Ulendon wrote:... Oakland is where the
surgery center is and I have a Friday appointment with the colo-rectal surgeon
Dr. Amy Tolan ...
Your Friday appointment with the surgeon is likely to be a very important meeting. By Friday, all scan results and biopsy results should be in, and the surgeon may then be in a position to give her view about what stage your cancer is and what your surgery options might be.
What you could do right now in the next couple of days is to get ready for this important meeting. You could read the surgeon's biography, for example. She is a Board Certified colorectal surgeon -- that's very good! She also mentions the acronyms TAMIS and TME in her bio. These are things that you should familiarize yourself with because they might turn out to be relevant for you. On the other hand, they might not be so relevant. It all depends on things like the size, location and grade of your tumor.
You should also review the relevant sections of the
NCCN Rectal Cancer booklet to see the range of procedures and treatments available for Rectal Cancer patients. Also, this booklet has a list of questions to ask the doctor (pages 70-73). You should be sure to have your own written list of prioritized questions ready to ask the surgeon. It would be even better if you could bring a friend with you to the meeting to help write down the answers that you are given to your questions -- but this is not always possible.
Meanwhile you could do some reading on the range of rectal surgery options, such as LAR, TAMIS, TEM, and APR, for example:
LARhttps://www.mskcc.org/cancer-care/patient-education/about-your-low-anterior-resection-surgeryTAMIShttp://tamisurgery.com/optionsTEMhttps://www.gwdocs.com/specialties/colon-rectal-surgery/tem/APRhttps://www.texasoncology.com/types-of-cancer/rectal-cancer/surgery-for-rectal-cancer/If your cancer is in fact coded as T3bN2 at 10 cm above the anal verge, as your gastroenterologist has suggested, then it may be that it will be a laparoscopic LAR procedure that your surgeon recommends. In any event, you should be prepared to listen to whatever options she might propose. Please note that the T3bN2 notation that your gastroenterologist mentioned is only the first part of the TNM staging code. The missing "M" component will be determined later based on the results of your CT scan. Before your Friday meeting you should familiarize yourself with the
TNM Staging System so that you can better understand what the surgeon is talking about.
Also, now that most of the information has been collected to determine your initial staging, it is time for Kaiser to assign an oncologist to your team. Actually, if your surgeon proposes a 5-week session of neo-adjuvant chemo/radiation prior to the surgery, then you would have
two oncologists on your team -- a medical oncologist and a radiation oncologist. (When you find out who they are, you should check their credentials to make sure they are Board Certified in their specialty.)
One final point: Now that you have been promoted to "Registered User" status you should be able to send/receive private messages (PMs) with members who want to communicate with you privately. This may be of interest to you because female patients undergoing pelvic radiation here sometimes have issues that they want to discuss privately with other female patients but do not want to discuss these issues on the main board.
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Note: If your surgeon is proposing a laparoscopic LAR procedure, there is a very important post here that you should read and discuss with your surgeon (read the last paragraph):
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=59120&p=467267#p467267Your surgeon may not be aware of this research. She got her Board Certification in 2014, but these findings came out later, in 2016.