anal cancer resection

May 31 2009
Hi,
I have advanced anal cancer. I have had chemo & radiation. There is residual cancer according to doctors. I can also still feel the lump. I have not had biopsy yet but when I do have it & if it is still cancer (which according to doctors is most likely) I have to make up my mind quickly about surgery. I would like people's opinions on whether resection is the best way to go when cancer is advanced. There is not evidence of spread but I was not given any mri or pet scans. My doctors are very reluctant to do them. I wonder if they know something I don't. I am going to have pet & radiation scans done through another center. I hope it will give me more info. The residual cancer seems to be growing. I also have a fistula which also complicates it. My pain is under control but it never went away all through treatment. They want me to have resection whether it has spread or not. They say there is no evidence of spread to lymph glands. Ct scans are not showing any. I have had a lot of problems recovering from surgery in the past. The doctors are all for surgery. I am worried if it has spread the surgery might debilitate me so much that my quality of life might be terrible. Are there many survivors of over 5 years of people with advanced anal cancer and I wonder what the chances that it has already spread.
I hope I have covered most of it. It is difficult doing normal things let alone having these types of decisions to make. Also, I know this is difficult but what usually kills -the actual anal cancer which my doctor said when it spreads goes to the bladder & is a terrible way to die or through spread to liver & lymph. Would having the surgery stop a really painful cancer or would a resection be done later if need be.
Thank you for any help.
Update: I had a pet scan which lit up in cervical lymph nodes on left side of neck Apparently it can spread there without showing up anywhere else. Although it is unusual. I feel the healthiest I have felt since I had temporary colostomy bag put in -they did this because my cancer was about 7-8 cm. I now have about 3 cm left in a new place outside my rectum that came up after I had original biopsy. I am terrified of getting so debilitated by operation that my body will not cope if cancer has spread. I had a bad time with colostomy surgery. Have only just recovered. Are there any people here who have had resection & survived more than five years? Trying to make the best decisions for myself.