• Is a permanent colostomy standard when cancer is close to the anus

    Asked by StegalMan on Tuesday, March 26, 2013

    Is a permanent colostomy standard when cancer is close to the anus

    7 Answers from the Community

    7 answers
    • Peroll's Avatar

      With respect to a standars every case is different thus what may be reported as standard will not always apply to you. Also things are changing rapidly in the capabilities so what is not possible today may be possible tomorrow. I personally have had three drugs and two surgical procedures that were not avaliable or possible when I was first diagnosed. Also with the tumor in my right lung my surgeon was originally going to remove the entire upper lobe of the right lung (the standard at that time) since the tumor was in the middle and hard to get to. But after removing the tumor in my left lung and finding my chest large and spacious, he decided he could do a wedge recision and save most of the upper lobe. Thus what was standard didn't apply. As Dave said if you don't like the answer one Dr gives you challange them to think of a better way and/or look for second opinion. Your currnet Dr might be able to learn something new by working with another Dr. If you do go for a second opinion do some research first and look for Drs that are pushing the state of the are in colon surgery so you can get the latest. Good Luck and let us know if you need any more help.

      over 7 years ago
    • LauraJo's Avatar

      Not necessarily,,,my tumor was about as low as you can get and still have a clean margin & save the anal sphincter. My surgeon told me right up front, that a permanent colostomy was a very real possibility, but that he would try to re-connect me. I went into surgery not knowing how I was going to come out, but I was very, very lucky, (and he's a darn good surgeon) and he was able to create & connect a j=pouch, thus restoring normal function after the temporary ileostomy for healing. You want to be sure you have a colo-rectal surgical oncologist & not just a general surgeon.

      over 7 years ago
    • carm's Avatar

      If this is the only option recommended to you, ask if you are a candidate for a J pouch. It is an internalized pouch so you would not need an outside appliance. Best of luck to you, Carm RN.

      over 7 years ago
    • Rosa's Avatar

      Mine (stage II) was very low too. My surgeon (a colorectal cancer specialist) told me that he would try chemo and radiation first. It worked, my tumor disappeared completely without surgery.

      over 7 years ago
    • jearlesred's Avatar

      My tumor was also very low and my surgical oncologist at Moffitt Cancer Center was able to reconnect without the need for a permanent colostomy. Just beware, if this happens, it will take some time for your internal muscles to retrain themselves to act like a normal rectum. There will be months where you will be cursing your surgeon, yourself, and everyone else around you. You will experience pain, urgency, and your life will center around the toilet. But, it does get better. I had to go on a low fiber diet for several months which also helped. Good luck!

      over 7 years ago
    • papabill's Avatar

      Hi StegalMan, Sounds a bit like my diagnosis and my pre-surgery question. For me the cancer was also in rectum very close to the anus/sphincter, but also I had two additional tumors in sigmoid colon, so while virtually most all of my rectum was removed, part of colon also removed during same surgery (these two tumors proved to be non-cancerous under biopsy), but unfortunately that part of colon gone). In initial discussions with surgeon he indicated in many cases as presented with excision of so much rectum right up to anus/sphincter the simplest procedure would be a permanent colostomy, but he felt in my case -- and no doubt his skill -- in that there was just enough after taking out virtually all of the rectum to reattach the colon to anus, he would do the resections with a temporary ileostomy. He did this and after about seven weeks he reversed the ileostomy and reconnected the plumbing. He also instructed me that my part was to build up the sphincter muscle by doing multi-daily sphincter tightening exercises before and after surgery and to maintain those exercises to ensure sphincter muscle remained strong enough to "hold back the tide." I was glad he did not go the easy way, but took the time to do what would be best for me -- the patient who would need to live with his decision. Certainly discuss this with your surgeon, and hopefully he/she is one that specializes in colo-rectal surgery and can give you rationale for selected procedure, and remember it is your body and you will need to live with the consequences. So you always have the right to a second opinion before he/she makes a cut into your gut. Having been there and can empathize and sympathize with your situation, if I can provide any added insight, please do not hesitate to contact me. Good luck and keep the faith.

      over 7 years ago
    • KarenN@StF's Avatar

      Location and histology of the tumor are both key elements. Patients with anal cancer (often squamous cell) usually don't require resection surgery/ostomy. Patients with rectal cancer (adenocarcinoma) very close to the anal verge often do require a permanent ostomy. For rectal cancer, the surgeon must be able to obtain a reasonable amount of unaffected tissue on each side of the tumor when it is resected to be able to reattach the colon to the recum. The key is being able to spare the rectal muscles/sphincter that control bowel evacuation. Sometimes with a low tumor reconnecting is just not possible. I agree with other recommendations regarding second opinions- always good to have additional review. Specifically colorectal surgeons should be consulted for rectal cancer surgery. If there is any chance at all that you can be reconnected, a good colorectal surgeon is your best bet. Good Luck!

      over 7 years ago

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