gone. If the doctors waited to only do a pathological staging, it would give a skewed result. Let me further explain. Suppose a patient presents with a T3N1M0 and is clinically staged as a stage IIIB. After chemoradiation, the tumor has shrunk to a T1 and no nodes are found to be affected with cancerous cells in the pathological examination (after surgery). If the doctor simply went by the pathological findings and nothing else, this same patient would present with a T1N0M0 diagnosis and be a stage I. This would cause problems with adjuvant treatments. A stage I patient is generally not given any other treatment such as chemo (unless there are some other extenuating circumstances) but a stage IIIB patient is. I'm probably jumping ahead here as you aren't even totally sure whether or not you have colon or rectal cancer. It is important, though, that you realize that while the two are similar, there treatments are different. (Most colon cancers are initially treated with surgery).
The first thing you need to do Bill, is to find out whether or not this is considered rectal or colon cancer and then proceed from there. I would also caution you to realize that, although well meaning, many oncs have a tendency to give surgical advise to patients, when in reality, this is not their field of expertise. I am a firm believer in letting the medical onc be the person who is responsible for the chemotherapy and the surgeon be responsible for the surgical advice. I would also highly
suggest seeking the advice (again, particularly if this is classified as rectal cancer) of a board certified colorectal surgeon. Too often, a general surgeon (who may very well be a top notch surgeon) will tell you that they can perform rectal cancer surgery....and the fact is that they can. However, be aware that the pelvis, particularly in the male, is a confining area to operate in. Everything within the pelvis is within millimeters of each other....ligaments, nerves, tendons, etc. Personally, I would only want a surgeon who does nothing other than colorectal surgery to be operating on me. The following link will provide you with surgeons who are board certified.http://www.abcrs.org/cgi-bin/search.pl
While I realize this is all 'yucky', that you just 'want it out" please take the time to find the right surgeon, onc, etc. These doctors will be important to your care for quite some time and you should have a good 'feeling' about them. If you have any doubts or just don't feel that the doctor/patient relationship is a good 'fit', then by all means, seek out a second opinion.
Sorry if I have overloaded you with information here. Good luck on your appointment. Please let us know how things go and what your next step(s) are.