Rectal Cancer – Post Surgery – Day 17

It has been a week since my last post surgery update and when it comes to healing after surgery that is really a long time. 

My main wound is now almost closed, and the other smaller wounds are also looking much better. I now longer have the “steri-strips” on them, and do no longer cover them with gauze either. 

Consultation with the surgeons
On Tuesday September 8, 2015 (post surgery day 13), I met with doctor Mark Welton and doctor Rebecca Kim, the two surgeons that did the operation on me. They were very satisfied with the development, and my health in general. The message was basically that unless some of the wounds starts acting up, or if I get a fever, then we are done, and I can start thinking of next phase of my treatment. They allowed me to start driving again, and even fly across the atlantic. 

Pathology on the removed tissue
The surgeons also went over the result of the pathology of the tissue that was removed during the operation (Piece of rectum, 30 cm of the colon, and 15 lymph nodes).

During the operation they removed some of the fat that is near that piece of the rectum where the cancer was (basically the surrounding fat, where the cancer had broken through to the local area). That fat contains lymph nodes and pathology was done on each of these. In other words, the doctors did not know at the time of the operation how many lymph nodes that they removed, they just removed the fat surrounding the cancer. (I think i heard they have some margins that they use as guidelines for this, so they know exactly how much tissue / fat to take out). I asked the surgeon, if he believed that he had taken enough, and I got a very confident “yes, certainly” as the answer to that. 

In my case it was as I mentioned 15 lymph nodes that were removed, and unfortunately 3 of these were still positive from cancer. I think the doctors based on this downgraded the result of the chemoradiation from 100% response to “relative”, but I am not sure yet, if I got that right. 

I got pretty sad for a moment, I think that I subconsciously had set my mind for the 100% response. It is not like my situation now is significantly different than before, but there are a few things that have changed, because of this. Or that is the way I see it at least: 

  1. My 6 month of chemo, will now not just be a safeguard against recurrence, it will also be an active treatment to make sure that we kill all cancer in my body. (sounds like the same thing? Well maybe it is, I will leave it up to you to judge).
  2. My 6 month of chemo will definitely be of a stronger type. I had discussed with my oncologist to just do the Xeloda tablets, if we saw a 100% response to the chemoradiation after surgery. Now I think that he will be more likely to suggest a combination that gives me an infusion chemo every 3 weeks as well. This  will be tougher to go through, and numbness of hands and feet is a permanent side effect that many people experience. 
  3. The small lesions in my liver and lung, are certainly very important to keep an eye on. The 3 positive lymph nodes did not light up on the PET scan, so I gather that there is absolutely no guarantee that the liver or the lung is cancer free.