Post-Surgery Decline in Rectal Cancer Patients: What to Expect?

Is it common for the body to deteriorate after rectal cancer surgery?

Hello Dr.
Ke,
Previously, my father was hospitalized at Kaohsiung Medical University, where he experienced a period of fever and elevated white blood cell counts.
He was hospitalized for over two weeks due to bowel obstruction, and it has now been a week since his discharge, but his condition seems to have worsened.
My father is becoming increasingly thin, his face appears pale, and the sclera of his eyes has turned yellow.
During today's visit to the outpatient clinic at Kaohsiung Medical University, the nutritionist mentioned that he has jaundice.
He is now unable to stand without assistance and his voice has become increasingly faint.
Dr.
Ke, does this mean that even the doctors may not be able to treat my father's illness? It is heartbreaking for our family to see his health deteriorate day by day.
Would transferring him to another hospital help, or is it likely that no hospital can treat him effectively? I am concerned that his weakness is due to malnutrition from not eating, or is it that his body can no longer endure this condition? I would like to transfer my father to the Veterans General Hospital in Kaohsiung, but I am unsure if they will accept him.
The journey from Pingtung to Kaohsiung is quite far, especially given my father's current health status.
Initially, I thought that after my father underwent surgery to remove the rectal cancer, he would be fine, but his current situation is not as good as we had hoped.
I have been wondering if this is due to improper handling during the surgery, or if rectal cancer at an advanced stage is simply untreatable.
I hope that if there is even a glimmer of hope, our family will not give up.

Yifang, 20~29 year old female. Ask Date: 2007/09/05

Dr. Ke Fangxu reply Surgery

Hello,
In response to your inquiry, due to your father's complex medical condition, it is unlikely that we can determine the cause of his current weakness through just a few email exchanges.
Older patients undergoing such surgeries typically experience a significant degree of physical depletion, and it is not uncommon for them to lose around 10 kilograms if the recovery process is not smooth.

While you have expressed concerns about the medical process at Kaohsiung Medical University Hospital, I still believe it would be better not to transfer him to another hospital.
The original surgical team is most familiar with your father's condition, and since Kaohsiung Medical University and Kaohsiung Veterans General Hospital are of comparable standards, transferring him may not necessarily provide any additional benefits aside from the inconvenience of travel.
I hope you can communicate and collaborate effectively with the attending physician to identify the most beneficial treatment approach for your father.
Wishing him a speedy recovery.

Reply Date: 2007/09/05

More Info

I'm sorry to hear about your father's condition. It sounds like a very challenging time for both him and your family. After surgery for rectal cancer, it's not uncommon for patients to experience a range of complications and side effects, especially if the cancer was advanced or if there were any complications during or after the surgery.

From what you've described, your father is experiencing several concerning symptoms: weight loss, jaundice (yellowing of the eyes), and significant fatigue. These symptoms can indicate a few potential issues:
1. Nutritional Deficiency: After surgery, especially for gastrointestinal cancers, patients often struggle with nutrition due to changes in their digestive system. If your father has not been eating well, this could lead to malnutrition, which can cause weakness, weight loss, and a pale appearance.

2. Jaundice: The yellowing of the eyes suggests that there may be an issue with liver function or bile duct obstruction. This could be due to metastasis (spread of cancer) to the liver or other complications from the surgery. Jaundice can also result from liver dysfunction, which may be secondary to cancer or other underlying conditions.

3. Infection or Inflammation: The fever and elevated white blood cell count during his hospital stay could indicate an infection, which can sometimes occur post-surgery. If an infection is present, it can lead to systemic symptoms like fever, malaise, and further decline in health.

4. Cancer Progression: Unfortunately, if the cancer was at an advanced stage before surgery, there is a possibility that it could have spread despite the surgical intervention. This could explain the rapid decline in health.

Given these symptoms, it is crucial to have a thorough evaluation by his healthcare team. They may need to perform imaging studies (like an ultrasound or CT scan) to assess the liver and bile ducts, as well as blood tests to evaluate liver function and nutritional status.
Regarding your concerns about transferring him to another hospital, it is essential to discuss this with his current medical team. They can provide guidance on whether a transfer is advisable based on his current condition and the resources available at the other facility.
It's understandable to feel hopeless when witnessing a loved one's decline, but it's important to remember that there may still be options for palliative care or supportive measures that can improve his quality of life. Palliative care focuses on relieving symptoms and providing support, regardless of the stage of the disease.

In conclusion, while your father's situation is serious, it's essential to communicate openly with his healthcare providers about your concerns and the best course of action. They can help you navigate this difficult time and explore all available options for his care. Your family's support and advocacy for his health are vital during this challenging period.

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