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pain at excisional biopsy site-delayed healing ?

7243
Posts: 223
Joined: Feb 2011

OK ... I need some support. I had an excision of the anal lesion/ulcer which turned out to be a tumor/SCC and finished chemo radiation 5 months ago. The issue is I'm still having pain in the area of that ulcer/lesion/tumor excision. It burns at times, itches and aches ... mostly when I sit. It is very specific to the area that was operated on I'm fairly sure... "feels like something is there". Bleeding and pain on BM has passed unless I'm constipated... but do have some very small areas of blood on occasion .... certainly not bleeding like before diagnosis. I still have some slight control issues, but doing pretty good. My PET CT at 3 months was totally normal in early May and I also had an exam under anesthesia to look at the area and the colo-rectal surgeon said normal ... nothing to biopsy.

My question is did anyone else out there have surgery, like an excisional biopsy or even an attempt to remove the entire tumor and have continued pain like I'm having? I can't help but think this is re-occurrence given I'm 5 months out even though the colo-rectal surgeon believes this is due to radiation. Any ideas fellow survivors? I'm taking colazal and using proto-foam.

Thanks ...

RoseC's picture
RoseC
Posts: 533
Joined: Jun 2011

Hi -

I had two areas removed prior to treatment and I also had biopsies of the area six months after treatment. I'm almost 3 years out and still have some pain at the original site during bm's, along with a little bit of blood now and then. Sometimes I feel like 'something's there' too - the feeling lasts for a couple of days after a difficult bm. My colo-rectal surgeon said it's perfectly normal, what with everything our body has been through. Catscan and internal exams have all come out fine.

7243
Posts: 223
Joined: Feb 2011

Hello RoseC .. thank you for sharing your experience. It is so helpful to hear from friends who have similar issues. Yes ... if I have a difficult BM this is painful too. And this is up in the canal right? Mine is inside not on he outside ... it's sort of weird how we can feel it in there don't you think? Anyone else feel this way? I assume the itchy tingly feeling is "healing". Thank you so much for your response!

RoseC's picture
RoseC
Posts: 533
Joined: Jun 2011

Yes, my pain is up in the canal. On the inside left. Just where the tumor was. I don't get that itchy tingly feeling now, but I remember having it during and after treatment.

And you're right - this forum is wonderful! It's so nice to be able to communicate with folks who have been through the same thing.

sephie's picture
sephie
Posts: 562
Joined: Apr 2009

yes, yes, yes, i have pain. i am 24 months post tx. i also had excisional biopsy 2 years ago-- rather large one. had lots of scar tissue from that even before radiation tx. colo. rectal surgeon at MDA did not do this excision so had to ask what I had had done because of all the scar tissue. i have hurt a lot but also hurt on the opposite side of anus due to the radiation. they are watching my inflammation and etc. i have finally started feeling a little less pain than usual. (of course, it is nothing like the 8 weeks post excisional biopsy--- i thought that i would be better off dead because the pain was so severe). it is finally getting better and better. sephie

7243
Posts: 223
Joined: Feb 2011

Sephie ... thanks. I assume you had radiation after that excision right? Did it take a long time for your scar area to heal? Can you recall this? That's my issue right now .... seems like it will never heal? I worry it's either chronic HPV or worse? What was your experience? Thank you so much for sharing!

mp327's picture
mp327
Posts: 3324
Joined: Jan 2010

It is a known fact that skin is slow to heal after radiation. My colorectal doc does not do routine biopies for this very reason--she only does them when there is an indication of possible recurrence.

7243
Posts: 223
Joined: Feb 2011

Martha ... you seem experienced. I have this burning, pain right at the area of excision ... it feels raw. Not painful on BM. I'm 5 months out. do you think it would take this long to heal? I had an ulcer at the base of the scar in the canal prior to radiation seen on EUS. Seems to long? Thoughts?

mp327's picture
mp327
Posts: 3324
Joined: Jan 2010

I can only tell you what my experiences have been. Occasionally, I think due to hard BM's, my skin will tear slightly and it seems to take forever to heal, especially if I get in constipation mode. Also, I had to have anal warts removed last September. I dreaded the healing process after hearing how difficult it was for radiated skin to heal. However, I was pleasantly surprised that time--it really went well. I could be that you have a small fissure or it could be continuing problems with your ulcerated area. Do you ever have any bleeding? My best advice would be to bring this to the attention of your colorectal doc. I would think that if there was anything there, it could be seen on anoscopy. I hope it turns out to be something that is not serious, but please get it checked out.

sephie's picture
sephie
Posts: 562
Joined: Apr 2009

yes, i had radiation and chemo after the excision. in the very beginning, a colo rectal surgeon cut from the outside of my anal opening ( i had ulcer on the outside) up into the anal canal up to the rectum. he tried to cut the entire tumor out but it was in to the tissues too deep. i got stitched up and thought i would die from the pain of healing. after 8 weeks of healing and i still hurt and bled, i went to MDA for exam and then started chemo and radiation. after radiation , i still had bleeding and pain for 2 years. it is now beginning to feel almost normal, not quite. i still bleed a little ( not due to constipation) and still can feel soreness but my soreness is on the outside anal tissue on the opposite side from my tumor. i had so much pain there that i am not sure if i really felt the pain on the inside after radiaiton. I had a DRE by the radiologist in june and he hurt me badly. scared me. angered me. they say what i have is due to radiation damage, they hope. so they still ck. me out pretty well . i might have permanent damage. sephie

RoseC's picture
RoseC
Posts: 533
Joined: Jun 2011

I'm sorry you're still hurting sephie. Hope it continues to get better.

One note - I never let ANYONE do a DRE except for my colo-rectal surgeon. She's very gentle and knows how to do it with as little pain as possible. I went in for a gyn exam a few weeks ago and she wanted to do an rectal exam - I refused to let her and said 'no, no, no - that's been done by colo-rectal - do not touch!'. My gyn was ok with that. NO-ONE goes in there except my colo-rectal surgeon!

Edit: Another thing about this - after I finished treatment, my radiation doctor did a DRE. He thought he 'felt' something and scared me badly. He said he thought the cancer was still there. I went to see colo-rectal and she said no, it was ok, just radiation damage. I don't think my radiation doctor knew the difference. Anal cancer is rare, and I believe some of the doctors are learning as they go. That's another reason I only let my colo-rectal surgeon do the exam - I don't ever want to be scared unnesessarily again. I do want them to learn, but not at the expense of my psyche. (My radiation doctor was very good technically, but his bedside manner was not good at all.) My oncologist (who I love) does take a look-see, but externally, not internally.

RoseC's picture
RoseC
Posts: 533
Joined: Jun 2011

Gee, I re-read what I wrote about not wanting them to learn at the expense of my psyche. That sounds so selfish. Of COURSE I want the doctors to learn all they can by treating my cancer. Truth is though, I haven't been back to see the radiation doctor since that last DRE...guess I'm gonna stay selfish (about him anyway)...

AZANNIE's picture
AZANNIE
Posts: 396
Joined: Mar 2011

Sounds like you and I had the same radiation doctor - no bedside manner. Is there any reason to keep seeing radiation doctor? I can't have anymore radiation to the area, so why see him??? I'm thinking about canceling my next appointment.

mxperry220
Posts: 391
Joined: Mar 2011

I too had been seeing my radiation doctor for the past 33 months. I had my annual physical in May with my primary care physician and he said I should have my follow-ups with my chemo doctor because I had the maximum radiation in my anal area. If there happens to be recurrance the chemo doctor would be the doctor to manage this. I am now seeing the chemo doctor as well as my colon rectal surgeon every six months. I am scheduled for a colonoscopy 11-11-11. I am now 35 months post diagnosis.

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