Another colonoscopy before surgery?

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Lee
Posts: 5507
Joined: Sun Apr 16, 2006 4:09 pm

Re: Another colonoscopy before surgery?

Postby Lee » Thu Oct 26, 2017 10:02 pm

SC77 wrote: . . . My original surgeon who performed my first colonoscopy told me he would not do the operation because of the complexities of rectal cancer. The nearest specialist is 3 hours away.
.


That 1st sentence says you might want to look around before having someone cuts you open. You should have a bit of time, a few weeks will not change the outcome. Maybe see the specialist for a 2nd opinion and decide from there. My concern, I've never heard of a colonoscopy for surgery purposes. Maybe go back and ask why.

Good luck,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

NHMike
Posts: 1107
Joined: Fri Jul 21, 2017 3:43 am

Re: Another colonoscopy before surgery?

Postby NHMike » Fri Oct 27, 2017 6:33 am

SC77 wrote:Thank you all for taking the time to reply! It is much appreciated. I'm confused and worried. My surgeon is not a rectal cancer specialist. There isn't one in my area. He has a good reputation. My original surgeon who performed my first colonoscopy told me he would not do the operation because of the complexities of rectal cancer. The nearest specialist is 3 hours away.

I don't have pain or burns from the radiation. Except for a bit of lingering cystitis and some hip and back pain after standing or working all day, I feel all right. I'm an elementary teacher and I've been working through treatment.

Now I have doubt and I'm questioning everthing. This has probably been my most depressed day so far.


My surgery is this Monday and it's about 75 minutes away and I'll need to get a hotel as there's so much prep work the day before that I can't drive in to the surgery. My GI guy discussed the oncologist, radiation doctor and surgeon with me and the advantages and disadvantages of using local and distant services. So we went with local services for oncology and radiation treatment and distant for surgery (after second opinions on oncology and radiation). This and the regular recommendations on this board for choosing a specialist for surgery if possible.

The logistics of a distant surgery and recovery can be quite complicated, especially if you don't have someone with you or other local support. I'm trying to minimize the amount of help that I'm asking from others but I don't think that it would be possible without some help, providing rides, bringing me things, etc. I think that it would be challenging to change surgeons at this late date if you wanted the surgery date to remain the same as hospital operating room and surgeon schedules can be quite complicated to work out and it would depend on their workloads as well. I think that it can be challenging working out the logistics on short notice as well.
Last edited by NHMike on Fri Oct 27, 2017 8:39 am, edited 1 time in total.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx

cbsmith
Posts: 55
Joined: Sat Nov 28, 2015 11:45 am
Location: New Brunswick, Canada

Re: Another colonoscopy before surgery?

Postby cbsmith » Fri Oct 27, 2017 6:40 am

I would never have this surgery from anyone other than a certified colorectal surgeon. The outcome of this surgery could affect the rest of your life. Going to a hospital 3 hours away for it is a small thing in the big scheme is things.
06/14-DX with FAP as 36yo Male
07/14-total colectomy, rectum removal, permanent ileostomy
08/14-DX Stage IIIC colon cancer KRAS mutant, MSS
09/14-12 rounds of FOLFOX
04/15-ended FOLFOX
07/15-CT showed one para-aortic lymph node, onc thought inflammation and said wait 3 mths
10/15-DX Stage IV, CT showed lymph node tripled in size and 1 small lung met
11/15-FOLFIRI + Avastin
06/16-lymph node is stable, now have a 2nd lung met
01/16-lymph node is stable, lung mets grown 2mm. Still on FOLFIRI + Avastin

User avatar
susie0915
Posts: 741
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Another colonoscopy before surgery?

Postby susie0915 » Fri Oct 27, 2017 7:48 am

I agree with others here. I remember telling my husband since my treatment would be pretty standard I thought the most important thing was having a surgeon that I felt confident in as rectal cancer surgery is a little more intricate. Definitely have a board certified colorectal surgeon. It is worth the travel time. You can do chemo locally, but I would really think about getting a second opinion for surgery. Good Luck
58 yrs old Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc feels scar tissue
7/17 no change lung nodule
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule or scarring/inflammation

User avatar
Atoq
Posts: 165
Joined: Wed Oct 25, 2017 9:31 am

Re: Another colonoscopy before surgery?

Postby Atoq » Fri Oct 27, 2017 11:06 am

My surgeon said that the tumor continues to shrink, after radiation and Xeloda, for 6 to 8 weeks. So they would evaluate the situation after that.

All the best

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung

C2WAVE2
Posts: 25
Joined: Sun Apr 23, 2017 3:22 pm

Re: Another colonoscopy before surgery?

Postby C2WAVE2 » Sun Oct 29, 2017 1:45 pm

I didnt have radiation or Chemo, but I had one colonoscopy that discovered the mass, and the surgeon
wanted to do a second one before surgery to scope it out, and mark where he was cutting.. This was after
I had CT and MRI..
4/24/17. 55yr Male, Dx RC near Retcum/Sigmoid junction
O4/28/17 Ct
O5/04/17 MRI
Prelim. T1 N0 M 0 CEA 3.2
O5/23/17 Surgery, LAR 4.5" incision to remove tumor Temp Ileostomy
6/1/17 Pathology report 6.5 x 4.3 x 1.7 cm tumor, Adenocarcinoma,
Moderately to Poorly Differentiated , 0/27 Lymph, T2N0M0
08/02/17 Ileostomy Reversal

AlexMichelle
Posts: 42
Joined: Sat Oct 28, 2017 11:54 am
Location: California

Re: Another colonoscopy before surgery?

Postby AlexMichelle » Wed Nov 08, 2017 3:54 am

Is your surgery still scheduled for Nov 9? If so, we are both having our surgery on the same day. Mine is scheduled for 9 AM. What time is yours? My tumor started out in the lower colon and has spread a little tiny bit in the rectal area so that is why I did not have radiation first. The surgeon seems to think he will be able to cut out the 4.5 cm tumor with margins and reconnect the rectum to the colon. The CT scan and MRI did not show the cancer anywhere else but of course we will not know for sure until the lymph node pathology comes back. He told me he did not think I would have to have a colostomy but not to be shocked if I wake up with one. I am having open surgery, unfortunately. Each day I bleed more and more with large blood clots and my stomach is so uneasy with rumbling and pain that I cannot wait to trade this pain for the new pain of surgery recovery. Today I had a complete bloodwork up again and EKG along with a one hour interview by the anesthesiology team. Tomorrow at noon I start drinking the prep. Would love to hear your plans for your surgery. Good luck to both of us.
F 9/14/17 blood, 10/05/17 endoscopy/colonoscopy 4.5 cm tumor lower colon/upper rectum/left side -11/09/17 open Rectosigmoid Colon Resection remove invasive adenocarcinoma, moderately diff marg clear.15 lymph nodes neg malignancy. benign liver w/fibrous nodule- rectum at 15cm Tumor location: above peritoneal reflection 4.2 x 2.7 cm Tumor inv muscularis closest 1.5 cm. pT2pNO Stage 1. No Lynch

NHMike
Posts: 1107
Joined: Fri Jul 21, 2017 3:43 am

Re: Another colonoscopy before surgery?

Postby NHMike » Wed Nov 08, 2017 8:35 am

AlexMichelle wrote:Is your surgery still scheduled for Nov 9? If so, we are both having our surgery on the same day. Mine is scheduled for 9 AM. What time is yours? My tumor started out in the lower colon and has spread a little tiny bit in the rectal area so that is why I did not have radiation first. The surgeon seems to think he will be able to cut out the 4.5 cm tumor with margins and reconnect the rectum to the colon. The CT scan and MRI did not show the cancer anywhere else but of course we will not know for sure until the lymph node pathology comes back. He told me he did not think I would have to have a colostomy but not to be shocked if I wake up with one. I am having open surgery, unfortunately. Each day I bleed more and more with large blood clots and my stomach is so uneasy with rumbling and pain that I cannot wait to trade this pain for the new pain of surgery recovery. Today I had a complete bloodwork up again and EKG along with a one hour interview by the anesthesiology team. Tomorrow at noon I start drinking the prep. Would love to hear your plans for your surgery. Good luck to both of us.


People having the same course of treatment around the same time often make great buddies as you're going through the same thing around the same time. I have a number of these buddies on another forum and we cheer each other on and provide advice and our experiences.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx


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