The Good, The Bad, and The Ugly

We saw the Medical Oncologist yesterday for the first time in 6-weeks. He was a bit surprised that I hadn't had surgery yet, but after I explained to him how I wanted to give some alternative methods a chance, and that I'm not real hip on the potential side effects of the surgery, he indicated that possibly surgery is not the right choice in my case.

He said because of my size, and the fact that we're not 100% certain the cancer is contained inside the rectum and potential complications of surgery, he seems torn between doing surgery and not doing surgery in my case. Generally, he would always recommend surgery at this point, but since there are other circumstances at play, he "is OK with me not having surgery."

He said because I am having second thoughts about the surgery, he thinks we ought to consider the other option which is to do cleanup with radiation and chemo.

The way I understand the percentages of recurrence in his estimation are this:

1) If we just do diet change and general lifestyle modification at this point and nothing else, I probably have somewhere in the 80% chance range of not having a recurrence.

2) If I go for another "cleanup" round of radiation and chemo, my chances go up 5% or so. So we're probably around 85%. While this may have tough short-term side effects, there are not as many potential long-term side effects. There is some potential for regional nerve damage and other side effects similar to if you had a burn in the region.

3) If I go for surgery, the percentage of non-recurrence goes up to the 85-90% range, but would require a permanent colostomy, and would have around a 10-20% chance of permanent impotence and/or bladder control loss.

He said if we are going to do surgery, it should be done ASAP, or within the next 4 weeks because at this stage the longer we wait the more trouble there will be from scaring.

I am leaning heavily toward the first two options. Really the only downside to crossing off #3 would be if later on I have recurrence and regret that I did not have the surgery. However, on the flip side of that, I could have the surgery, they could remove the tumor (and my rectum and anus), do the pathology and not find any more cancer. That would really make me regret :)

In the weeks to come, I will be discussing these options with my 2nd opinion Medical Oncologist, my Radiation Oncologist, and my Naturopathic Doctor (my primary care physician). We are in a "data mining" operation right now and will not make a final decision until we have enough information to make a decision we can be comfortable with.

There is no black-and-white answer here. I just have to make a decision I feel most comfortable with and proceed from there.

As always, your thoughts, prayers, and encouragement are greatly appreciated.