Janice has had a number of CT scans over the years to explore whether surgery might be a possibility. She first saw a surgeon referred to her by her oncologist, who concluded surgery would be very difficult after seeing the CT scan. As expected too much small bowel is affected. If this were to be removed, there was more than a possibility that an iliostomy would have been necessary. She was and is not prepared to have that procedure.

If it could have been done without an iliostomy, she would experience different problems, such as needing to void many times a day, effectively keeping her a prisoner at home. There would be even more difficulty maintaining nutrition and body weight.

An MRI scan she had after seeing another surgeon following initial referral to a gastroenterologist with a special interest in problems after pelvic radiotherapy (see under Management) also agreed that surgery was not an option. Such was also the consensus of opinion of other surgeons Jan saw when hospitalised with very prolonged attacks of pain and vomiting (bowel blockage) has positively ruled out surgery.

The long-term scenario did not give cause for optimism, but at least she was relatively well between attacks, although the frequency of attacks continued to increase.