First of all, let me welcome you to the forum. I hope that you will register so that other members can 'communicate' with you via email or PM and vice versa. Next, let me assure you that your husband's treatment that has been laid out is very standard for rectal cancer. I don't know where the onc (I assume it was an oncologist - or perhaps a GI doc??) is getting his information from regarding the blood work. I'm assuming that your husband had a CEA test - pretty standard for colorectal cancer. Depending on the test used, the normal for a non-smoker ranges from 0-2.5 for the Seimens/Bayer test and 0-5 for the Roche test. (There are higher limits for a smoker). So, not sure with a level of 0.9 why the onc would believe that is high! Are you sure you have your values right??
As to why the radiation. Rectal cancer that is stage II or above, no matter how small the polyp might be, is generally treated in the neoadjuvant setting (presurgery) with chemoradiation. With one suspicious lymph node, that would place your husband in that staging range. The studies have all shown that when chemoradiation is given prior to surgery, it cuts the risk of LOCAL recurrence by approx 50%. Keep in mind that is LOCAL and not distant recurrence. A patient truly does NOT want to get a local pelvic recurrence - painful & hard to treat. So the reasoning behind neoadjuvant chemoradiation is twofold. First, the treatments are often necessary to shrink the tumor to help avoid a colostomy and/or give the surgeon better success at a reconnection. Secondly, the chemoradiation 'sterilizes' the nodal field. The pelvic area is rich in nodes and once the cancer gets into the lymph system there is always that chance that it can travel - to local areas and/or distant organs, like the lung or liver. You need to also understand that the pelvis is like a 'hub' for the lymph & vascular system - cancer can travel anywhere from the pelvis. Finally, you must realize that the pelvis, particularly in the male, is a harder to reach area. It is beneficial for the surgeon to have all treatments at his/her disposal (and the rad treatments will help in sterilizing the nodal field) to help make the surgery and future a success.
I'm assuming that your husband has had all the standard testing done which would be: a colonoscopy, blood work, CT/MRI/PET and an endorectal ultrasound. You need to also know that the 'standard of care' for chemoradiation is to allow the patient to have the oral form of chemo - Xeloda - during the 5-6 weeks of radiation. No, it's not fun but.....it is doable and your husband can get through it. There are a lot of tips that you should know about before your husband starts the treatments but rest assured, the chemorad treatments are standard and, IMO, are beneficial.
Do you have a surgeon yet? If so, do you know if the surgeon is a board certified colon and rectal surgeon? I ask because so many general surgeons will do the surgery but...most of us on here who deal with rectal cancer would HIGHLY recommend you seek out a board certified colon and rectal surgeon. These are surgeons who only deal with surgeries pertaining to the colon and/or rectum. They have passed rigorous testing, have done a specific fellowship (these are the guidelines for the USA) and again deal only with surgeries pertaining to the colon and/or rectum. Remember that in the male, the pelvis is a very tight area and you truly do want a surgeon who is specialized in this surgery to obtain the best outcome. Below is a link that you can use to make sure that the surgeon your husband decides on is board certified. In addition, I'm also posting a link that will better help you understand the staging process, etc. Remember that in rectal cancer, the patient is given a clinical staging. This is done BEFORE any treatment that would alter the 'staging'. If rectal cancer were only staged via the surgical pathology report, most patients would NOT be given accurate information because the tumor would have shrunk and/or any suspicious lymph nodes would likely not be there anymore. Treatments are based (both before and after surgery) on the clinical staging so it is very important for the doctors to have an accurate assessment of the patient's staging before any neoadjuvant treatment begins.
It's a lot to take in right now but take a breath and you'll both do fine. I would highly suggest getting a 3 ring notebook, complete with dividers. Your husband will be having repeat testing from now on and it's a good idea to keep all the reports from these tests. Make sure that you get the reports from the following: colonoscopies, ultrasounds, pathology, blood work, CT scans, etc. These reports are your husband's and he is allowed to have copies. If the onc is not cooperative, ask to have copies sent to your GP and get them from him/her. GOod luck. Remember you can always seek a second opinion. Not all oncs are ones that dismiss - find an onc that your husband feels comfortable with and trusts. He/she will be your main doc for quite some time, but rest assured that with a suspicious lymph node - neoadjuvant chemoradiation is the standard of care for rectal cancer patients.http://www.cancer.org/Cancer/ColonandRe ... cer-stagedhttp://www.abcrs.org/cgi-bin/search.pl