So he kept more of her rectum than normal with a J pouch? And that's where she has her cancer, in what would be "large bowel" mucosa (lining), correct, of her rectum? They're not saying it's in her small bowel mucosa (lining), but in the rectal mucosa? I'm not sure I totally understand how she was constructed, but having the rectum change to "colon" cancer is understandable, because the rectum is the last part of the large bowel system. If he saved her entire rectum, he left her with bowel that *could* change, in time, because that's the danger of having UC for a long period of time: the potential change to dysplastic cells and cancerous changes.
I agree that she needs an oncologist *and* a CRS (they should work together as a team) to arrange for her the most appropriate chemotherapy plan and/or surgical plan. And one plan should not take away the option of the other (though I imagine surgery should come first if deemed an option she chooses, then chemo; chemo just takes a toll on your whole system). However, if the tumor is large, it might be beneficial to shrink it before removal. These are things that need to be cleared with the physicians. I do remember years ago, one of the chemos we used most frequently for colon cancer was one that didn't impact patients quite as hard as others, though my last year as an oncology nurse was in 1998, and chemo plans and treatments change like the wind.
Good luck to her.
