Should My Mom Undergo Surgery for Stage IV Colon Cancer?

What are the concerns regarding surgery for colorectal cancer?

Two months ago, my mother went to the emergency room due to a fever and was later hospitalized, where she was diagnosed with sepsis caused by a bacterial infection.
During her hospitalization, the source of the infection was investigated, and one report indicated it was due to a purulent condition in the uterus.
However, after three weeks in the hospital, we were not informed of the other two sources of infection.
Eventually, the hospital confirmed that she had uterine fibroids and a purulent condition in the ovaries, which they believed to be the primary cause of the infection, leading them to recommend surgery by a gynecologist.

Ultimately, during the surgery, they removed the uterus, and during the follow-up visit, we were informed that cancer cells were found in the removed uterus, suspected to be colorectal cancer.
After completing a colonoscopy and imaging studies, it was confirmed to be stage IV colorectal cancer.
According to the doctor, the polyp was nearly obstructing the intestine, so surgery needed to be performed urgently.
However, my mother had just undergone a traditional hysterectomy a month ago.

I would like to know if we should follow the doctor's advice and proceed with another surgery.
Currently, it is stated that the cancer cells have not metastasized to other areas but are present in the surrounding lymph nodes, which will be addressed during the surgery.
Given our previous experience, I am genuinely concerned about the possibility of further complications after the surgery.
There are not many large hospitals in Keelung, and even if we wanted to seek care at a larger hospital, it would impose a burden on the patient and could delay treatment.
This situation is truly distressing.

jrjrjr66, 30~39 year old female. Ask Date: 2021/12/18

Dr. Xu Kaixi reply Surgery

If diagnosed with colorectal cancer with near obstruction, and if the patient's condition permits, after an anesthetic preoperative assessment indicating acceptable surgical risks, it is still recommended to undergo colorectal cancer surgery at a major hospital as soon as possible, even if the time since the last surgery is short.

Reply Date: 2021/12/18

More Info

When faced with a diagnosis of Stage IV colon cancer, the decision to undergo surgery is complex and should be made after careful consideration of various factors. Your mother's recent medical history, including her previous surgery for a uterine condition and the subsequent discovery of cancer, adds layers of complexity to her current situation.
Firstly, it is important to understand that Stage IV colon cancer indicates that the cancer has spread beyond the colon, typically to nearby lymph nodes or distant organs. In your mother's case, it appears that while the cancer has not metastasized to distant organs, it is present in the surrounding lymph nodes. The urgency of the situation is underscored by the fact that the tumor is close to obstructing the bowel, which can lead to serious complications if not addressed promptly.

The recommendation for surgery is based on the need to alleviate any potential obstruction and to remove the cancerous tissue. Surgical intervention in cases of colon cancer, especially when there is a risk of obstruction, is often necessary to improve quality of life and to potentially extend survival. Given that your mother has already undergone major surgery recently, it is understandable that you have concerns about her ability to withstand another operation. However, the surgical team will conduct a thorough pre-operative assessment to evaluate her overall health, including her recovery from the previous surgery, her nutritional status, and any other underlying health issues.

In terms of timing, it is generally advisable to proceed with surgery as soon as it is deemed safe by the medical team. Delaying surgery could lead to further complications, including bowel obstruction, which can be life-threatening. It is crucial to communicate openly with your mother's healthcare providers about your concerns and to seek their guidance on the risks and benefits of proceeding with the surgery.

Post-surgery, your mother will likely require additional treatments, such as chemotherapy, to manage the cancer. The treatment plan will depend on the surgical outcomes and the specific characteristics of the cancer. It is important to have a comprehensive discussion with her oncologist about the expected recovery process, potential side effects of treatments, and the overall prognosis.

In summary, while the decision to undergo another surgery is understandably daunting given your mother's recent medical history, it is essential to prioritize her immediate health needs. Engaging in open dialogue with her healthcare team will provide clarity and help you make informed decisions regarding her treatment plan. Remember, the goal is to manage the cancer effectively while ensuring your mother's comfort and quality of life.

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