Hi Fr Pat and Pastor Jeff,
My son wanted oncologists that would work closely with his nephrologist. The first colorectal doctor and surgeon who discovered his cancer after an emergency room visit were pretty nonchalant in regards to his transplant concerns. We got some great recommendations from his original transplant center. The oncology team chosen included his nephrologist in every decision and update. As you all know, the transplanted kidneys are placed quite low in the abdomen. They recommended he have proton radiation on his tumor in order to protect the graft from radiation. Proton radiation is quite a bit more "pinpoint" than typical radiation. He was fortunate and the tumor shrunk enough for him to have a robotic assisted LAR surgery. After he recovered from the surgery he did 12 rounds of chemo. His scans are clear now and we can hope it stays that way on future scans. Sadly, the prognosis for kidney transplant patients with rectal cancer isn't as wonderful as you could hope, the research is a bit a of a dark read. I can see why they refer to cancer with words like "warriors, fighters, battle" its a long hard war with an enemy that may return.
We should all push our younger family members with transplants to have colonscopies long before they reach 50. No one expects younger people to have colorectal cancer and the early symptoms were ignored when he reported them to his primary physician. His symptoms, first reported 3 years post transplant were diagnosed as hemorrhoids. 11 years post transplant his cancer was discovered at stage 3C. Some of you may remember that we have two sons with transplants, our older son did have a colonoscopy after his brother's cancer was discovered. All was well with him. Anecdotally speaking, as we all know the level of immunosuppressives needed on a daily basis can vary widely from person to person. The son who developed cancer requires much higher doses than his brother to maintain the proper levels in his bloodstream.
Thanks for asking PastorJeff, it means a lot.