My dad was diagnosed with Ca Rectum recently and gone through a Laparoscopic ULAR (Ultra Low Anterior Resection) surgery, NO chemotherapy or radiotherapy is given before surgery. Doctors said they would let us know on the next steps of treatment to be given on the next review. I am very much worried whether if he could tolerate the side effects of chemotherapy as he is aged and has other medical histories like Diabetes, Hypertension, Ischemic Heart Disease. I am so worried that if the chemotherapy would shorten his lifespan. Now that entire section of a tumour has been removed in the surgery should he be given a Adjuvant chemotherapy? Can someone help me with suggestions, please?
Age: 68
Personal history: South Indian, Non-smoker, Non-Drinker, Follows Vegetarian Diet
Past Medical history: Diabetes Mellitus, Hyper Tension, Ischemic Heart Disease
Past Surgical history: History of PTCA + Stent to LAD in 2012, Urological surgery for bilateral renal calculi in 2005
25/04/2018: Rectal bleeding
16/05/2018: CT Scan: Irregular circumferential wall thickening in the rectum
17/05/2018: Sigmoidoscopy & tumour sample collected
18/05/2018: CEA 3.0 ng/ml
19/05/2018: MRI Scan: Full thickness intrarectal invagination of the anterior wall of mid third of the rectum
19/05/2018: Rectal Biopsy with Intramucosal Carcinoma
29/05/2018: Colonoscopy
02/06/2018: Laparoscopic ULAR (Ultra Low Anterior Resection)
07/06/2018: Pathology report T3 N1 PN0 LV0. (1/14 perirectal lymph nodes identified with evidence of tumour invasion. No evidence of perineural invasion/ lymphovascular tumour emboli.).
Tumor size: 4.5 * 4 * 0.8cm
Microscopic tumor extension: Tumor invades the muscularis propria and perirectal fat. One regional lymph node is positive