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Small wart, didn't have before, in treatment with Radiation now, should I have it removed?

kirby77
Posts: 48
Joined: Jul 2012

I have a small wart on my anus, external, well almost internal if you know what I mean. I have never had warts, I am entering my 4th week of radiation, and having Proctitis. The wart actually causes additional pain. Should I have it removed? Or will I have more pain/swelling if I do? I think the radiation and chemo lowered my immunity to combat HPV warts. I had a couple of external warts on my perineum(space between anus and scrotum) removed years ago, but never on my anus.

My colorectal doctor does not remove warts in his office only in surgery. There are docs that specialize in wart removal, but don't know if they would do it while I am in treatment. What has your experience been? It's embarrassing and uncomfortable, I thought they were not supposed to be painful?

mp327's picture
mp327
Posts: 2979
Joined: Jan 2010

I can not answer your question--only a doctor is qualified to do that. If I were in your situation, I would return to the colorectal doctor and ask about removal during treatment. I am betting that he will say it must wait until you are finished, but I can't say for sure. I had 3 internal warts removed a couple of years ago, but that was 2 years post-treatment. Healing of radiated skin is always a concern, so this is why you may be told to wait until after treatment ends. I just don't know. Please let us know what you find out.

StruTanToot
Posts: 108
Joined: Aug 2012

I initially had surgery to remove warts and the biopsy of one came back cancerous. I don't know if all the warts were removed during surgery.

I got two opinions after my anal cancer diagnosis from docs at comprehensive cancer centers. Three doctors (two radiation and one chemo oncologist) and one chemo nurse have told me that radiation essentially kills both the cancer and condyloma. They also told me that it is rare that the warts return.

I was having surgery to remove warts about every six or seven months, but the warts always came back. Having them come back and having one come back cancerous is my biggest fear. Consequently, I have asked about this several times. Again, the oncologists say it's rare. I also asked the surgeon...he said the warts could come back, but not necessarily as cancer.

So...I imagine radiation will take care of the warts, but you need to talk to both your oncologists about the warts.

As for being embarrassed...trust me, I know how you feel. The one place though where I just try not to care is where I'm being treated. You have to tell them and just get over being embarrassed (please know I don't mean to sound harsh). You just don't have another choice, especially since the warts progressed to cancer.

I've realized too that embarrassment is going to be a huge part of my life now with DREs and all the other monitoring that comes with being diagnosed with anal cancer. I try to compartmentalize that aspect of my life. Going to treatment, seeing the doctor, or anything related to anal cancer...that is the box I am forced to open. It's not pleasant and it's embarrassing, but I get to close the box after I leave the hospital and but it away.

I'm sorry to go on so long. I really identify with what you're feeling. Talk to your doctors and try not to worry a lot about the embarrassment in a medical setting. The embarrassment is part of the treatment...it's all unpleasant, but the embarrassment ends when you leave. Lastly...I guarantee no one, no doctor or nurse or anyone else at the treatment center, loses any sleep thinking about what we might have done or not done to have genital warts.

All the best, and keep us posted. Hang in there!!!

kirby77
Posts: 48
Joined: Jul 2012

So, I am not sure if I have an inflammed hair follicle or wart. She wasn't pro-removal due to my proctitis and ongoing radiation. I'll consult my med-onc tomorrow.
Stru, thanks for the advice and empathy when it comes to confronting and dealing with embarrasing situations. HPV no matter how prevalent is stigmatizing. You're right dealing with it, and then closing the door to thinking about it is a great coping skill. Thanks for reminding me of pushing embarrassment aside and be pro-active.

I asked my rad-onc if radiation would treat the wart she wasn't sure, I guess it's better than guessing about it.

This is week 4, a short week, but none the less, I am moving forward. My rad-onc, told me today to expect a treatment break due to side-effects. I am determined to move forward. Having proctitis at this stage isn't a great thing, but I hope I can move forward and manage it.

I am still taking 1/2 Vicodin plus Tylenol ES once a day to control the pain, I am afraid of taking more due to fear of constipation.
Diet wise, I am probably eating all the wrong things, last night I ate alot of broccoli. I am so used to eating a lot of veggies and fruit with my meals. Does corn, salad and things like broccoli really make elimination more painful? I have not tried a BRAT diet and fear I would just plug up if I did.

What did you all eat? BRAT diet or whatever?

mp327's picture
mp327
Posts: 2979
Joined: Jan 2010

I'm glad your rad-onc was honest with you about not knowing if the radiation would zap the wart or not. I guess it's one of those "wait and see" kind of situations. I'm sorry your doc feels that a treatment break is going to be necessary, as I know you want to get this done and over with.

As for eating broccoli, I think that might be a bad choice--too much fiber. Corn and salad are probably not the best choices either. I could not eat anything with a high fiber content during treatment, as everything just went right through me. I ate a lot of protein (chicken, eggs) and yogurt, which is good for the intestinal tract. I did have to eat the BRAT diet a couple of times for a short period. I really suffered with diarrhea all through my treatment.

Please continue to keep us posted. You continue to be in my thoughts and prayers.

rds711
Posts: 113
Joined: Dec 2011

Kirby,

You're in the home stretch at week 4, one day at a time and soon you will begin the healing phase. About mid week 5 I was questioning whether I could do the last couple treatments but I decided I just wanted it all to be over so I limped through the last couple. Use that determination one day at a time.

By week 4 I didnt want to have anymore bowel movements and I was just exhausted. I still had a fairly healthy appetite but mainly ate soft foods like mashed potatoes, I craved pancakes and macdonald hamburgers now and then, no cheese. I stayed far away from anything with fiber, no salads, veggies etc. Carnation instant breakfast and gatorade with protien also fit the bill and had the protien I needed. I had stool softener's and immodium that I used as needed to kind of walk a tightrope with my bowel movements. You want soft, not liquidy or hard stools.

You're almost there Kirby, you can do this. Once the treatments stop the healing begins. Take care of yourself and rest as much as you need too.

Keeping you in my prayers,

Randy

StruTanToot
Posts: 108
Joined: Aug 2012

Thank you all who posted some info on diet. I'm in my second week of treatment and the BMs are rapidly becoming more painful. I had some issues with constipation and have had to take laxatives. I think the constipation was from the anti-nausea medication, which I hope is wearing off.

BTW...I experienced NO nausea at all and only two mouth sores so far. I'm happy to be able to share some good news!

I'm a little worried about the burning and pain during BMs, so please know I'm grateful for any info on diet that you provide.

mp327's picture
mp327
Posts: 2979
Joined: Jan 2010

I am going to post for you the general instructions for dealing with diarrhea out of the book titled "Eating Well Through Cancer" by Holly Clegg & Gerald Miletello, M.D.

"Diarrhea can follow certain chemotherapy or radiation treatments. This can be a problem with certain drugs, such as 5FU, CPT-11 and antibiotics. If the diarrhea starts, the first thing to do is to stop all intake of high fiber foods--such as nuts, seeds, whole grains, legumes, dried fruit and raw fruits and vegetables--stool softeners or laxatives. Follow your doctors' instructions with regards to Lomotil, Immodium, or Pepto Bismol. Start clear liquids after fasting two to four hours. Force fluids up to eight to ten glasses per day. Water, clear soup, broth, flat soda or a sports drink are excellent fluids to replace those lost by diarrhea. Avoid dairy products since they tend to make diarrhea worse. Avoid gassy foods and carbonated beverages. Hot and cold beverages, alcohol, coffee and cigarettes tend to aggravate diarrhea. Be sure to sip fluids throughout the day to prevent dehydration."

"Bananas, rice, applesauce and toast are good foods to begin eating following a decrease in your diarrhea. Once you are tolerating these foods, progress to bland low fiber foods, such as chicken without the skin, scrambled eggs, and canned or cooked fruits without skins. Crackers, pasta without sauce, white bread or gelatins are good choices. Try to avoid foods high in fiber, such as grains, raw vegetables, whole wheat, raw fruit, oatmeal and brown rice."

"Nuts, beans and milk products may worsen the diarrhea. Any high fat food should be avoided. Try to avoid caffeine and hot or spicy foods. Once your diarrhea has subsided, you can adjust your diet accordingly. Foods low in fiber and fat are helpful in decreasing your diarrhea."

"If your rectum becomes red or sore, use a commercial wet towel without alcohol and avoid dry toilet paper. Desitin or a combination of Aquaphor and Questran in a 9 to 1 ratio will act as a protective barrier to your perirectal area. Ask your physician to prescribe these medications."

"If your diarrhea continues without relief for greater than twenty-four hours, please notify your physician."

I know a lot of this is information you already know, but perhaps there is a morsel of new info in here that can help you. I hope so, anyway!

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