HELP RC post APR Bladder dysfuction

[mtipte]

As many of you know my mum had APR surgery and permanent colostomy now, then infection 10 days in clinic with antibiotics and now still with Foley catheter due to complications with her bladder. Apparently some nerves were inevitably damaged and it doesn't allow to empty the bladder properly.

Did any of you experience the same? It will delay adjuvant chemotherapy for sure (now it's been 5 weeks since she had surgery). I'd also like to know if it is safe to wait more after surgery to start mop up chemo- I read some of you had some complications and started chemo later. Would it also be ok to take only Xeloda? As Folfox seems to cause major side effects - and I read somewhere the outcomes are quite the same, my mum had xeloda as neoadj tolerating it very well.

Thanks for reading.

Regards.

Mario.

[MegTayMcc]

Hi Mario,
I'm not sure if I can be of much help, but I've found myself in a similar situation as your mom. I had my apr surgery January 25th, so many complications with wound infection and draining. It delayed my chemo (folfox) start date by 4 weeks. My onc wasn't worried, and stressed how important it was to be better shape before beginning. I'm still dealing with bladder issues as well, and find your moms situation to be quite interesting. I see my surgeon again next week and hope to get some answers relating to that.

I did post a topic a couple weeks ago, "some post APR questions" with a lot of great feedback you may find helpful.

Take care, things will get better

[JudeD59]

My chemo was delayed because my LAR incision opened up and we had to wait for it to heal. My LAR was in August of 2015 and I couldn't start chemo until the surgeon cleared me. Then when I had my first infusion in November, i had a bad reaction to it with all my blood levels going out of whack. So they kept bringing me in for blood tests and then sending me back home without having the infusion because the levels weren't where they needed to be. Finally, my oncologist decided that if I had my reversal, my body might be able to tolerate the infusions better since I was always dehydrated with the ileostomy. When I told my surgeon that plan, he said that it was already February and I would need to recover awhile and chemo only really benefits if it's started within the first three months after tumor removal. So I had a dilemma. I spoke to my oncologist who met with the whole cancer center team and it was decided that having the chemo so long after the tumor removal would probably mean it wouldn't help much with mopping up stray cells and might put me in the hospital since my body had such a bad reaction to it. I didn't have any more infusions of the mop-up chemo and it's been a year and a half since surgery and all my CEA's and scans have been good.

I don't know if that helps, but I did a lot of research and you can find studies that have been done weighing the effectiveness of chemo done soon after surgery compared to chemo started months after surgery. The chemo and radiation before surgery shrink and sometimes obliterate the tumor and then the surgery removes any remaining tumor plus margins around it to make sure the parts they sew back together don't have any cancer cells. The chemo after is a precaution to kill any stray cells that may have remained in the system. So the pre-surgery radiation and chemo are more important than the post-surgery chemo. I still wanted to have that extra insurance, but I didn't have a choice. And so far, despite my high CEA's before surgery, I'm NED.

Remember, my situation was having adjuvant chemo over six months after my surgery. With your mom, it might only be two months and it might still be beneficial. Look into the studies and see what time frame makes a difference. It's been a year since I did my research and I can't remember exactly what the studies found to be the time period that was optimal.

Good luck to you and your mom.

Judy

[mtipte]

Thanks for replying. I have read the range is 4 to 6 weeks but the surgeon said she needs to be ok to see the oncologist. What worries me is LVI and the 3 nodes positive for cancer. There is a subpleural node too but the surgeon said it is common to be a scar from a past infection and told us not to worry about ut. So now just trying to give her blueberries and graviola. Did they help? She cant take melatonin or aspirin. The docs said aspirin causes unnecessary bleeding. Any advice on it? I cant find celebrex anywhere here, just curcumin and cats claw.

Regards.