Question: My mom is diagnosed of having a rectal cancer. The biopsy report says "Section shows well formed neoplastic glands lined by pleomorphic columnar cells infiltrating the mucosa & submucosa with scattered peritumoral lymphocytes: rectosigmoid growth well differentiated adenocarcinoma"

An expert colorectal sergeon treating mom said she has a perforation in colon so chemo and radiation before srugery is dangerous. So first sergery and then chemo and radiation.

Is he on right track?
which stage is this cancer?
Is it 100% curable?
what would be the course of action?

Hi, I have provided some attachments. Please review them.

Thanks Doc for the prompt reply.
I have uploaded more reports of CEA, blood and urine reports, US abdomen.
Please review them.
The CT abdomen and US abdomen reports were not taken on the prescription of colorectal surgeon. Rather they were taken on prescription of a General Physician in another hospital. I brought CT abdomen and US abdomen reports along with me when I consulted the colorectal surgeon. I am making this point because the CT abdomen report was not made under supervision of the colorectal surgeon. But he interpreted the already done CT abdomen, US abdomen and he must have made his radiologist review the CT abdomen images as he kept the CT films with him for a day. He performed CEA, some blood and urine tests, CT chest, ECG and Sigmoidoscopy with biopsy.
And after interpreting all the reports including biopsy report he told that because of perforation it may not be safe (may spread to other parts) to do chemo, rt before surgery.
I would also like to make a point here: This colorectal surgeon has a successful history of operating many cancers in colorectal region.

For a second opinion I consulted an oncology surgeon with all the existing reports.
Now he performed US Neck, CT chest to check whether the cancer has spread to other parts.
I want to make a point here: I observed the interpreting is being done by his assistants but not by him.
After interpreting the US Neck, CT chest reports he said the cancer is confined to only rectum and he was about to start the treatment. The treatment was to give 4 weeks of chemo, rt before surgery (For each week chemo for one day as in-patient and rt for 5 days as out-patient). Here I interrupted him by mentioning about the perforation indicated by the colorectal surgeon. Oncology surgeon got a doubt here and he wanted to have the existing CT abdomen images reviewed by his radiologist. I handed over the CT abdomen films and DICOM images CD to him. The next day his radiologist came with the following report:
---Thickening of walls of upper and middle third of rectum.
---Peri-rectal fat standing and nodes+
---Fat plane of uterus is lost.
---Fluid density in R peri-rectal/adrenal region – collection.
The interpretation by the oncology surgeon goes as below:
The fat around the infected part of the rectum (tumour) got burnt and the tumor is pushed into the uterus wall.
There may be some UN-identified liquid in a small region in-between the rectum and uterus.
It may be due to a perforation in the tumour.
To better investigate he wanted to perform a “CT Pelvis and Rectal Contrast” wherein he would inject some white liquid through the anus and perform the CT. If the injected white liquid is found in the UN-identified liquid then a perforation can be confirmed.

I am confused now.
Please advice how to proceed.

Thanks for the clear explanation. I am going to get her treated by an oncology surgeon only.

Uploaded new reports of MRI done last day.
Please interpret them and explain.

Can you please prescribe the treatment by looking at the MRI?

Is it ok to go for chemoradiations. I mean how to overcome the side-affects?

Thanks in advance XXXXXXX Gajula