In terms of how the stage affects the surgery, I think what most people are concerned about would be whether it turns out that you need open surgery and what people often don’t want -- whether you would need to end up with a stoma.
If the stage is high and the tumour is locally invasive, meaning it’s stuck down to the abdominal wall or small intestine, then that often than not would be an open surgery. It means that you will have a much longer incision down the middle of your abdomen. That’s one way the stage affects the surgery.
If you have a tumour that’s very advanced, or if you have a tumour in a certain location, there are circumstances where we need to use a stoma. A stoma essentially means pulling out a segment of your colon or small intestine, making a hole in the skin, allowing the faeces to decant out into a bag. It can be permanent.
Depending on what stage your tumour is, and where it’s located, you may potentially need radiotherapy and/or chemotherapy before the surgery. It is something that you have to accept that any form of colon surgery may end up with you needing a stoma. It can be tumour factors. It can be patient factors—in the sense that the patient suddenly turns unstable midway through the surgery. This means we may be forced to cut short the surgery, bring out a stoma, stabilise the patient and then we have to accept that the stoma is there for a period of time. This could mean at least 3 to 4 months before the stoma is reversed. It can be temporary, it depends on what kind of tumour and what location and stage the tumour is in.
