I'm sorry that you've had to go through this. Cancer is often very tough on the spouse.
My situation was close to his for the surgery: 5 cm tumor, 5 cm from AV and margins clear after the operation. BTW, did he have an LAR surgery?
Did all of the doctors (Kaiser and the second opinions) recommend the APR? If you have recommendations for it from a top cancer hospital, then he may have his answer.
The most important thing is short-term survival and then long-term survival. Once you have those, then you can think about bargaining for functionality. That's where I am today. I'd like to avoid permanent neuropathy from Adjuvant Chemo but am doing it anyways with all of the horrible potential side-effects. One factor after my surgery is that I've basically had a functional vasectomy. Everything works except getting sperm from the prostate to where it's supposed to go. The problem is described at
https://www.uoaa.org/forum/viewtopic.php?f=2&t=26184 and it appears that there are many others with this. We're old enough so that kids aren't possible anyways. The surgeon did tell me that ED was a risk from surgery.
I have an temporary ileostomy and it has been somewhat of a learning experience dealing with it. There are some advantages to it (you can go to the bathroom anytime you want and not have to wait for stuff to come out) but there are a bunch of things to learn. I would imagine that the same is true with a Colostomy. There are lots of folks with them where they are discussed more often and in more detail on Ostomy-focused forums like
https://www.uoaa.org/forum/viewforum.php?f=2 and
https://www.meetanostomate.org/phpBB2/index.php so that may be a place to look.
I'm sure that you know what a roller coaster of an emotional ride it is as a caregiver. The person with cancer also goes through this but the worries are different. First you bargain for your life and then you bargain to not lose anything and it's a big blow when you lose something permanently. So the person with cancer has to come to terms the potential reality of losing something that they've always had.
A few things that are commonly suggested here:
- Get a board-certified colorectal surgeon at a high-volume center
- Get a genomic tumor analysis if your insurance covers it so that you know exactly what gene mutation he has
- Read up on life with a colostomy and get opinions from people that have one to see how manageable it might be for him
