Should My Mom Undergo Surgery for Stage 4 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, they investigated the source of the infection, and one of the findings indicated that it was due to a purulent condition in the uterus.
However, after three weeks in the hospital, they did not inform us of the other two sources of infection.
Eventually, the hospital confirmed that she had uterine fibroids along with a purulent condition in the ovaries, which they believed to be the primary cause of the infection.
Therefore, they referred her to a gynecologist for surgery.

Ultimately, during the surgery, they removed the uterus, and upon follow-up after the operation, 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 as soon as possible.
However, my mother had just undergone a traditional surgical procedure to remove her uterus 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, which is quite distressing.

jrjrjr66, 30~39 year old female. Ask Date: 2021/12/19

Dr. Xu Kaixi reply Surgery

If a diagnosis of colorectal cancer with near obstruction has been confirmed, and if the patient's condition permits, with an acceptable surgical risk after anesthesia preoperative assessment, it is still recommended to undergo colorectal cancer surgery at a major hospital as soon as possible, even though it is close to the time of the last surgery.

Reply Date: 2021/12/19

More Info

When faced with a diagnosis of stage 4 colon cancer, especially after a recent surgery for a different condition, it is completely understandable to feel anxious and uncertain about the next steps. Your mother’s situation is complex, and it is crucial to weigh the benefits and risks of undergoing another surgery.

Stage 4 colon cancer indicates that the cancer has spread beyond the colon to nearby lymph nodes or other organs. In your mother’s case, the fact that the cancer has not metastasized to distant organs is a positive sign, as it may allow for more treatment options. The urgency expressed by her doctors regarding the need for surgery is likely due to the risk of bowel obstruction from the polyp, which can lead to severe complications if not addressed promptly.

Surgery is often a critical component of treatment for colon cancer, especially when it is causing symptoms or complications, such as obstruction. The primary goal of surgery in this context would be to remove the tumor and any affected surrounding tissue, which can alleviate symptoms and potentially improve quality of life. Additionally, if there are cancerous lymph nodes, the surgical team may also remove those to prevent further spread.

However, given your mother's recent surgery and the associated recovery, it is essential to consider her overall health and ability to withstand another operation. A thorough preoperative assessment by an anesthesiologist and the surgical team will help determine if she is fit for surgery. Factors such as her current health status, nutritional status, and any underlying conditions will be evaluated.

It is also important to have a candid discussion with her healthcare team about the potential risks and benefits of surgery. Ask them to explain what the surgery will entail, the expected recovery process, and the likelihood of complications. Understanding these aspects can help you make a more informed decision.

In addition to surgery, other treatment modalities such as chemotherapy or targeted therapy may be considered, especially if the cancer is deemed unresectable or if there are concerns about her ability to recover from surgery. Chemotherapy can help shrink tumors and manage symptoms, potentially making surgery more feasible later on.

If you are concerned about the quality of care available in your area, it may be worthwhile to seek a second opinion from a larger medical center with expertise in oncology. While this may involve some logistical challenges, it could provide you with more options and reassurance regarding her treatment plan.

Ultimately, the decision to proceed with surgery should be made collaboratively with her healthcare team, taking into account her preferences, values, and overall prognosis. It is crucial to ensure that she feels supported and informed throughout this process, as cancer treatment can be overwhelming both physically and emotionally.

In summary, while the recommendation for surgery is based on the urgency of her condition, it is essential to consider her overall health and the potential risks involved. Engaging in open dialogue with her medical team and possibly seeking a second opinion can provide clarity and help you make the best decision for your mother’s care.

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