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Medical Forum / Diseases and Disorders / Cancer / May 2005ATTN: Steph
Steph, Thank you for your response to my question. You said I should ask if Transrectal Excision and radiotherepy is an option. I am going in 8 days to see a professor of surgery at the Pelican Cancer Foundation. Their literature says it is a recognised leading world authority for precision surgery for colorectal cancers.It says their surgery is known as total mesorectal excision or TME. Is this the same as the option you suggested I asked about? Regards Frank > Steph, Thank you for your response to my question. You said I should ask > if [quoted text clipped - 6 lines] > asked about? > Regards Frank TME is a particularly careful way of doing standard surgery, Frank. It is not the same as transanal local excision. Local excision is not suitable for every cancer, but you should certainly ask > Steph, Thank you for your response to my question. You said I should ask if > Transrectal Excision and radiotherepy is an option. I am going in 8 days to [quoted text clipped - 4 lines] > asked about? > Regards Frank Replying, because I don't see a reply from Steph to this post. Maybe, he'll notice. J >> Steph, Thank you for your response to my question. You said I should ask >> if [quoted text clipped - 11 lines] > Maybe, he'll notice. > J No TME is standard surgery, but done with a very particular technique. It's really the gold-standard for conventional surgery now. Transanal excision avoids standard surgery > >> Steph, Thank you for your response to my question. You said I should ask > >> if [quoted text clipped - 5 lines] > >> mesorectal excision or TME. Is this the same as the option you suggested > >> I asked about? Rectal surgeries <http://www.brighamandwomens.org/generalsurg/specproc/colonrectal_proced.asp> http://www.cancer.org/docroot/CRI/content/CRI_2_4_4x_Surgery_10.asp?sitearea= http://www3.mdanderson.org/focus/colon/guide.htm (I don't recall seeing transnal/transrectal mentioned on the above) > No TME is standard surgery, but done with a very particular technique. It's > really the gold-standard for conventional surgery now. http://www.rcsed.ac.uk/journal/vol44_1/4410012.htm TME The operation of anterior resection with total mesorectal excision (TME) has become the gold standard for the treatment of cancer of the rectum, except where the tumour is close to or involving the anal sphincter complex. The reason for this relates to the low incidence of local recurrence after this procedure, which has now been reported by several independent groups.1-3 Although controversy still exists around the role of TME in tumours of the upper rectum, it is now widely accepted for tumours of the middle and lower third.4 The procedure has two main drawbacks. Firstly, there is a high risk of anastomotic breakdown (in the region of 15%)5, and many surgeons use a defunctioning ileostomy to ameliorate the effects of this complication should it occur. Secondly, it can be associated with a high incidence of urgency and faecal leakage, and, on the basis of evidence from functional studies and randomised trials, it is becoming standard practice to fashion a short colopouch to improve functional results.6 http://cancer.stanfordhospital.com/forPatients/services/surgery/mesorectalExcision/ Patients who have rectal cancer that is confined to the lower two-third of the rectum are generally considered good candidates for TME surgery.Although TME surgery improves outcomes, it is also a complicated, major surgery. In addition to lowering the risk of permanent colostomy, having an experienced surgeon can also reduce the risk of damage to important nerves that run through the mesorectum. For example, when surgeons can spare the pelvic nerves, patients have less urinary and sexual problems after surgery. Despite the greatest care, management of post-surgery complications can be challenging for patients. > Transanal excision avoids standard surgery http://www.colorectal-cancer.net/surgeryrectalcancer.htm http://patient.cancerconsultants.com/rectal_cancer_treatment.aspx?id=913 I think the above two mention/describe Transanal excision. Is that the one you advocate, Steph? And for whom? both Jill and Frank? If so, I'll look for better links. Thanks J >> >> Steph, Thank you for your response to my question. You said I should >> >> ask [quoted text clipped - 69 lines] > Thanks > J I advocate it for patients who are suitable. Essentially, they are patients with T1 or early T2 tumours, which are low in the rectum. The surgeon has to make the call whether they are transanally resectable. > >> >> Steph, Thank you for your response to my question. You said I should > >> >> ask [quoted text clipped - 73 lines] > with T1 or early T2 tumours, which are low in the rectum. The surgeon has to > make the call whether they are transanally resectable. Well, yes, but (I could be wrong) but it looks like they're both going (for 2nd opinions) to consulants or surgeons who tell them what they want to hear/do. Are you following along (with both Jill/Eric and Frank C)? Am I wrong about that? Maybe I am. Thanks Steph, J Now I'm confused... In my case, I didn't get a clear answer on staging (I was T3) until after the surgery. How would the surgeon know what stage it is prior to surgery - experience? rectal ultrasounds? Elsie > Now I'm confused... In my case, I didn't get a clear answer on staging > (I was T3) until after the surgery. How would the surgeon know what > stage it is prior to surgery - experience? rectal ultrasounds? > > Elsie Both |
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