This topic is about a person who recently discovered a second, small colon cancer after having surgery for rectal cancer and undergoing chemotherapy. They are now facing the possibility of having their entire colon removed, which would result in a permanent stoma. The person is understandably shocked and is seeking advice and insights from others who might have faced similar situations.

Here are some helpful points and advice:

1. **Seek Multiple Opinions**: It's important to consult with more than one colorectal surgeon, an oncologist, and if possible, a gastroenterologist. Comparing their recommendations can help in making an informed decision.

2. **Understanding Total Colectomy**:
- The size of the tumor is less critical than its pathology, as even small tumors can spread.
- Having a second primary cancer indicates a high risk of future occurrences, and removing the colon can eliminate the risk of colon cancer.
- Repeated surgeries on different colon segments can lead to complications like scar tissue and obstructions.

3. **Life with an Ostomy**:
- Many people live healthy and active lives with a permanent ileostomy or colostomy. While the initial adjustment can be challenging, managing it becomes routine over time.
- There can be significant psychological relief from not having to worry about recurring colon or rectal cancer.
- Online communities, such as MeetAnOstomate.com, offer practical tips and emotional support.

4. **Considering a J-pouch or Internal Pouch**:
- This option allows stool to pass through the anus, avoiding a permanent external bag, but involves complex, multi-stage surgery and a long adaptation period.
- Experiences vary; some find the benefits worth the risks, while others prefer a conventional ileostomy.
- Reading patient accounts and discussing options with surgeons can provide valuable insights.

5. **Lifestyle Adjustments**:
- Post-surgery, adjusting your diet by reducing sugar and red meat and increasing greens can promote overall health.
- Some mention colon hydrotherapy as helpful before colectomy, though it's not universally endorsed.

6. **Practical Tips and Perspectives**:
- If a surgeon discourages reversal, consider seeking another opinion, as successful reversals have been done with minimal colon remaining.
- Surgeons focus on operations, so balance their advice with input from oncologists and primary-care physicians.
- Prepare questions in advance and insist on clear answers about margins, recurrence statistics, complication rates, and long-term function.
- Lean on family, friends, counseling, or faith groups to help manage stress during this decision-making process.