questions

worriedsick123

Hi I am new to the board and i have a few questions im hoping someone will be able to help me with. My MIL was recently diagnosed with anal cancer, she went to a general Dr for what she thought to be hemroids, that dr sent her to a proctologist who looked at her and said it was cancer. there was no biopsy or anything done he just looked at it and that is what he said. he ordered a colonoscpy which came back clean. he said he could get it all with surgery since it was only on the outside and just about 1 inch up on the inside. he refered us to a colorectal surgeon who we have not seen yet the appointment is in a couple of day. She has been having ongoing stomach issues for a long time since before we found out about the cancer but last weekend she was in lots of pain in her abdomen area and we took her to the emergency room. they ran lots of tests and did scans but we still have no answers. the emergency room dr said she has a few gall stones but she didnt think that was the problem and said something about her pancreas enzymes being high or that is what i thought she said. she also said the opening to her gall bladder or pancreas was swollen. She gave her some med to help with her stomach pain and told us to see a gasteonologist. Is it possible, that even though the colonoscopy came back clean that the cancer could be in her pancreas or her gall bladder? the proctologist we have been to already has never told us anything about the staging or anything like that so we really dont know what is going on from the way he talked it was a minor thing and could just be treated with surgery and he said a few zaps of radiation. shouldnt they be doing more to find out if the cancer has went anywhere beyond the anus? could her stomach issues be related to this cancer? she says she cant eat anything beyond a couple of bites and she feels full and has stomach aches often this has me worried. what questions should i ask this new dr when we go see him? Any advice is greatly appreciated.

mp327

Hi worriedsick123--

I'm sorry to hear of your MIL's symptoms but I'm glad you have come here to ask questions.  Keep in mind that none of us are doctors.  We are survivors of anal cancer.  I am disturbed by the fact that your MIL's proctologist did not do a biopsy and diagnosed her after only a visual exam.  If the tumor is located partially externally and partially internally, then I do not believe surgery will be the best option.  I hope the colorectal surgeon she will be seeing has had experience with treating anal cancer and will be prompted to do all the necessary testing to make a definitive diagnosis and set up a treatment plan.  One exam she should ask about is an anoscope, which can be done in the CR surgeon's office with no prep.  It's a short scope used to view only the anal canal.  It will give the doctor a good look at the tumor, where it's located, and it's proximal size.  What he will not be able to do with that exam is determine whether or not the cancer has spread to any other areas, such as lymph nodes or distant organs (metastatic anal cancer typically goes to the liver or lungs, but not always).  The next step should be a PET scan to rule out any spread to the aforementioned areas.  Tumor size can then be determined.  Once these preliminary tests are done, your MIL will most likely be referred to a medical oncologist (chemo doctor) for consultation and a radiation oncologist for a radiation consult.  After that, the ball should get rolling towards treatment.

 

I can't answer your question about whether or not the cancer could have spread to her pancreas or gallbladder.  This could only be ruled out with further tests, I presume.  As for stomach pain, I had bloating and cramping prior to being diagnosed with anal cancer, so it's possible that some of her pain is related to the tumor.  I also had severe constipation issues, fatigue and unexplained weight loss. 

 

As for her proctologist stating that anal cancer is a minor thing and could be treated with surgery and a few zaps of radiation, I beg to differ.  Anal cancer is serious and rare.  Ask lots of questions of the colorectal doctor and make sure he is up on his knowledge about anal cancer, especially since the proctologist was obviously of no help.  Press for further testing:  the anoscope and PET scan, at the very least.  Also, if you wish to be much more informed about anal cancer and the recommended treatment guidelines, visit the website for the National Comprehensive Cancer Network (NCCN.org).  You will need to register, but that will allow you to access all of this vital and most current information.   Being educated about this disease will help you and/or your MIL to make a list of questions for the CR surgeon. 

 

I wish your MIL all the best and I must say, I admire you for coming here as her advocate.  Please keep us posted on how things go for her. 

Lorikat

Ditto what Martha said.  I

Ditto what Martha said.  I was also told by the doc who found my cancer tat it was "no big deal" and would melt like butter with a little radiation.  My family doctor, however,disagreed and sent me to specialists.  The tumor was invasive, but with acombination of radiation and chemo am in remission at 18  months post treatment.  I had no surgery and so far no colostomy.  

Marynb

Worriedsick
Hi,

I am sorry about your MIL. I strongly urge you to get your MIL to a very reputable comprehensive cancer center. You can start by going to US News and World reports Hospital rankings specifically for cancer!

I had all the symptoms your mother in law describes and they were all cancer related! The doctors that I saw locally never connected the dots and were treating symptoms independently. I had to go out of state,but thank God that I did! I highly suggest that you act quickly and get to a good cancer center! Do not acceot the idea that it is better to stay with a familiar doctor or hospital. Trust me, cancer kills!

AZANNIE

worriedsick

I also ditto what the others have said. My colorectal dr suspected cancer and did a biopsy which confirmed his diagnosis.  I hope you get some answers.

Ann

 

sephie

demand ealier appt

i agree with what everyone else is telling you.   go to colorectal surgeon NOW... my proctologist missed mine for a year... thank heavens yours sent you to someone else.   cancer can only be determined for sure with biopsy.  my tumor  was on the outside of anus and the inside. ( looked like a bubble or hemmy)..  PET scans will determine if there are other sites....  good luck..... thinking of you....  sephie