|Discussion in 'All Categories' started by Dr DILIP RANJAN - Jan 22nd, 2013 10:34 am.|
Dr DILIP RANJAN
|This is about my wife . she is suffering from CA rectum . got opreted on AUG 08. BUT recurrence was noticed on AUG 12. After that radiation and chemo has done. and ther is 48% reduction in size was found .therapy was done onoct 12. please suggest me what are the option left for a safer life . Is permanent colostomy only way? I am in delhi. My contact number is+919452693551
anticipating a prompt reply
re: recurrence of ca rectum by Dr M K Gupta - Jan 24th, 2013 11:56 am
Dr M K Gupta
|Dear Dr Dilip Ranjan
We are sorry for your wife. Some patients with rectal cancer present to comprehend locally advanced or recurrent illness that is not easily resected. Certain requirements for unresectability are variable instead of clearly defined. You have not written with the stage she was suffering from and the Operation note of previous durgery. Some define a locally advanced tumor jointly with endorectal ultrasound proof a T3/4 or N1 tumor, a treadmill that is clinically bulky. In patients with rectal cancer, the circumferential resection margin (CRM) is an important pathological staging parameter. Measured in millimeters, it is thought as the retroperitoneal or peritoneal adventitial soft-tissue margin nearest the deepest penetration of tumor. Although dependant on retrospective data, the American Joint Committee on Cancer in addition to a National Cancer Institute-sponsored panel have recommended that at least 12 lymph nodes be examined in patients with colon and rectal cancer to substantiate the lack of nodal involvement through the tumor. This recommendation accounts for until this quantity of lymph nodes examined is reflecting both aggressiveness of lymphovascular mesenteric dissection before surgical resection combined with pathologic identification of nodes from the specimen. Retrospective research has revealed that this level of lymph nodes examined in colon and rectal surgery could possibly be linked to therapeutic outcome. Staging studies are usually necesary if recurrence or advancement of disease is suspected; MRI may be particularly attractive determining sacral involvement in local recurrence. Treatment Due to increased likelihood of local recurrence plus a poorer overall prognosis, the treating rectal cancer varies somewhat from that relating to colon cancer. Differences include surgical technique, using radiation therapy, and also the approach to chemotherapy administration. In addition to determining the intent of rectal cancer surgery (i.e., curative or palliative), you should consider therapeutic the whole process of the constant maintenance or restoration of normal anal sphincter, genitourinary, and sexual functions.
So we will advice you to constact any colorectal surgeon and you should explore all the treatment option possible according to nodal metastasis.
M K Gupta
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