Chapter 31
Low Anterior Resection Syndrome (LARS) is a condition almost every rectal cancer patient will experience after reversal surgery. It is pretty well guaranteed that patients will be dealing with some potentially severe bowel dysfunction issues once their plumbing starts working again.
Very few will escape reversal surgery without some degree of LARS.
LARS is a collection of symptoms or issues that most rectal cancer patients will experience after surgery to resect or remove all or part of the rectum. This surgery removes the last 6-8 inches of the large intestine or the rectum with an anastomosis of the colon low in the rectal area. Anastomosis means that the two remaining ends of the large intestine and the lower rectal area are either sewn or stapled together.
I have the staples.
These symptoms may include the following; a frequency and urgency of sometimes uncontrollable bowel movements. Numerous bowel movements over an hour or two, also known as clustering. Stool incontinence or no stool for a day or two, then numerous bowel movements on another day and increased gas.
Not all patients experience every symptom. Each patient is unique. Some patients may notice that their symptoms resolve over time, while others like me may continue to have ongoing symptoms, possibly for the rest of their lives.
To determine the severity of a patient's LARS, a simple five question survey was developed. Each question has three different answer options, with each answer having a numerical value. At the end of the five questions, the numerical values are tallied up with a max score of 42 possible points.
If your total is between 1-20 points you are considered to have no LARS. Between 21-29 points you have minor LARS and from 30-42 points, major LARS. Every single time I have done the test, I am in the 30-42 major LARS category.
On the Colon Talk forum many members with the most severe cases of LARS have opted to reverse their reversal choosing to live with a permanent bag or a colostomy. I am pretty sure if I spent most of my day in the washroom confined to my home because I have no control whatsoever over my bowel movements, I too would reverse my reversal.
It just simply comes down to a quality of life issue.
I am grateful I am able to live a pretty normal life even with what would be considered major LARS.
I find LARS really does not interfere with my daily activities. I do find myself making it a priority to always know exactly where the closest washroom is located wherever I go.
Very few will escape reversal surgery without some degree of LARS.
LARS is a collection of symptoms or issues that most rectal cancer patients will experience after surgery to resect or remove all or part of the rectum. This surgery removes the last 6-8 inches of the large intestine or the rectum with an anastomosis of the colon low in the rectal area. Anastomosis means that the two remaining ends of the large intestine and the lower rectal area are either sewn or stapled together.
I have the staples.
These symptoms may include the following; a frequency and urgency of sometimes uncontrollable bowel movements. Numerous bowel movements over an hour or two, also known as clustering. Stool incontinence or no stool for a day or two, then numerous bowel movements on another day and increased gas.
Not all patients experience every symptom. Each patient is unique. Some patients may notice that their symptoms resolve over time, while others like me may continue to have ongoing symptoms, possibly for the rest of their lives.
To determine the severity of a patient's LARS, a simple five question survey was developed. Each question has three different answer options, with each answer having a numerical value. At the end of the five questions, the numerical values are tallied up with a max score of 42 possible points.
If your total is between 1-20 points you are considered to have no LARS. Between 21-29 points you have minor LARS and from 30-42 points, major LARS. Every single time I have done the test, I am in the 30-42 major LARS category.
On the Colon Talk forum many members with the most severe cases of LARS have opted to reverse their reversal choosing to live with a permanent bag or a colostomy. I am pretty sure if I spent most of my day in the washroom confined to my home because I have no control whatsoever over my bowel movements, I too would reverse my reversal.
It just simply comes down to a quality of life issue.
I am grateful I am able to live a pretty normal life even with what would be considered major LARS.
I find LARS really does not interfere with my daily activities. I do find myself making it a priority to always know exactly where the closest washroom is located wherever I go.
You learn this pretty quickly after your reversal.
My diet also needed to be re-evaluated. Not so much what I eat or drink, but how much I eat since larger volumes of food just accelerated my washroom visits. I have really toned down my portion sizes especially since my reversal.
I have resigned myself to the fact that I most likely will live with some degree of LARS for the rest of my life.
If and when I eventually do kick ass cancer’s ass, I will gladly take my clumsy neuropathy and whatever degree of ongoing LARS I end up with. In the big picture it’s a very small price to pay for beating cancer.
I try not to fuss too much about these relatively minor issues I need to deal with on a daily basis. I know literally millions of cancer patients around the world would trade places with me in a heartbeat.
Reminds me of that old saying.
My diet also needed to be re-evaluated. Not so much what I eat or drink, but how much I eat since larger volumes of food just accelerated my washroom visits. I have really toned down my portion sizes especially since my reversal.
I have resigned myself to the fact that I most likely will live with some degree of LARS for the rest of my life.
If and when I eventually do kick ass cancer’s ass, I will gladly take my clumsy neuropathy and whatever degree of ongoing LARS I end up with. In the big picture it’s a very small price to pay for beating cancer.
I try not to fuss too much about these relatively minor issues I need to deal with on a daily basis. I know literally millions of cancer patients around the world would trade places with me in a heartbeat.
Reminds me of that old saying.
'No matter how bad you think you have it, wake up each day and be thankful for your life. Someone somewhere is fighting to survive'.
While we are on the topic of syndromes.
Anxiety is your body's natural response to stress. It's a feeling of fear or apprehension about what is to come. I have never suffered from anxiety. However, after my treatments and during my surveillance phase I did experience scanxiety.
Yes scanxiety, a portmanteau courtesy of the cancer world.
I first read about scanxiety on the Colon Talk forum. It was often discussed by members who were approaching upcoming CT or PET scans either during treatment or follow up surveillance. I had never heard of this word before until I got cancer and I thought it was a very creative twist on the word anxiety.
A higher than normal or a few progressively rising CEA levels would also trigger my scanxiety. This happened to me back in 2016 when my CEA level had crept a little higher on three consecutive blood draws. Dr. N was mildly concerned and bumped up my scan to see what if anything was going on. This was when my scanxiety peaked. Thankfully the CT scan came back all clear and my CEA level dropped on my next blood work.
Whew, I had been a fuck'n mess for a good month.
Once my treatments ended, my follow up protocol for the next five years would include an annual CT scan. I quickly realized prior to my first follow up scan, scanxiety is indeed real. I found it difficult to sleep and my mood changed. I was completely consumed and fixated on my upcoming CT scan.
Afterall, nothing can ruin your cancer remission like a spot or shadow detected on a scan.
For me my scanxiety would usually set in about a week before my actual scan took place at the Bracebridge hospital. After my scan, it got progressively worse every day for the next two to three weeks before my annual appointment with my oncologist Dr. N. It was on this visit when she would disclose the radiologist's findings from the scan.
The Cancer Centre’s policy is to never release results of blood work or scans over the phone. Only in person with your oncologist will you get your results.
Once I heard my scan was all clear and after a big exhale, my scanxiety completely disappeared.
While we are on the topic of syndromes.
Anxiety is your body's natural response to stress. It's a feeling of fear or apprehension about what is to come. I have never suffered from anxiety. However, after my treatments and during my surveillance phase I did experience scanxiety.
Yes scanxiety, a portmanteau courtesy of the cancer world.
I first read about scanxiety on the Colon Talk forum. It was often discussed by members who were approaching upcoming CT or PET scans either during treatment or follow up surveillance. I had never heard of this word before until I got cancer and I thought it was a very creative twist on the word anxiety.
A higher than normal or a few progressively rising CEA levels would also trigger my scanxiety. This happened to me back in 2016 when my CEA level had crept a little higher on three consecutive blood draws. Dr. N was mildly concerned and bumped up my scan to see what if anything was going on. This was when my scanxiety peaked. Thankfully the CT scan came back all clear and my CEA level dropped on my next blood work.
Whew, I had been a fuck'n mess for a good month.
Once my treatments ended, my follow up protocol for the next five years would include an annual CT scan. I quickly realized prior to my first follow up scan, scanxiety is indeed real. I found it difficult to sleep and my mood changed. I was completely consumed and fixated on my upcoming CT scan.
Afterall, nothing can ruin your cancer remission like a spot or shadow detected on a scan.
For me my scanxiety would usually set in about a week before my actual scan took place at the Bracebridge hospital. After my scan, it got progressively worse every day for the next two to three weeks before my annual appointment with my oncologist Dr. N. It was on this visit when she would disclose the radiologist's findings from the scan.
The Cancer Centre’s policy is to never release results of blood work or scans over the phone. Only in person with your oncologist will you get your results.
Once I heard my scan was all clear and after a big exhale, my scanxiety completely disappeared.
I was still cancer free.
There is no better feeling leaving a Cancer Centre cancer free.
Trust me on that one.
Yet, in another year my scanxiety would return.
I hate cancer.
There is no better feeling leaving a Cancer Centre cancer free.
Trust me on that one.
Yet, in another year my scanxiety would return.
I hate cancer.