Need Radiation Expert to answer my question

Would a Radiologist PLEASE answer my question I asked on Ded. 21 regarding the treatment for a small rectal cancer (similar to a skin cancer) which could be treated successfully with radiation except that the radiologist that was consulted is of the opinion that the patient cannot have anymore radiation due to having had a cobalt implant 40 years ago.  She is 79 years old & would like to know if the benefit of having more radiation might outweigh the trauma (psychological & physical) of having radical surgery which would mean a colosoomy.  We would certainly appreciate a prompt answer.
Thank You
PS  Please answer soon!

[Garry Choy, MD, MS]

The treating radiation oncologist is likely worried about the complications of excess radiation versus benefit.  It is unlikely that radiation can be successful in treating a rectal cancer, even if it is low grade.  Most rectal cancers are best treated via surgery, particularly the low grade treatments.  Unfortunately as you rightfully pointed out the problem with surgery is the unfortunate need for a colostomy.  I would seriously discuss these quality of life issues against what kind of surgery can be done with the primary surgical oncologist along with the radiation oncologist in a multidisciplinary meeting -- see what they both think.  Kind regards and hope this helps.