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diagnosis changed from stage one to stage two; IMRT

Posts: 110
Joined: Aug 2012

Dear friends...I had my radiation simulation today at Duke and start treatment on Monday. I asked about the PET scan I had done on Wednesday. The doc said that a couple of lymph nodes were involved.

I had been told at another hospital that it was stage one, but no PET scan was done.

The doc said the nodes are beside the cancer and were going to be treated anyway. He also said that they would be using a stronger dose of radiation.

They will also be doing IMRT.

All the emotions I had when I was first told I had anal cancer returned in full force upon hearing that it's stage two. My fear level went up a lot when I heard.

I guess I'm asking if anyone has any thoughts, especially anyone past stage one. Also, it seems like IMRT is the best way to go, but I'd like to hear any thoughts on that as well.

Thank you all for all the support you have given me.

mp327's picture
Posts: 3545
Joined: Jan 2010

I still believe that IMRT is the best type of treatment. It is more precise, sparing surrounding tissue from a more severe degree of damage.

I'm sorry you are staged at a 2, but in most cases, treatment for stage 1 and stage 2 are the same, as they radiate the entire pelvic area, lymph nodes included, in either situation. I think this is what your doctor told you. One question you might want to ask is what dose of radiation you will receive. They will begin your treatment over the entire pelvic area, then at a certain point the treatment area will be reduced, perhaps once or twice, with the end of treatment (or the boost) aimed directly at the tumor. I received a total of 54 gys and I was on the fence between stage 1 and 2. I believe the max dosage that can be given without causing damage to the spinchter muscle to cause possible permanent incontinence is 59 gys.

Don't let the stage 2 diagnosis get you down. You are going to be fine.

Posts: 1054
Joined: Oct 2011

Iwas Stage 3B. I am out of town right now and keep meaning to check the total gys I received. (I'll do that next week) That being said tho, even at Stage 3B my 12mo PET scan came back NED (no evidence of disease). I did have some tumor placement issues and required the colostomy, but as far as anal cancer goes, a great 1yr report. As Martha said, you'll be fine. Try to focus on the holiday season ahead when this will all be a thing of the past, and you will be the one giving advice and moving forward in recovery. As always, all in my prayers.

Posts: 435
Joined: Mar 2011

Like you I was diagnosed as Stage 2 Anal Cancer. After running a MRI the doctors discovered an enlarged lymph node. The PET and CT scans did not show an enlarged lymph node. My chemo doctor said my lymph node could be enlarged due to all the tests I had run in a week period of time. My radiologist advised he would treat the lymph node as if it was cancer to be on the safe side. I am 3 1/2 years out from my last treatment. As a positive note my chemo doctor said if I had to have cancer this was the one to have. He said they have a high rate of success treating anal cancer if diagnosed early.

Posts: 110
Joined: Aug 2012

Thank you for the encouragement and information.

I did some research online, and based on the info I read about staging, I might be at stage 3A with T1 N1 M0. I guess I need to stop worrying about the stage. I meet with the radiation doctor on Tuesday, and I'll get more details.

The resident told me about the lymph nodes. He said too that it was still completely curable.

I'm just really scared I think. I had been doing better, but with this news and with treatment starting on Monday, I'm very anxious. I try to count my blessings. I know there are a lot of people with a much worse diagnosis than mine. I guess I just wasn't prepared for more bad news.

One more question...how do I send a private email? I can't figure it out.

Thank you all.

mp327's picture
Posts: 3545
Joined: Jan 2010

What that resident told you is correct--even at stage 3A, your chances of being cured are very high. I know it's a scary time, but you will get through this and everything will be okay.

To send a private message, go back to the page where you log in and you will find in the middle column a place to get to messages. Click on new message (I think that's what it says) and it will take you to the screen where you can do so. Let me know if you can't get there.

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