When "No Cancer" Doesn't Mean "No Treatment"
A few days ago, I met a patient who taught me something about how fragile the patient experience can be.
She was a young woman who had been diagnosed with an early stage rectal cancer. At first, it seemed straightforward: the cancer was removed with a polypectomy. But then came the fine print – the pathology showed positive margins.
Her doctors wanted to be thorough. A repeat colonoscopy and biopsy were done. This time, the report came back negative. She was relieved for a moment, but then came the next step: she was referred to surgery.
The first surgeon explained she might need an abdominoperineal resection (APR). For anyone outside medicine, that means removing the rectum entirely and living with a permanent colostomy bag. She left devastated. That was not the life she imagined.
Still hoping for another option, she sought a second opinion. The next surgeon suggested that he might attempt a low anterior resection (LAR) with a temporary diverting ileostomy, but said that depending on what was found, she might still need an APR.
What she wanted was simple: no colostomy.
What she heard was confusing: two big operations, one with a temporary stoma, one with a permanent stoma, and no guarantees either way.
Then came another twist, she was referred to radiation oncology to discuss the role of chemoradiation. By the time she walked into our clinic, she was mentally exhausted and in tears.
Her words still echo in my head:
"Why am I being treated when the biopsy shows no cancer?"
And here's the thing, – her question was valid. It wasn't ignorance. It was confusion born from a system where multiple specialists, all with the best intentions, gave her different pieces of the truth. None of them were wrong. But none of them were able to bridge the gap between medical nuance and her need to understand.
This is the reality for so many patients. They bounce between opinions, procedures, and treatment options, all of which are technically correct, but feel like contradictions.
Why patients struggle
Rectal cancer treatment is layered. For some very early cancers, local excision can be enough. But when pathology shows high-risk features – like positive margins – standard guidelines recommend formal resection with lymph node clearance. That's where surgeries like LAR and APR come in. Sometimes, if surgery isn't an option or a patient refuses it, chemoradiation is considered.
But to a patient, all of that sounds like a foreign language. Stomas, resections, "watch-and-wait," chemoradiation – it's overwhelming. They aren't just making medical choices. They're making choices about how they'll live every single day afterward.
Where RemissionRoute fits in
This patient's tears weren't just about cancer. They were about fear, loss of control, and being asked to choose without really understanding. And she isn't alone.
That's why we built RemissionRoute. To take scenarios exactly like this and explain them in plain language. To walk patients through:
- What each surgical option means.
- What temporary and permanent stomas really involve.
- What chemoradiation can and cannot achieve.
- Why a "negative biopsy" doesn't always mean the risk is gone.
It doesn't replace the doctor's role. But it fills the space between the consultation and the sleepless night at home. The space where patients replay every word, half-understand some, and Google the rest.
This woman's story isn't unique. Every clinic day, there are patients who leave overwhelmed, confused, or mistrustful because the medical system speaks in terms they can't absorb.
RemissionRoute is for them. To give them clarity. To give them confidence. To help them make decisions not out of fear, but out of understanding.