"Posterior margin is involved with tumour" - plain English please?

Just trying to understand the language:

My husband had a resection for colorectal cancer in 2022. Six months after chemotherapy, there was a recurrence. He had chemoradiation earlier this year and then two months ago he had an abdominoperineal excision with permanent stoma. The perineum wound is stubbornly not healing, although improving, and he hasn't been able to be without the catheter yet. 

The consultant told us the operation might not have been fully successful. 

Then we got the letter, in which he wrote: "Unfortunately the posterior margin is involved with tumour, and therefore there is a chance that this excision has not been curative and there is chance of the cancer coming back again." I googled that phrase and it seems to mean the margin was positive - ie, that there are still cancer cells present. Is that correct? Or is it a maybe? 

They've chosen not to offer adjuvant therapy at this point, just close surveillance and an offer of a discussion regarding "additional therapies" if there's a recurrence. Next CT scan in February.  

Thank you for interpretations! 

  • Hi, ducks, and thank you for posting.

    I am sorry to learn of your husband's situation, this must be a difficult time.

    When cancer is removed with surgery, as well as the tumour, an area surrounding the cancer is also removed, this is known as the margin.

    The aim is to have a clear (also known as negative) margin. If there are no cancer cells found this suggests all the cancer cells have been removed lowering the risk of the cancer coming back.

    If cancer cells are found this is known as a positive margin, which means the doctors cannot say with certainty if all the cancer has been removed, therefore there is a possibility that the cancer may come back.

    This sounds like this is the case for your husband, so now he will be closely followed up. If there are signs that the cancer has come back further treatment may be offered at that time.

    Do clarify this with your husband's colorectal team, if he has a nurse specialist (CNS) they will be able to talk this through with him.

    I hope this helps a little. Please feel free to get back to us if you have any further questions or need support. You would be welcome to speak with one of our cancer information nurses on the helpline. The freephone number to call is 0808 8004040 Monday to Friday 9am to 5pm

    Take care,

    Jemma

  • Thank you Jemma that helps.