The more I read about the side effects suffered by many women after radiation for rectal cancer, the more I see them downplayed in places such as the ACA website, the more women say that their doctors never informed them of the risks or how to best address them, the more I wonder whether the largely male onco/radiology world is giving any seriously thought to whether some women should not receive radiation before surgery, when it seems to be routinely dispensed.
The primary reason for pre-surgical radiation and chemo appears to be to "make the tumor easier to remove." In fact, it would appear to be close to the sole reason, since situations where radiation of tissues in the area to prevent spread seem warranted can be addressed during or post surgery.
I have recently read the stories of several women who report that their tumor shrank significantly (50% was cited) after 4 cycles or so of pre-surgical Folfox, but then the plan is to go ahead and irradiate them anyway.
It is the norm, as my neurosurgeon would say, to undergo a risk/benefit analysis before undertaking any medical procedure . I am wondering whether the doctors involved in these cases, largely male, are taking a woman's sexual health and quality of life into consideration AT ALL. Let us not forget that a couple of decades ago the hysterectomy was the most frequently performed surgery and the one most likely to be deemed unnecessary. Let us also not forget that surgeons exerted themselves to develop nerve-sparing surgical techniques in prostate surgery, the sole point of which is to help a man preserve his sexual function and continence, not to make surgery easier or save his life. Why don't they do routine irradiation of the prostate bed after surgery to maximize progression-free survival? They only do it if a rising PSA indicates need.
I would love to see some discussion of this, especially with colorectal surgeons. I wonder if anyone has had or read about such a discussion.