frequency of rectal exams after radiation

magillilnb
magillilnb Member Posts: 39 Member
in Anal Cancer #1

I am starting to wonder about my radiation oncologist, but wanted to hear from others.  My radiation ended in early December, and since then I've had various scans and a biopsy all of which showed no cancer.  I am now seeing a colorectal surgeon about reversing my colostomy, and she has done two physical exams of my vagina (I had a fistula) and my rectum. One of the exams was done under anesthesia, so she could poke around without hurting me. Her exam while I was conscious was not painful.

My radiation oncologist wanted to see me for a follow up, and he was very insistent on doing vaginal and rectal exams.  He claimed that his fingers can do a better job than any scan. I told him I did not want him to do those exams, since my other doctor is already doing them, and because it hurts too much. He didn't get angry, and he told me it was my right, but I could tell he was irritated. He said he couldn't help me, unless he could examine me.

I don't understand what his fingers can detect that my colorectal surgeon's can't, and why he is so insistent. I had called his nurse and told her months ago that I would not continue to see him, if he could not be more gentle and she talked to him about it. She said she has to remind him with other patients and some he doesn't examine at all because it's too painful. When I saw him recently, he said he understood that it's uncomfortable, which told me he didn't get it that it is very painful and not just uncomfortable.  I'm about to the point of not seeing him anymore.

Any advise or similar situations?

Nancy

Comments

  • RoseC
    RoseC Member Posts: 559
    #2
    I only had one follow-up exam

    I only had one follow-up exam by my radiation oncologist. It was around 1-2 months after finishing treatment. He wasn't sure the treatment had worked, said he felt something still there - scared me bad. Within a few days I had an exam by my colo-rectal surgeon, who said everything was as expected and things were fine. I never went back to see the radiation oncologist. My feeling is that he wasn't experienced enough with what was normal and what wasn't after anal cancer radiation treatments. Don't get me wrong, he did a great job with the radiation itself - it's the follow-up I don't think he knew enough about. My chemo oncologist did external exams, not internal. He called the colo-rectal surgeon when he had a question. In my opinion, that was a much better approach for both him and me. I don't regret not seeing the radiation oncologist again. I'm very comfortable with only my colo-rectal surgeon doing the internal exams.

  • magillilnb
    magillilnb Member Posts: 39 Member
    #3
    RoseC said:

    I only had one follow-up exam

    I only had one follow-up exam by my radiation oncologist. It was around 1-2 months after finishing treatment. He wasn't sure the treatment had worked, said he felt something still there - scared me bad. Within a few days I had an exam by my colo-rectal surgeon, who said everything was as expected and things were fine. I never went back to see the radiation oncologist. My feeling is that he wasn't experienced enough with what was normal and what wasn't after anal cancer radiation treatments. Don't get me wrong, he did a great job with the radiation itself - it's the follow-up I don't think he knew enough about. My chemo oncologist did external exams, not internal. He called the colo-rectal surgeon when he had a question. In my opinion, that was a much better approach for both him and me. I don't regret not seeing the radiation oncologist again. I'm very comfortable with only my colo-rectal surgeon doing the internal exams.

    RoseC

    I think my radiation oncologist probably has experience, but his turn is over, and the colorectal surgeon is who is helping me now. I think he has ego issues or there's something more sinister going on, and I don't want to entertain either possibility.

    I'm glad you're happy with your colorectal surgeon, too.

     

  • islandgirlculebra
    islandgirlculebra Member Posts: 155 Member
    #4
    magillilnb said:

    RoseC

    I think my radiation oncologist probably has experience, but his turn is over, and the colorectal surgeon is who is helping me now. I think he has ego issues or there's something more sinister going on, and I don't want to entertain either possibility.

    I'm glad you're happy with your colorectal surgeon, too.

     

    I only went back for one

    I only went back for one appointment with the radiation oncology department (basically to get the vaginal dilators) and actually saw one of the other doctors because I didn't like the main guy who was in charge of radiation oncology...... I see the following doctors every four months: Colo-rectal surgeon for exams, chemo oncologist because she keeps on top of scans that need to be done periodically, a Gynocologist Oncologist, and my General Practitioner. I think this is quite enough doctors to be seeing, and never saw the point in going back to the radiation oncologist since they said if the cancer came back, I would not be getting radiation for it ............. Other than checking the lymph nodes in my groin and abdomen, no doctors other then the Colo-rectal surgeon and the Gynocologist Oncologist ever do any kind of exams.........

  • AZANNIE
    AZANNIE Member Posts: 445 Member
    #5
    Exams

    I think I had one follow up exam with radiation oncologist and didn't like his attitude. My oncologist knew my feelings about the radiation oncologist and said I didn't need to see him anymore so I didn't. My colorectal dr does the exams. I still see medical oncologist but he leaves the exams to CR dr.

    Ann

  • z
    z Member Posts: 1,414 Member
    #6
    magillilnb said:

    RoseC

    I think my radiation oncologist probably has experience, but his turn is over, and the colorectal surgeon is who is helping me now. I think he has ego issues or there's something more sinister going on, and I don't want to entertain either possibility.

    I'm glad you're happy with your colorectal surgeon, too.

     

    magillilnb

    Wonder if we had the same radiologist, sounds just like mine.  He hurt me in the beginning of my tx and wanted to examine me after tx, I couldn't let him finish it hurt so bad.  I never went back. 

    I had a correctol surgeon (professor) at a teaching hospital and he was wonderful, he used his pinky.  My oncologist was very gently also.  I trusted my correctol surgeon and my oncologist.  Now I have been released from the correctol surgeon after 2 years post tx in 2011.  Now I have my gyno feel and I trust him as his PA is the one who found it and said it wasn't a hemroid.  I will go to my 3 year colonoscopy in 2015.  So thats how I get the area checked my gyno and my colonoscopy.  I wish you well. Lori

  • mxperry220
    mxperry220 Member Posts: 496 Member
    #7
    Radiation Oncologist

    If I remember correctly I saw my radiation oncologist for 1 year after treatments every 90 days as welll as my colon rectal surgeon.  He did a digital rectal exam each time.  I am  5 years 3 months post treatement and am seeing my colon rectal surgeon annually.

  • mp327
    mp327 Member Posts: 4,440 Member
    #8
    mxperry220 said:

    Radiation Oncologist

    If I remember correctly I saw my radiation oncologist for 1 year after treatments every 90 days as welll as my colon rectal surgeon.  He did a digital rectal exam each time.  I am  5 years 3 months post treatement and am seeing my colon rectal surgeon annually.

    Exams

    My colorectal doctor did rectal exams on me every 3 months for the first 4 years, then every 6 months after that, which is still my schedule.  My rad onc did them on me every 3 months or so for about a year and a half after treatment, then released me from his care.  My med onc has never done a rectal exam on me.

  • jcruz
    jcruz Member Posts: 379 Member
    #9
    exams

    My rad onc does an exam each time I see her, usually just rectal but sometimes vaginal.  My surgeon has done few exams except when I've been under anesthesia for follow-up biopsies.  He's quite concerned about hurting me.  And his hands are much bigger than my rad onc's.  I'm fine with her doing the exams every 3-6 months (I'm now 18 months post-tx)  I have a PET scan this Tuesday and will see her on Friday (I'm trying to prepare for a few moments of "discomfort") and then the med onc the following week.  The med onc has never examined me except to listen to my heart.  

  • magillilnb
    magillilnb Member Posts: 39 Member
    #10
    Lori, Ann, mxperry, MP, and jcruz

    Thanks for sharing your experiences.  

    I have to get another test on Tuesday...gastografin enema...which I am really looking forward to.  Who wouldn't want a balloon with liquid in her ****??? It's to determine if the fistula has healed itself and I can get the colostomy reversed. I meet with the colorectal surgeon afterwards and will ask her if she thinks I need to continue seeing the rad oncologist.  If she thinks it's important, I'll ask her who she would recommend.  And I'll let her know my current doc is not an option. 

    More news as it happens.

    Nancy

  • eihtak
    eihtak Member Posts: 1,473 Member
    #11
    magillilnb said:

    Lori, Ann, mxperry, MP, and jcruz

    Thanks for sharing your experiences.  

    I have to get another test on Tuesday...gastografin enema...which I am really looking forward to.  Who wouldn't want a balloon with liquid in her ****??? It's to determine if the fistula has healed itself and I can get the colostomy reversed. I meet with the colorectal surgeon afterwards and will ask her if she thinks I need to continue seeing the rad oncologist.  If she thinks it's important, I'll ask her who she would recommend.  And I'll let her know my current doc is not an option. 

    More news as it happens.

    Nancy

    magillilnb....

    Hi, I think you are on the right track. My ostomy was originally to be reversed and although I had no complaints about my radiation doctor, she had done her job and it was over. I saw a specialist at a larger medical center about reversal (as I live in a rural area) and the damage to the sphincter area was extreme. He was in contact with a colorectal doctor in my area and recommended waiting a bit longer than originally planned in hopes for a better outcome. Six months, a year, year and a half, and at two years both colo rectal and specialist agreed that a reversal in itself may work but I would most likely not have any control and be incontinent of my bowels.

    I am 3 yrs post treatment now and have adjusted well. I am in a couple support groups and have met several people that have had very successful reversals. I will keep you in my thoughts as you get through all the necessary tests and surgery and hope you are on your way to successful healing!!

    (sounds like your radiation onc may need a refresher course on communication skills)

    katheryn 

  • magillilnb
    magillilnb Member Posts: 39 Member
    #12
    eihtak said:

    magillilnb....

    Hi, I think you are on the right track. My ostomy was originally to be reversed and although I had no complaints about my radiation doctor, she had done her job and it was over. I saw a specialist at a larger medical center about reversal (as I live in a rural area) and the damage to the sphincter area was extreme. He was in contact with a colorectal doctor in my area and recommended waiting a bit longer than originally planned in hopes for a better outcome. Six months, a year, year and a half, and at two years both colo rectal and specialist agreed that a reversal in itself may work but I would most likely not have any control and be incontinent of my bowels.

    I am 3 yrs post treatment now and have adjusted well. I am in a couple support groups and have met several people that have had very successful reversals. I will keep you in my thoughts as you get through all the necessary tests and surgery and hope you are on your way to successful healing!!

    (sounds like your radiation onc may need a refresher course on communication skills)

    katheryn 

    Katheryn

    I'm sorry you were not able to reverse your colostomy. I knew if I were told I couldn't have a reversal, that I would have been very disappointed, but I also knew I would deal with it. Cancer (and I guess any major illness or trauma) teaches you that you have to do what you need to do to keep going forward. 

    The "balloon" was not used on me.  I had told the tech that I'd had radiation and was worried that it would hurt with the apparatus.  He talked to the doctor, and they ended up using a much smaller device without the balloon. It didn't hurt at all, and I did not have leakage all day as they had warned. All the dye went straight into my bag and they didn't see any evidence of a fistula. So, it did heal itself even with radiation!  I was so glad, and my colorectal surgeon hugged me she was so happy to give some good news for a change.  She is doing the reveral on 4/20. She warned me that it would be possible that because of scar tissue (I think that's what she said) I might have to have another colostomy for a few months. I really trust and like this woman and have great confidence in her, so I know whatever happens, she's done her best.

    We also discussed my needing to return to the rad onc for exams, and she said it wasn't necessary that he examine me, as long as someone did. She said it was important to continue using the dilator. So I'll continue seeing her for my exams and the med onc for my PET scans. 

    Nancy

     

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