Meeting with My Team

Each team member, due to their specialties, gave me a different angle on my condition. Though I met with them individually, these doctors had worked together for a while, so the picture they were painting was cohesive, yet each one was focused on a particular aspect.

As I understand it, the surgeon is the lead. The biggest goal was to get the cancer out of my body. In support of this goal, I would have chemoradiotherapy, ie, both chemo and radiation, concurrently. This is referred to as neoadjuvant because mine was advanced and rather large, he would have to remove the entire rectum and then reconnect the good end of the colon directly to the anal sphincter (coloanal resection). IF that was successful, there would obviously be changes in my bowel function, as the rectum is a sort of reservoir and provides most of the cues and voluntary muscle control for proper/normal waste elimination.

Furthermore, the surgeon cautioned that because the tumor was very close to the anal sphincter, it was very possible that a coloanal resection would not work and I would have to have an abdominoperineal resection (APR) which meant the removal of the rectum and anus, which further meant a permanent colostomy. I understood that. I therapy, as in pre-surgical, assistive therapy.

The radiologist would use his technology to kill off and shrink the tumor as much as possible, thus stopping any spread of the disease and making it easier for the surgeon to remove. The chemotherapist's goal was to weaken cancer cells to make them more susceptible to the radiation. So, it was a layered attack.

The surgeon's assessment was cautious. He made me aware of the possibilities. Yes, he may be able to completely excise (surgically remove) the rectal cancer. However, would be 'bagged' for life, and in my mind, mutilated. I really could not dwell on that or I would lose it. That was the very worst thing I could think of to ever happen to me. Honestly, given a choice, I'd rather sacrifice a limb, I thought.

The meeting with the radiologist was easier to take. I like technology and I easily got the gist of what he could do. Radiation would be beamed into the diseased area and kill off the cells there. As the tumor, or parts of it died, it would presumably shrink and become easier to remove later. The cautions here were that the radiation could not tell the difference between good tissue and bad, plus the rectum is located where other important and sensitive organs reside. The entire region would be irradiated and thus affected. The extent of effects on good tissue depend on the amount of radiation I'd receive and my own body. Each person is different, though it was clear there would be side effects as damage was done to good tissue as well as bad.

The chemo fellow sort of repeated part of the warnings. Cancer treatment chemicals injected into the body are intended to kill cells, usually rapidly-growing cells, the main indicator that they are cancerous. Cancer cells are what they are because they don't know how or when to stop growing like normal cells. Alas, there are lots of other cells in the body, normal cells, that are also fast-growing and these would be killed off or damaged as well. For instance, red blood cells (RBCs) are usually a concern. They reproduce rapidly so the chemo targets them. But of course we normally produce a lot of RBCs because we need a lot of them. They carry oxygen through the body, which is obviously important. Anemia, ie diminished RBCs, easily wears a person out because there just isn't enough oxygen being circulated.