Anoscopy

Wisteria83

I'm scheduled to see the surgeon for follow up on July 6th.  It will be slightly over two months after last treatment.  I'm very nervous about this visit because I'm not sure what to expect, and just the thought of someone putting anything in my bottom scares me because of the pain factor that I'm anticipating.

My rad onc said on Thursday that I could definitely expect DRE and very likely anoscopy.  Everything I've read about the procedure has been about having it done as diagnostic...so far I've found nothing about having it done post radiation.

My questions to you all are:  How far past treatment were you when you first had it done?  How painful was it?  Did you need to do a bowel prep first?  How long did it take?  What position were you in?  Were you sedated first?  Can I request sedation?  Were biopsies taken?  What if I don't want biopsies taken? (I'm concerned about the healing issues involved).  

I read that the scope is 2-5 inches long and 2" in diameter...about the size of a hard medium to large BM.  OMG!!!  The skinny, soft BMs hurt me now!

Is Lidocaine gel enough to make it not hurt?  Does that acid stuff they use hurt?  

As much as I'm interested in knowing if the tumor is still there or not, I really don't want to go through this procedure.  I'm a huge chicken when It comes to pain. I'd like to hear about your experiences.  Thanks in advance.

~Wis

mp327

Wisteria

Here is a link to wikipedia that shows pics of and explains the anoscope.  I seriously doubt that the anoscope is 2 inches in diameter as you mentioned.  That would be quite large and intolerable, even for someone who's never had anal cancer/radiation.  I have never been sedated for this scope and have never found it to be painful, only slightly uncomfortable.  My first one post-treatment was performed at 6 weeks.  I've never had to do a prep and my only biopsies were done during colonoscopy and when I had surgery under general anesthesia for 3 anal condylomas 2 years post-treatment.  My doctor does this examination very quickly--I've never had any problems.  Her office uses a table that has a place to kneel at on the end, then the table is tilted up on that end.  They always cover me with a sheet.  I've never had the acetic acid test, so I can't speak to your question about that.  I hope this answers some of your questions.

 

https://en.wikipedia.org/wiki/Anoscopy

Mollymaude

Wis

I had a flex sigmoidoscopy with biopsy a few months after treatment and a biopsy was taken where the tumor had been. I was knocked out for that. Then I got anoscopy about ten months after treatment because my rectal exam was so painful and oncologist felt "something". He sent me to surgeon who did anoscopy in OR. Turns out what they felt was probably a muscle spasm. Based on how sore I was after the procedure I could not have tolerated the procedure awake. Next time I get anoscopy they will be trying to dig out my scarred in IUD as well so I'll get two procedures with one anesthesia.

Martha, not sure how you tolerated those exams with scope. I have a DRE next week I'm dreading just because of discomfort. I still have a sore bottom, hard chair seats or bar stools are uncomfortable. And sometimes depending on how sore I am still have to sit on one cheek In the bath tub.I guess we are all a little different. 

mp327

Mollymaude

I suppose we do all heal a little differently and some more completely than others.  I have occasional episodes of uncomfortable BM's accompanied by a little noticeable bleeding.  However, these episodes are few and far in between.  I am almost 9 years out of treatment--probably longer out of treatment than anyone else who is still active on this site.  So, perhaps this is due to the length of time that's passed since my treatment took place, I don't know.  However, I will say that I dreaded my first post-treatment anoscopy, but my doctor was very aware of this and was very gentle.  I would say at the worst, it was uncomfortable, but definitely not painful.  I have even taken some long bike rides since treatment--something I thought I'd never be able to tolerate.

Mollymaude

Martha

Thanks, your 9 year out perspective is invaluable. I hope I will still be encouraging others when I'm nine years out!

AmyD1310

Wisteria83
Hi there,
I wanted to share my post-treatment experience so far...maybe it will give you some relief. I finished treatment on 3/2/17. I had a DRE/anoscopy on 4/10/17. It was uncomfortable, but not painful. Positioning for this was on knees with belly/chest on the table. No sedation. I was lucky to be told that he no longer could see/feel anything. I had another follow-up due to some pesky cysts that appeared (likely due to radiation damage to my skin "down there). He did another DRE/anoscopy in same position, no sedation, and again i was lucky to hear good news of no tumor. I am not scheduled to see him again for another 3 months. Both DREs/anascopies only took about 5 minutes each. My doctor did not take a biopsy either time because he was concerned about the healing process. There was no prep regarding bowel movements although I assume they prefer you to be somewhat cleaned out beforehand. A Fleet's enema would work well for that. I hope this info is helpful, and I hope you are doing well!

-Amy

mp327

Mollymaude said:

Martha

Thanks, your 9 year out perspective is invaluable. I hope I will still be encouraging others when I'm nine years out!

Mollymaude

Awwwwww, thank you.  How sweet!  I just remember how terrified I was when I was diagnosed and that I really had no one to talk to who had been there, done that.  I really don't anyone else to feel so alone in this journey.  I will say, though, that a lot of minute details have faded from my memory about the whole experience of diagnosis, treatment, and early follow-up.  Sometimes I have to look back in my journal to recall certain things.  I guess that's good.  The human mind does have a way of keeping us from dwelling on pain and suffering we may have experienced, I guess.  I hope that knowing there is someone such as myself who is a long-term survivor and living a pretty normal life 9 years out will be encouraging to all who are beginning this journey or haven't been as far out of treatment as me.  Thanks for your input on this site--I know you give many people good information, encouragement and support.

Wisteria83

Thanks all

If there's anything I learned from this site and my own experience, it's that we do all heal at different rates.  Having the same cancer doesn't necessarily mean that we all follow the same healing schedule. (Thanks Martha!). As for myself, I think the worst has happened after I finished treatment!  Every week and sometimes everyday brings about something either new and different or a repeat of a side effect that I already had.  It's always changing!

Mollymaude...I wish they would put me out like they did for you, but I doubt they'll do that on request!  I figure even Valium might be a saving grace for me.  I also have problems sitting, but not all the time.  It depends on how my BMs have been.  Since losing so much weight, I have no fat to speak of and sitting in the tub means sitting on bones, so I always have to tuck a foot under me just to raise my bottom up off the hard surface.

Amy...I can't imagine a more embarrassing position to be put in.  I know they did that to me when I had surgery (Jack knife position) and I'm so glad I was out for the count.  All my exams had me on my side with my legs drawn up and that was bad enough.  I'm glad my surgeon who will be doing the exam is a female.  Yes, in spite of all the people who've seen my nether regions, I still get embarrassed.  Silly, I know.  I should be past this.  It's just another body part.  Hearing "NO TUMOR" has to be the best thing in the world to hear!  Did you get examined alone in the room or was someone with you?  I really don't like my husband in the room while I'm being examined.  That's another silly thing.  I'll wear my F**k Cancer tank top that he bought me, so he'll be with me in spirit.  I dread the thought of even an enema since I want nothing up my bum!  I can't imagine how I'm going to relax enough for her to insert anything.

mp327

Wisteria

If you can take just enough Valium to get relaxed that might be good idea.  Find someone to drive you to your appt. so you won't have to worry about it.  And be sure to let the doctor know before the exam that you are still quite tender down there.

As for your discomfort in sitting, due to having no padding, so to speak, I would suggest getting a donut or some kind of soft pad to sit on.  I actually have 2 memory foam pads, one on top of the other, on my desk chair for that reason.  I don't know how memory foam would hold up under water, but you might try that when you bathe.  I know they make memory foam bath mats to have outside your shower, so perhaps one of those would work in the tub.  Just a thought.  At 95 pounds, my sit bones are quite sensitive too, so I understand your discomfort.

As for having anyone else in the exam room for anoscopy, I have never done that.  I used to be quite uncomfortable getting any kind of medical examination, but since the experience with anal cancer, I am not so embarassed about mooning my doctor or putting my feet in the stirrups for a gyno exam.  To doctors, it's just so routine.  I received my radiation treatment in the "frog" position and when I had to have 3 anal condylomas removed 2 years after treatment, I was put in the lithotomy position, with my feet high in stirrups and knees bent at a 90-degree angle, butt exposed!  I was knocked completely out for that procedure, thank goodness!  My anoscopes are done with me kneeling on the platform at the end of the table, bending at the waist, and lying prone.  The table is tilted up so that my bottom is higher than my head--the jacknife position.  My surgeon is always quick to do the exam and before I know it, I'm out of there!

As for healing, the best advice I can give you is just to be patient.  I may have stated this previously, but it took me about 2 year to finally feel like I was fully recovered.  I've a few ups and downs since then and some things will never be the same, but I do not deal with the side effects that seemed to hang on during those first 2 years.  This is a marathon, not a sprint.  I wish you all the very best with your upcoming appointment!  Hugs!

Jane s

Wisteria

I finished treatment in Jan 2017, and had my first follow up anoscopy in May, and I have my second in 2 weeks.  They sedated me for the first one and will again for this one.  I can't imaging going through one of these after radiation, without sedation!  I'm also 100 pounds and it still hurts to sit.  I'm very nervous about this procedure, terrified of this cancer coming back.  

How did yours go?

Jane

tanda

Anoscopy

Hi Jane,

 

Are you talking about an HRA(high resolution anoscopy) or a routine anoscopy?  The HRA usually requires some sedation and may be a bit painful (I have never had one) I have had a few routine anoscopies; I wasn't sedated and they didn't hurt at all  Be sure to tell your doctor that you are still very sore; hope that he/she goes slowly and gently.

Wisteria83

Jane s said:

Wisteria

I finished treatment in Jan 2017, and had my first follow up anoscopy in May, and I have my second in 2 weeks.  They sedated me for the first one and will again for this one.  I can't imaging going through one of these after radiation, without sedation!  I'm also 100 pounds and it still hurts to sit.  I'm very nervous about this procedure, terrified of this cancer coming back.  

How did yours go?

Jane

Anoscopy

Hi Jane!

I never actually had the anoscopy or DRE done in July.  I was too sore, so my rad onc and surgeon both held off.  At each appointment, they took a peek, just to see how the tissues were healing.

I had my first DRE and internal vaginal exam just last week by my rad onc.  This is nearly 4 months post treatment.  He wasn't going to do it, because I've been dealing with a severe case of sciatica and I was in excruciating pain and unable to walk.  I told him I wanted him to do the exam because I NEED to know if the treatment worked.  With the help of him, my husband and the nurse, I managed to get up on the table and into position with my feet in stirrups.  He did the exam with a lot of lidocaine gel and the smallest speculum they had, and truthfully, I barely felt a thing.  Maybe because I was having so much pain in my leg?  Anyway, he felt some lumps and bumps both anally and vaginally which he said could be scar tissue, so while he feels optimistic that they got all the tumor, the exam was inconconclusive.  I'm scheduled for the anoscopy on 9/5, but that may end up being postponed because I may be having back surgery this week.  I'll know more tomorrow when I see the neurosurgeon.  A herniated disk is just what I needed after underging cancer treatment, right?

I know my colo-rectal surgeon who will be doing the anoscopy won't be using any sedation when she does the exam, so I'm not looking forward to it.  I watched a Youtube video of someone having it done, and while it looks to be an embarrassing procedure because of positioning, it also looks like the scope is a good size...and not something I want put in me.  Can't be helped though.  It's the only way to find out if this cancer is gone or not.  I'm scared too.

mp327

Anoscopy

I am almost 9 years out of treatment and have had numerous anoscopies, none of which have been painful, even the one I had 6 weeks post-treatment.  I would say sometimes they were a little uncomfortable, but never painful. 

Wisteria, I'm sorry about all that you are dealing with.  I hope your back surgery goes well and that your upcoming anoscopy shows that your cancer is gone.  Please keep us posted as you can.

Jane s

tanda said:

Anoscopy

Hi Jane,

 

Are you talking about an HRA(high resolution anoscopy) or a routine anoscopy?  The HRA usually requires some sedation and may be a bit painful (I have never had one) I have had a few routine anoscopies; I wasn't sedated and they didn't hurt at all  Be sure to tell your doctor that you are still very sore; hope that he/she goes slowly and gently.

Anoscopy

I just checked and mine will be an HRA.  That is what I had in May, also.  My doctor found some lesions, which he removed, but no cancer.  The CT showed a large (6 cm) mass, which they say is most likely scar tissue, the remains of the 7 cm tumor, but my doctor didn't see any signs of it in the exam, which was good news.  

I had a regular anoscopy before treatment started, with no sedation, and it was pretty uncomfortable.  I actually had a sigmoidoscopy with no sedation and it was freaking horrible, also, that was when they found the tumor so all in all bad experience..

 

Jane s

Wisteria83 said:

Anoscopy

Hi Jane!

I never actually had the anoscopy or DRE done in July.  I was too sore, so my rad onc and surgeon both held off.  At each appointment, they took a peek, just to see how the tissues were healing.

I had my first DRE and internal vaginal exam just last week by my rad onc.  This is nearly 4 months post treatment.  He wasn't going to do it, because I've been dealing with a severe case of sciatica and I was in excruciating pain and unable to walk.  I told him I wanted him to do the exam because I NEED to know if the treatment worked.  With the help of him, my husband and the nurse, I managed to get up on the table and into position with my feet in stirrups.  He did the exam with a lot of lidocaine gel and the smallest speculum they had, and truthfully, I barely felt a thing.  Maybe because I was having so much pain in my leg?  Anyway, he felt some lumps and bumps both anally and vaginally which he said could be scar tissue, so while he feels optimistic that they got all the tumor, the exam was inconconclusive.  I'm scheduled for the anoscopy on 9/5, but that may end up being postponed because I may be having back surgery this week.  I'll know more tomorrow when I see the neurosurgeon.  A herniated disk is just what I needed after underging cancer treatment, right?

I know my colo-rectal surgeon who will be doing the anoscopy won't be using any sedation when she does the exam, so I'm not looking forward to it.  I watched a Youtube video of someone having it done, and while it looks to be an embarrassing procedure because of positioning, it also looks like the scope is a good size...and not something I want put in me.  Can't be helped though.  It's the only way to find out if this cancer is gone or not.  I'm scared too.

Anoscopy

Hi Wisteria

My anoscopy is scheduled for Sept 5, also, so if yours goes as planned, we can go through it together, virtually.  Either way i'll be thinking aobut you.  It's helpful knowing other people out there are going through the same thing.  This is so hard.  And you have all that pain on top of it!  Ugh.  Have you tried acupuncture?  It was the only thing that finally helped my stepmothers sciatica.  I hope you can get some relief.  Sending you hugs.

Jane

Wisteria83

Jane s said:

Anoscopy

Hi Wisteria

My anoscopy is scheduled for Sept 5, also, so if yours goes as planned, we can go through it together, virtually.  Either way i'll be thinking aobut you.  It's helpful knowing other people out there are going through the same thing.  This is so hard.  And you have all that pain on top of it!  Ugh.  Have you tried acupuncture?  It was the only thing that finally helped my stepmothers sciatica.  I hope you can get some relief.  Sending you hugs.

Jane

Probably going to postpone Anoscopy

Hi Jane,

It IS helpful to know that others are going through the same thing.  Makes it a bit easier somehow.  That's why this board is so helpful.

 I didn't try acupuncture this time.  My insurance (Medicare) doesn't cover it, nor does it cover massage therapy, and I can't afford it out-of-pocket.  I think it's terrible, but there's no fighting it.  My son, a former Marine, gets accupuncture and it's covered by the VA.  You'd think that since they are both federal, that they would cover the same things, but no such luck.  I can understand them not wanting to cover experimental treatments, but both accupuncture and massage therapy are both proven therapies.

 I've had spine problems for many, many years.  Degenerative Disk Disease and osteoarthritis in both cervical and lumbar vertebrae.  In 1994 I had a fusion at C5-6, and in 2002 I had another fusion at level C6-7.  Now I have a titanium plate and screws at those levels.  I've been in Pain Management and on narcotic pain meds since early 2000's, with extra pain meds for occasional severe flares and break-through pain.  (I also have Fibromyalgia, which for me, narcotics doesn't help.  It does help the DDD.)

 

Shortly after CA treatment ended, I began having hip and low back pain as many of us here do.  Within days though, my back pain became worse and then the sciatica reared it's ugly head and completely overtook all the "regular" pain I had been experiencing. 

 I saw the neurosurgeon on Wednesday of last week, had a new MRI and EMG on Thursday.  I have two herniated disks...L4-5 and L5-S1 and some stenosis which is impinging the nerve.  The pain in my right buttock and entire right leg is excruciating, and I'm having some numbness and tingling in my foot. The back pain has now diminished so that I barely feel it.

  I went through this last summer, had some conservative treatments including accupuncture and steroids and the pain resolved after two epidural steroid injections.  This time, conservative treatments didn't help.  After three unsuccessful spinal injections, a series of Prednisone, two shots of Toradol and the addition of Gabapentin (Neurontin) for nerve pain, both my surgeon and I decided that surgery is my best option, so tomorrow morning I'll be having surgery...a laminectomy and discectomy at those problematic levels.

On the bright side, this sure has taken my mind off my cancer!  Best of luck to you on the 5th with your anoscopy, Jane.  I'll be with you in spirit!

Hugs, back atcha!

 

mp327

Wisteria83 said:

Probably going to postpone Anoscopy

Hi Jane,

It IS helpful to know that others are going through the same thing.  Makes it a bit easier somehow.  That's why this board is so helpful.

 I didn't try acupuncture this time.  My insurance (Medicare) doesn't cover it, nor does it cover massage therapy, and I can't afford it out-of-pocket.  I think it's terrible, but there's no fighting it.  My son, a former Marine, gets accupuncture and it's covered by the VA.  You'd think that since they are both federal, that they would cover the same things, but no such luck.  I can understand them not wanting to cover experimental treatments, but both accupuncture and massage therapy are both proven therapies.

 I've had spine problems for many, many years.  Degenerative Disk Disease and osteoarthritis in both cervical and lumbar vertebrae.  In 1994 I had a fusion at C5-6, and in 2002 I had another fusion at level C6-7.  Now I have a titanium plate and screws at those levels.  I've been in Pain Management and on narcotic pain meds since early 2000's, with extra pain meds for occasional severe flares and break-through pain.  (I also have Fibromyalgia, which for me, narcotics doesn't help.  It does help the DDD.)

 

Shortly after CA treatment ended, I began having hip and low back pain as many of us here do.  Within days though, my back pain became worse and then the sciatica reared it's ugly head and completely overtook all the "regular" pain I had been experiencing. 

 I saw the neurosurgeon on Wednesday of last week, had a new MRI and EMG on Thursday.  I have two herniated disks...L4-5 and L5-S1 and some stenosis which is impinging the nerve.  The pain in my right buttock and entire right leg is excruciating, and I'm having some numbness and tingling in my foot. The back pain has now diminished so that I barely feel it.

  I went through this last summer, had some conservative treatments including accupuncture and steroids and the pain resolved after two epidural steroid injections.  This time, conservative treatments didn't help.  After three unsuccessful spinal injections, a series of Prednisone, two shots of Toradol and the addition of Gabapentin (Neurontin) for nerve pain, both my surgeon and I decided that surgery is my best option, so tomorrow morning I'll be having surgery...a laminectomy and discectomy at those problematic levels.

On the bright side, this sure has taken my mind off my cancer!  Best of luck to you on the 5th with your anoscopy, Jane.  I'll be with you in spirit!

Hugs, back atcha!

 

Wis

Wishing you all the very best with your surgery tomorrow.  I hope all goes well and that you have a speedy recovery!