Risk of infection with rectal surgery? (Nottingham, UK)

CLL diagnosis 6 years ago, not yet in treatment, lymphocytes low and stable, but recently diagnosed with anaemia, prompting bowel investigations. Two polyps found, one removed during colonoscopy, but the other is a 4 cm beast, so just biopsied. Both polyps benign, but the larger one (in the rectum) has to come out. Had MRI a few days ago to assess how deep it is. Now waiting for consult with surgeon. Here comes the question: Should I be asking my haematologist to get involved in advising the colorectal team re. mitigating the risk of infection and contingency-planning for treating infections if the mitigation fails? (Dr Chris Fox.. that would be you.) Thank you in advance.

[JigFettler Volunteer]

HI!

Yes - you should involve your Haematologist. Probably also the Microbiologist.

However many on this Forum have been to this "place" and will feed back experience.

I am post FCR with sustained low lymphocytes and immunoglobulin, my Haematologist said I have no reason not to have all bowel screening and biopsies as needed.

There is a risk of infection and sepsis anyway, that risk will be higher with CLL. Of course the risk of NOT looking after ones bowel is greater!

Jig

[edelweiss]

I think the answer is most definitely "yes" in regards to getting your hematologist to speak with your gastroenterologist/surgeon. When I was diagnosed with a secondary cancer (breast) and had to have a mastectomy and then chemo, my hematologist spoke to both the breast surgeon and oncologist. Because of those conversations, they treated and monitored me even more closely for risk of infection/bleeding during the surgery and post-op, and hospitalized me to watch for tumor lysis syndrome when the first round of chemo was given. (I am yet untreated for CLL but had a high lymphocyte count at the time of surgery). I felt incredibly grateful that my Cll doctor did that and that all three doctors were willing to communicate with each other. Don't assume the communication will happen automatically. Take an active role in requesting that the doctors involved talk to each other and follow-up to make sure they have done so. Wishing you all the best.

[devonrr]

I’ve had open surgery twice. Once before treatment and once after.

From the initial consultation with both surgeons I stressed my CLL and then again at my pre op assessment and chat with the anaesthetist. I know the first surgeon communicated with my haematologist.

My CLL was not affected by surgery and I recovered as any other. I did keep an eye on the wound. But don’t panic just make people aware. Don’t try and tell them how to do their job.

A good phrase is “ I’m told I have the immunity of a 90 year old because of my blood cancer”. Most health professionals understand that.

I presume it’s the same hospital so your notes are readily available.

Best wishes

[Hidden in reply to devonrr]

Yes, same hospital. Thank you. 🙂

[Hidden]

Thank you all for your replies. I have contacted the haemo outreach service, and they've given me contact details for the specialist CLL nurse, and the consultant's secretary. (I was seen in a different hospital when I was first diagnosed, and referred back to my GP for monitoring, but I think I will need a new referral to the haemo at Nottingham City hospital when the time comes. I met the consultant and the CLL nurse at a CLLSA conference last October, though.)

For the current issue, I will feel more comfortable asking the gastro surgeon to involve the haemo team if I can say it's already on their radar. I feel less anxious about it already, thanks to your reassurance. 🙂 Thanks again. x

[bigunwill2]

I had half my colon removed with no problems. Gave antibiotics before surgery and after surgery. I started chemo 2 1/2 weeks later.

[Hidden in reply to bigunwill2]

That's reassuring. Thank you, but I'm sorry you had to go through all that. 😮