• Had J-pouch 19 years ago due to UC - now have 2 different oppinions

    Asked by Flowers55 on Friday, May 17, 2013

    Had J-pouch 19 years ago due to UC - now have 2 different oppinions

    One Dr wants to operate first -(he did orig. surgery now in OK) local c/r surgeon wants to do chemotherapy first - CONFUSED - HELP

    1 Answer from the Community

    • KarenN@StF's Avatar

      First, let me say, I'm sorry you are facing cancer, and second, please remember that your medical journey has unique twists and turns that you and the phyiscians you choose, have to keep in the picture as you make choices along the way. You have a voice about your care and please continue to seek information until you are confident with your choices. You are the priority! I think it is important for you to understand each physicians rationale for the recommendation they give, so please ask them, "Why is that best for me?"
      I don't have specific experience with this, but questions that come to mind-Where exactly is the tumor located? Does it originate in small bowel tissue or in what remains of rectal/anal tissue? Small bowel cancers are not common, but if it is an adenocarcinoma, they are generally treated like adjacent anatomy, meaning, the end of the small bowel nearest to colon would be treated like colon cancer, the end of the small bowel nearest to the stomach would be treated like gastric cancer, so if your cancer originated in small bowel in or around the j-pouch, the rationale might be surgery followed by chemo, like in colon cancer. If your cancer orginates in the rectal/anal tissue, the rationale may be chemo first, like in rectal cancer. Your doctors can explain their reasons in more detail for you based on your unique circumstances.
      Many cancer centers have multidisciplinary case reviews where your medical history, CT scans and pathology reports can be reveiwed by many cancer doctors and a consensus for treatment can be reached. Maybe that's an option as well. Good Luck!

      over 3 years ago

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