Another colonoscopy before surgery?

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SC77
Posts: 5
Joined: Wed Aug 09, 2017 6:52 pm

Another colonoscopy before surgery?

Postby SC77 » Wed Oct 25, 2017 9:14 pm

I just met with my surgeon this evening. I finished 30 rounds of radiation and Xeloda October 10th. My surgeon wants to do a colonoscopy next week to see what to do before surgery which is tentatively scheduled for Nov. 9th. Is this normal? I wasn't expecting this.
40/ F
Diag. Stage III rectal 7/27/17
Started Xeloda and radiation/22/17
Finished 30 treatments on 10/10
Surgery scheduled for 11/9/17

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O Stoma Mia
Posts: 973
Joined: Sat Jun 22, 2013 6:29 am

Re: Another colonoscopy before surgery?

Postby O Stoma Mia » Thu Oct 26, 2017 1:12 am

SC77 wrote:I just met with my surgeon this evening. I finished 30 rounds of radiation and Xeloda October 10th. My surgeon wants to do a colonoscopy next week to see what to do before surgery which is tentatively scheduled for Nov. 9th. Is this normal? I wasn't expecting this.

I don't know if it is normal or not, but I would say that it would have to be done by a very experienced doctor who knows the risk of bowel perforation just after conclusion of pelvic radiation and who will be exceptionally careful during the procedure.
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Aqx99
Posts: 320
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Another colonoscopy before surgery?

Postby Aqx99 » Thu Oct 26, 2017 6:41 am

SC77 wrote:I just met with my surgeon this evening. I finished 30 rounds of radiation and Xeloda October 10th. My surgeon wants to do a colonoscopy next week to see what to do before surgery which is tentatively scheduled for Nov. 9th. Is this normal? I wasn't expecting this.


I didn't have a colonoscopy before surgery after radiation, they gave me another CT to see how things were. I'd be a little nervous about getting a colonoscopy so soon after radiation. I was told the tissue is so fragile, that even pushing for a hard bowel movement could tear it. You may want to question this decision.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL
1/11/18 CA 125 8.6 U/mL
1/23/18 Reversal

NHMike
Posts: 853
Joined: Fri Jul 21, 2017 3:43 am

Re: Another colonoscopy before surgery?

Postby NHMike » Thu Oct 26, 2017 7:00 am

SC77 wrote:I just met with my surgeon this evening. I finished 30 rounds of radiation and Xeloda October 10th. My surgeon wants to do a colonoscopy next week to see what to do before surgery which is tentatively scheduled for Nov. 9th. Is this normal? I wasn't expecting this.


My surgeon wanted an MRI four weeks after the end of chemo and radiation for planning purposes. It provided a considerable amount of useful information for the surgeon and me. My surgeon told me about the MRI and surgery plan before I started chemo and radiation so I was expecting the MRI request. I did not know that this could be done with a colonoscopy as well.
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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susie0915
Posts: 647
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Another colonoscopy before surgery?

Postby susie0915 » Thu Oct 26, 2017 7:16 am

I had a pet scan after chemo/radiation. I didn't have another colonoscopy until a year after my surgery. I'm not sure if it is normal.
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

NHMike
Posts: 853
Joined: Fri Jul 21, 2017 3:43 am

Re: Another colonoscopy before surgery?

Postby NHMike » Thu Oct 26, 2017 9:52 am

susie0915 wrote:I had a pet scan after chemo/radiation. I didn't have another colonoscopy until a year after my surgery. I'm not sure if it is normal.


It sounds like surgeons use MRI, Pet Scan and Colonoscopy as their main tools for surgical planning. Maybe CT scans as well?
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

Lee
Posts: 5383
Joined: Sun Apr 16, 2006 4:09 pm

Re: Another colonoscopy before surgery?

Postby Lee » Thu Oct 26, 2017 10:20 am

Aqx99 wrote:I didn't have a colonoscopy before surgery after radiation, they gave me another CT to see how things were. I'd be a little nervous about getting a colonoscopy so soon after radiation. I was told the tissue is so fragile, that even pushing for a hard bowel movement could tear it. You may want to question this decision.


I'm not aware of anyone who got scoped following radiation. I would ask the surgeon why. Form a personal view point, I was so sore and tender in that area following radiation, not sure I could have handled a scope at that time.

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!

[Ana & Alex]
Posts: 89
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: Another colonoscopy before surgery?

Postby [Ana & Alex] » Thu Oct 26, 2017 11:05 am

I second everyone else, when it comes to tissue damage after radiation. I was pretty damaged myself, having suffered a 3 degree burn in my a-hole... You should choose your surgeon wisely, and be aware of the risks involved.

I in my case had a sigmoidescopy and a CT scan before surgery. It was important for me and for my surgeon to have a direct visual evaluation done, before it all went down.

But she is a very experienced surgeon and for me it was worth the risk, giving her more security in planning for my surgery.

So, yeah, there are people who are scoped right before surgery, just make sure you are in good hands and that the surgeon scoping you is the same that is going to perform your surgery... that would be my advice...

All the best for your surgery..
I hope it goes smoothly!

Ana
Dx @ 29 yo. Mum (2 y.o.) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d
12/2017: Aspirin, Vit. D3, Curcumin, Multivitamin.

Lee
Posts: 5383
Joined: Sun Apr 16, 2006 4:09 pm

Re: Another colonoscopy before surgery?

Postby Lee » Thu Oct 26, 2017 11:49 am

SC77 wrote:I just met with my surgeon this evening. I finished 30 rounds of radiation and Xeloda October 10th. My surgeon wants to do a colonoscopy next week to see what to do before surgery which is tentatively scheduled for Nov. 9th. Is this normal? I wasn't expecting this.


Is your surgeon a board certified colon rectal surgeon? If not, I would HIGHLY recommend getting one. You really want a surgeon with the extra training when dealing with rectal cancer.

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!

User avatar
susie0915
Posts: 647
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Another colonoscopy before surgery?

Postby susie0915 » Thu Oct 26, 2017 12:26 pm

I forgot I did have a sigmoidoscopy after chemo/rad. That's when the surgeon told me all that was left of tumor was scar tissue. So maybe a colonoscopy can be
standard procedure. I don't think a sigmoidoscopy goes as far as a colonoscopy, but I had rectal cancer that was only 5 cm from anal verge. It wasn't bad, I don't remember having any problems with it.
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

Aqx99
Posts: 320
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Another colonoscopy before surgery?

Postby Aqx99 » Thu Oct 26, 2017 1:32 pm

susie0915 wrote:I forgot I did have a sigmoidoscopy after chemo/rad. That's when the surgeon told me all that was left of tumor was scar tissue. So maybe a colonoscopy can be
standard procedure. I don't think a sigmoidoscopy goes as far as a colonoscopy, but I had rectal cancer that was only 5 cm from anal verge. It wasn't bad, I don't remember having any problems with it.


How soon we forget! I had a digital exam and a sigmoidoscopy before my surgery. I guess I was blocking out the part where he told me he could wiggle my tumor around, whereas he couldn't before.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL
1/11/18 CA 125 8.6 U/mL
1/23/18 Reversal

NHMike
Posts: 853
Joined: Fri Jul 21, 2017 3:43 am

Re: Another colonoscopy before surgery?

Postby NHMike » Thu Oct 26, 2017 2:00 pm

Aqx99 wrote:
susie0915 wrote:I forgot I did have a sigmoidoscopy after chemo/rad. That's when the surgeon told me all that was left of tumor was scar tissue. So maybe a colonoscopy can be
standard procedure. I don't think a sigmoidoscopy goes as far as a colonoscopy, but I had rectal cancer that was only 5 cm from anal verge. It wasn't bad, I don't remember having any problems with it.


How soon we forget! I had a digital exam and a sigmoidoscopy before my surgery. I guess I was blocking out the part where he told me he could wiggle my tumor around, whereas he couldn't before.


I had the digital before and after chemo and radiation as well.
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

User avatar
susie0915
Posts: 647
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Another colonoscopy before surgery?

Postby susie0915 » Thu Oct 26, 2017 2:39 pm

Aqx99 wrote:
susie0915 wrote:I forgot I did have a sigmoidoscopy after chemo/rad. That's when the surgeon told me all that was left of tumor was scar tissue. So maybe a colonoscopy can be
standard procedure. I don't think a sigmoidoscopy goes as far as a colonoscopy, but I had rectal cancer that was only 5 cm from anal verge. It wasn't bad, I don't remember having any problems with it.


How soon we forget! I had a digital exam and a sigmoidoscopy before my surgery. I guess I was blocking out the part where he told me he could wiggle my tumor around, whereas he couldn't before.

Lol. I know. but it's right there in my signature.
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

SC77
Posts: 5
Joined: Wed Aug 09, 2017 6:52 pm

Re: Another colonoscopy before surgery?

Postby SC77 » Thu Oct 26, 2017 6:45 pm

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.
40/ F
Diag. Stage III rectal 7/27/17
Started Xeloda and radiation/22/17
Finished 30 treatments on 10/10
Surgery scheduled for 11/9/17

SC77
Posts: 5
Joined: Wed Aug 09, 2017 6:52 pm

Re: Another colonoscopy before surgery?

Postby SC77 » Thu Oct 26, 2017 8:48 pm

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.
40/ F
Diag. Stage III rectal 7/27/17
Started Xeloda and radiation/22/17
Finished 30 treatments on 10/10
Surgery scheduled for 11/9/17


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