New Member - Looking for Some Reassurane

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awolf007
Posts: 1
Joined: Fri Mar 15, 2024 5:24 pm

New Member - Looking for Some Reassurane

Postby awolf007 » Fri Mar 15, 2024 5:41 pm

Hello All,

I'm a 45 yr old male who is 14 months post-op from a partially robotic hemicolectomy for a 3cm stage I/II tumor in the splenic flexure. The tumor was removed with "strong health margin" on both sides. 22 lymph nodes harvested and all were free of pathology. The staging came back as a I/II with a garden variety adenocarcinoma that was non-aggressive and had a low recurrence potential. The reason it was staged at I/II was due to some penetration into the surrounding mesentery but nothing beyond. All surrounding mesentery was removed with the rest of the specimen. I recovered quickly and have since had 2 clear CT scans (8/1/23 and 2/5/24). I've also had a new test implemented called CTDNA (liquid biopsy as many call it) which tracks "circulating tumor DNA" in your blood. This was implemented as an adjunct means of determining whether or not to use chemotherapy following the surgery. The oncologist stated that there was no clear reason to undergo chemo given the statistics of the cancer/surgery (all cancer thought to be removed, no cancer in lymph nodes, non-aggressive variety, etc). All the CTDNA scans at 4 weeks, 7 weeks and 10 weeks were negative.

Fast forward to now, 14 months later and all is well, EXCEPT I still get occasional dull and tingling ache in my left side where the surgery was performed. My bowel habits have changed a bit, but if I drink water, stay active and eat fiber, I stay pretty consistent with movements. Its just difficult when I get these mild pressure build-ups and on and off aching in the left lower back (right above hip bone) and tingling sensations, etc. not to think that I'm growing a new tumor. I am scheduled for my first follow-up colonoscopy on 3/25/24, so I suppose we'll know for certain then if anything is going on. Guess I was hoping to hear from the group that these issues I'm experiencing were to be expected with a resected colon and that it is likely a matter of diet. NOTE: I haven't changed my diet AT ALL since recovering from surgery. In fact, my surgeon had me back on solids by evening of day 2 in the hospital. (Hospital stay was 3 days).

One last key point - I also have Rheumatoid Arthritis. This could obviously play a role in additional inflammation. It is currently not being treated. I was taking Humira for a 18 months leading up to the surgery. Stopped Humira before surgery on 12/14/22. Haven't treated the RA since as the inflammation markers never came back in any substantial numbers since. Still have occasional flare-ups in my hands/wrists, but nothing major.

Anyone else find that their colon was much more sensitive in the longer term following surgery and that a diet overhaul was required to avoid on and off discomfort? Thanks for listening !

DarknessEmbraced
Posts: 3817
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: New Member - Looking for Some Reassurane

Postby DarknessEmbraced » Sat Mar 16, 2024 8:49 am

Congratulations on being cancer free! I hope you get good results from your colonoscopy. I had an open surgery in 2014 for stage 2a colon cancer. My tumor was in the rectosigmoid junction. Since surgery, I either have many small bowel movements a day, constipation or sometimes diarrhea. I always have bloating, gas and cramping especially after I eat. My GI put me on medication for constipation which does help for the most part. When it's not enough, I use Restoralax(here)/Miralax(US) which does help. The pressure and aching your feeling could be due to cramping and bloating. I have buscopan(bentyl also works) for cramping. I know it's hard not to worry. *hugs* I didn't need chemo and I'm still cancer free. I still worry that my cancer will come back.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: New Member - Looking for Some Reassurane

Postby roadrunner » Sat Mar 16, 2024 1:39 pm

Surgery leaves scars. It would be surprising if you did not have some residual change in sensation at the surgical site. I have had many surgeries, and each has left such symptoms behind. Here, you have reported zero factors indicating persistent disease in a background context of low risk. Unless your physicians are concerned, I would not be.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

User avatar
Green Tea
Posts: 461
Joined: Mon Oct 24, 2016 10:48 am

Re: New Member - Looking for Some Reassurance

Postby Green Tea » Mon Mar 18, 2024 11:23 pm

awolf007-

I tend to agree with the comments of roadrunner and Darkness_Embraced. It seems to me that a major surgery like left hemicolectomy will leave some residual problems, especially if your surgery had an open-surgery component.

You said that your surgery was "partially robotic", but if the other part was an open surgery, then this could explain some of the problems.

First, look at the diagram below and notice that the surgery will require a large segment of colon to be removed, but then there is the next problem of how to connect the two remaining healthy parts of the colon that are now separated from each other by a rather large distance of more than a foot. This is probably where the open surgery component comes in. (I'm not sure that robotic surgery can do all that is required to link the two healthy part of the colon together.) . Before connecting the two healthy sections of colon the surgeon needs to detach these segments from their bindings to the abdominal wall so that they can be moved over enough to reach each other for the re-connection.

This procedure -- called "mobilization" of the colon -- requires multiple incisions on healthy tissue, and that is where the scars are most likely generated. In addition, if this procedure is done as open surgery with the bowel exposed to the open air, then there is the likelihood of generating a number of adhesions in and around the exposed bowel. (When the bowel is exposed to open air what happens is that the slimy mucous membrane around the bowel becomes very sticky like glue, and this glue-like mucous causes adhesions to form around the segments of bowel that have neen exposed.)

Image

So, what I suspect is that you are suffering occasionally from what has been called "angry bowel syndrome", namely pains and bowel discomfort due, in essence, to the scars and adhesions that resulted from the non-robotic part of the surgery.

The images below show some aspects of the left hemicolectomy procedure, and the possible outcome if many scars and adhesions develop.

The possible implications for you are that you may need to change your diet so that you avoid things that cause problems to an "angry bowel," like, for example, popcorn, peanuts, corn nuts, raw celery sticks, raw broccoli, asparagus stems, and any other foods that are particularly difficult to digest. Also, the need to avoid carbonated beverages, beans, and whatever else that can produce gas and bloating.

Image
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Image
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Pagola44
Posts: 340
Joined: Mon Jul 03, 2023 7:57 pm

Re: New Member - Looking for Some Reassurane

Postby Pagola44 » Tue Mar 19, 2024 12:41 am

Hey not sure if this helps,

But i had surgery on my right side, about 10 months ago, yet i have pain on my left side, like tingling/pressure (i think it's food moving through me)
i think our colons just don't work efficiently anymore
29m Male.
DX: CC, Right Hepatic Flexure, 4cm, T3, G2, M0
Stage III3B , Positive lymph nodes: (2/20)
Baseline CEA value: 1.98
LVI and PNI: absent
Surgical margins: clear
No lynch Syndrome or MSI
Primary surgery type: Laparascopic

kiwiinoz
Posts: 1170
Joined: Thu Jan 03, 2013 11:44 pm

Re: New Member - Looking for Some Reassurane

Postby kiwiinoz » Tue Mar 19, 2024 7:54 pm

Hi there,
1st of all, congratulations on being in a position to worry only about the after effects of surgery.
Interesting that you were on Humira for Rheumatoid Arthritis. I had taken Humira for Psoriasis. After about 1 year I moved to Ustekinaumab (known as Stelara) which was doing a good job of keeping the psoriasis in check. However, after being diagnosed with Stage IV cancer and meeting my Oncologist, who was also a professor at the University of New South Wales (Sydney Australia) and one of the leading guys in cancer research in Australia, he put the fact that with no familly history of colorectal cancer, a healthy diet and lifestyle and no other contributing factors, that the reason I ended up with cancer at 39 was due to the monoclonal antibodies in stelara suppressing my immune system.
I have been using topical steroids since as whilst the psoriasis has come back, I don't want to suppress my immune system in that way again. Anyway, just my 5 cents worth.
The point I wanted to make was that I had adhesions and had similar issues for several years, until I had another operation to remove the adhesions.
What does you GI specialist say is causing the pain?
Cheers
Kiwi
Stage IV Rectal Cancer (39 Year old male at dx)
pT3N0M1 (wish that was M0)
Diagnosed 05 Dec 2012
LAR 05 Jan 2013
VATS 27 Feb 2013
FOLOFX April 2013 - Sep 2013
Clear Scan 03 Dec 2013 - August 2020
Port Out 26 March 2015


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