I recently had Lower Anterior Resection surgery in Southern California. In the interest of sharing useful information for people that come to this site seeking support, I would like to share my story. I found this forum very helpful and I want to give back in some small way.
I had rectal bleeding; I was examined via a rigid sigmoidoscopy followed by a colonoscopy and diagnosed with colorectal cancer. I quickly went in for an additional flex-sig / ultrasound and ct scan. The doctors believed the tumor was a T2N0. The referring Colorectal surgeon said I needed an Anterior Resection (possibly a LAR.) The news that I had cancer was tough; coping with the potential for the quality of life issues after surgery made things tougher.
I immediately went about getting a second opinion… rather... second opinions. My proctologist said that radiation and chemo would not be necessary but I needed the LAR. I spoke with three surgeons in the So-Cal area and I finally settled on Dr Kevork Kazanjian at UCLA. I felt the most comfortable with Dr Kazanjian, he is the head of the colorectal cancer department at UCLA Westwood and I had a personal referral. I can not say enough good things about Dr Kazanjian, he and his team have been great throughout the whole process. I interviewed surgeons in the So-Cal area before settling on Dr K, including surgeons at USC and Cedar-Sinai. If you have questions about my experience with various surgeons, do hit me up. I have to say I really liked Dr Kaiser’s style at USC as well; he came recommended by an individual on this board. I saw a few other surgeons that I felt looked at me as a pay-check. If the doctor insists on examining you when you’ve already been diagnosed, it may be for a quick buck.
My LAR surgery was early in the morning. I arrived at UCLA and signed in. I was taken to the pre-op area and changed into my gown. I had showered with CHG soap two days prior and the morning of as advised by Dr Kazanjian’s team. They gave me an epidural; I’m glad I decided to go this route as I did not experience very much pain. My wonderful and supportive girlfriend was with me the entire time, until I was taken to the operating room. I opted for robotic surgery; I saw the robot as I went into the operating room. They put me out and I woke up about 7 hours later (the LAR itself does not take this long, but they placed a temporary diverting loop ileostomy as well.) Naturally, I was hoping to avoid the Ileostomy; it was the first thing I checked post surgery as they rolled me down the hospital hall and I was still in a bit of a funk from the anesthesia. I was unhappy about the Ileostomy, but all-in-all it wasn’t that big a hassle for the two months or so that I had it. My thumbs were numb, likely because I’d pinched a nerve while my arms were extended during surgery. The numbness went away after about 24 hours. I was quite concerned about the potential for post-op issues with urination and sexual function. I was thinking about this a bit the first few days in the hospital; by the time the nurse arrived to take the catheter, I was really ready to have it out and try urinating. I was very relieved (pun intended) that everything worked as expected; that goes for sexual function as well. The good news after surgery was: clean margins; the tumor was a T1N0.
One thing to mention is that I did vomit after returning home from surgery. My stomach was in knots; I thought my ileostomy may have been blocked. It turned out that the Imodium I was taking really shut-down my digestion. I spoke with the doctor, stopped taking the Imodium and was ok after that.
About 6 weeks after LAR surgery I went in for a gastrografin enema study. In order to be sure that you’ve healed adequately and that there is no leak at the anastomosis, ex-rays are taken while fluid is put into your body via an enema. It was not all that fun; it upset my stomach a bit and the fluid came out of my ileostomy bag. I got through it. The doctor conducting the enema said some things that troubled me a bit; in the end, the surgeon looked it over and said everything was normal. I was set to have the ileostomy taken down.
Ileostomy take down was a quick surgery. The days that followed in the hospital were nerve-racking as I was again worried about post-op quality of life; specifically LARS (Lower Anterior Resection Syndrome.) I burped a lot the first few days and my stomach felt a bit funny; eventually my bowel came to life and I had a really liquidy bowel movement. I believe it was two days after surgery. After I got home I had a few (two?) more liquidy bowel movements, but they became very normal sold bowel movements very soon. I now use the bathroom more frequently (let’s say 2-3 times a day) and some foods cause me to go more often. I have not experienced major LARS symptoms.
Advice - for anyone facing this situation my heart goes out to you. Cancer is scary and I often found myself asking “why me” or “how did this happen to me”? The bottom line is that you’ve got to get it taken care of. Here is my advice.
- If you have rectal bleeding, go for the colonoscopy, even if you’re young. It may not be hemorrhoids. I was worried about the colonoscopy procedure and the potential for infection which caused me to delay a bit; do ask lots of questions of the hospital staff and do you research, but get the colonoscopy.
- Get organized, get all of your documents (diagnosis, result of colonoscopy, etc…) and digital info (ct scan) organized, stick it in a folder and on a usb drive. Have it with you when you visit surgeons / hospital facilities.
- If you must go for surgery, speak to board certified colorectal surgeons. My advice is to interview several. Write down a list of questions about the procedure, the risk potential, quality of life concerns. Ask these questions of all of the surgeons. Meet with them multiple times if necessary. Use google to check out the surgeons; use colon talk to do research. Understand what you’re getting into. Determine which surgeon one you are comfortable with.
- Live your life, have fun every day and spend time with the people you love most.
That’s it. Feel free to reach out if you have any questions.
40 / Male
Colon Cancer in the recto-sigmoid junction. Lesion is non aggressive: T2N0, ~5cm x 2.5cm in size, 13cm from the anal verge.
Lynch status: negative
LAR w/ Diverting Ileostomy Dec 2016
Post-Surgery Pathology: T1N0, clean margins, NED
Clean Colonoscopy Nov 2017