<s>[INST] my brother in law has rectal cancer.  had surgery to remove tumor.  he was not abl to get chemo due to low tolerance.  radiation produced scar tissue and a second surgery is too risky.  pet scan lit up in bladder tailbone and lymph nodes away from orig tumor site.  doctors are saying it is too complicated for them to treat.  referred them to mayo clinic for second opinion.  he is going down fast.  how long if no treatment? [/INST] Hi, Thanks for writing in. I understand that your brother-in-law is having a cancer with local spread. Post surgery the primary cancer has been removed, but the disease process has continued to involve other areas; the sacrum and pelvic lymph nodes. In such situations, he can get high intensity focused radiation treatment if possible as decided by his oncologist to slow down the disease progress as he is not healthy enough to with stand chemotherapy. This way his disease progress can be slowed down but not stopped. The survival in such cases is usually 12 months to 15 months without treatment. I hope the second opinion at Mayo Clinic helps in improving his over all survival. </s>