Newly diagnosed
Hi All,
I am a female in my early 50's just given a definitive diagnosis of anal cancer. I had surgery this past Monday to remove a mass that showed pre-cancerous( in Situ) cells from a colonscopy biopsy done in early Dec. My surgeon was unable to remove the entire tumor due to deepness and sphincter invlovement and he just called me yesterday with the news that it is indeed cancer and also sent my pathology report to me( which is scary as I really don't know the implication of some of the findings). I had intital contact with my oncology case manager a couple of hours after the surgeon called and he(an RN) will be setting up a lot of appts for tests for me to complete next week to stage the cancer and plan my treatment.
I am just looking for support as I go through this process and sudden ( within a month over the holidays!) diagnosis of thinking I had a bad hemi to being diagnosed with cancer. I am dealing with my family, my job and my friends along with trying to wrap my head around this and be strong and plan for the treatment.
I know that a lot of you are long time survivors and thrivers of this terrible disease and I am encouraged by your courage and treatment outcomes.
I am scared to death of the side effects of treatment not only physically but the emotionl toll too. I am a take charge, fairly type-A person and this has indeed, rocked my world!
Thank you and I look forward to hearing your stories and sharing mine.
K
Comments
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Kat7
I am so sorry that your diagnosis has brought you here, but I promise you that you are among friends and people who can understand like no one else what you are about to go through. I am nearing 6 1/2 years post-treatment and I hope that gives you lots of encouragement. This disease, although considered rare, has high rates of successful treatment, so you have every reason to be hopeful that you will beat this disease! It sounds like it's been caught early, which is definitely in your favor. I know you are shell-shocked by your diagnosis, just as I was when I was told I had cancer, and it's easy to see nothing but doom, but believe me, you can and will get through this.
It sounds like your medical team is getting right on this and working quickly to get you staged and ready for treatment. It took 6 weeks from the time of my diagnosis until I began treatment and it seemed like an eternity. I hope that won't be the case for you.
I'm glad you are reaching out for support. I did not have the benefit of this site or any others when I went through treatment and it was both scary and lonely! We are here for you! This is a great group of people who often have more useful information than what you'll get from doctors and nurses. We've talked about most things related to this disease and there's no holding back here if something needs to be discussed, even if your real-life support team of family and friends don't wish to hear such things. Ask us whatever questions you may have and someone will most likely know the answer!
Treatment, as you probably already know, can be challenging but you will get through it. Staying well-hyrated and taking meds to stay ahead of any pain are key to making this ordeal as least traumatic as possible. Of course, there are lots of other things and we will help you through all of that. You mention that you are a take charge kind of person, which is not a bad thing. You must be able to speak up and demand answers from your medical team if they are not forthcoming with them, as some people experience. I was fortunate in that I've not had to deal with that. Putting my life in others' hands was difficult for me, but I trusted all of my doctors and they always paid attention to my needs and answered my questions. I hope you'll be in good hands!
Please keep us posted on how all of your staging goes and when you might begin treatment. I'm sorry you have to be here, but I think you'll find great support. Take care.
Martha
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Kat7.....
Hi, I won't repeat everything that Martha just said but they are my feelings as well. I recently had my 4 yr post treatment follow-up scan and am still waiting on results but have every reason to believe they will be good (as they have thus far). Prior to, during, and in the months following treatment it was tough.....but I made it, and I bet you will as well. I am now active, back in college at 56yrs old, and actually feel healthier than I have for many years.
As you proceed we will help with tips of hopefully helpful advice that have worked for all of us to make this ordeal more tollerable, but lets wait till needed!
One of the hardest things for me was that I had no one that could relate to this specific cancer, and although they offered support it was such a personal area and really would have loved to have this forum to turn to, but I did not find it until after.....I'm glad you have us now!
I will have you in my thoughts as you move forward.
katheryn
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Kat7
Welcome to our supportive family. I personally feel blessed that I found this forum because this diagnosis is a roller coaster. It goes by quickly, but seems to take forever to get going. I am a year (almost to the day) out from finishing treatment. And that is hard to believe!
You will get through this and we will help.
Sending a virutal hug and strength to you as you navigate through setting up your treatment plan.
Judy
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Greetings, Kat7!mp327 said:Kat7
I am so sorry that your diagnosis has brought you here, but I promise you that you are among friends and people who can understand like no one else what you are about to go through. I am nearing 6 1/2 years post-treatment and I hope that gives you lots of encouragement. This disease, although considered rare, has high rates of successful treatment, so you have every reason to be hopeful that you will beat this disease! It sounds like it's been caught early, which is definitely in your favor. I know you are shell-shocked by your diagnosis, just as I was when I was told I had cancer, and it's easy to see nothing but doom, but believe me, you can and will get through this.
It sounds like your medical team is getting right on this and working quickly to get you staged and ready for treatment. It took 6 weeks from the time of my diagnosis until I began treatment and it seemed like an eternity. I hope that won't be the case for you.
I'm glad you are reaching out for support. I did not have the benefit of this site or any others when I went through treatment and it was both scary and lonely! We are here for you! This is a great group of people who often have more useful information than what you'll get from doctors and nurses. We've talked about most things related to this disease and there's no holding back here if something needs to be discussed, even if your real-life support team of family and friends don't wish to hear such things. Ask us whatever questions you may have and someone will most likely know the answer!
Treatment, as you probably already know, can be challenging but you will get through it. Staying well-hyrated and taking meds to stay ahead of any pain are key to making this ordeal as least traumatic as possible. Of course, there are lots of other things and we will help you through all of that. You mention that you are a take charge kind of person, which is not a bad thing. You must be able to speak up and demand answers from your medical team if they are not forthcoming with them, as some people experience. I was fortunate in that I've not had to deal with that. Putting my life in others' hands was difficult for me, but I trusted all of my doctors and they always paid attention to my needs and answered my questions. I hope you'll be in good hands!
Please keep us posted on how all of your staging goes and when you might begin treatment. I'm sorry you have to be here, but I think you'll find great support. Take care.
Martha
Hello, Kat7. I am sorry that you had to take a crash course in anal cancer. However, I'm glad that you will be able to take advantage of this extremely helpful forum during your treatment and receive comfort from the members as you go along. I didn't find it until after my treatment was finished.
mp327 is oh, so right with what she says about speaking up and demanding information. From my years as an RN, I assure you that it's sad, but true, that the squeaky wheel gets the grease. You are your own best advocate.
mp327 is also right about staying ahead of the pain. Don't wait until you are suffering before medicating yourself - it's much harder to control that way. If the pain meds are inadequate to the task, speak up about that, too. The same goes for nausea - medicate well before you are wretching. If you wait, it's too late.
You can ask us anything. We are not prissy or squeemish discussing the cancer, biology, treatments, or aftermath. We won't bat an eyelash.
Virtual roses and chocolates to you.
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My biggest blessing wasjudyv3 said:Kat7
Welcome to our supportive family. I personally feel blessed that I found this forum because this diagnosis is a roller coaster. It goes by quickly, but seems to take forever to get going. I am a year (almost to the day) out from finishing treatment. And that is hard to believe!
You will get through this and we will help.
Sending a virutal hug and strength to you as you navigate through setting up your treatment plan.
Judy
My biggest blessing was finding this forum when I was beginning treatment. No kidding, this is one of the best resources for finding the things you need at whatever stage you are in. These folks have been there, done it. If they have not done it they will help you research it and somehow find an answer or where to look for one if at all possible. The past posts on this forum are a plethera of information on just about every part of the journey. I consider myself a newbie but, in the area of the initial treatment now that I have completed it all :chemo/radiation......I think I can chime in now!!!!!
I agree that in the beginning it is so overwhelming and seems like it will never end. But, when it is over it will take a few weeks to realize that it was like a blep on the radar.........and your many of memories will be fuzzy. That might be due to the pain killers and such which you WILL NEED! Don't be like me and try to be stoic thinking I could do without. BIG MISTAKE! This is one time you need to yeild to the little pill or pain patch which ever they give you.
But, most of all there will always be someone here to talk it over with or just share what is going on. Just know......we have been there ......and back!
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Thank you all!
As I saw that I had replies to my post, I began to cry tonight. It means so much to have your knowlegde and support and I thank you all for your encouraging responses and I am blessed to have found you early on. I will post again as I move through the staging and treatment process. I am hoping to be able to begin treatment soon but don’t know about how healed up I might have to be to begin the process as I am only 6 days post-op now.
I do have confidence that I am in the hands of a team that will take care of me and be effective and responsive to my needs, questions, etc. My previous experiences with my HMO, who I have had for 25 years, has been very positive (including a melanoma detection and surgery cure 10 years ago) and they are absolutely some of the best in efficiency and knowledge.Hugs to to all,Kat0 -
Hi Kat,Kat7 said:Thank you all!
As I saw that I had replies to my post, I began to cry tonight. It means so much to have your knowlegde and support and I thank you all for your encouraging responses and I am blessed to have found you early on. I will post again as I move through the staging and treatment process. I am hoping to be able to begin treatment soon but don’t know about how healed up I might have to be to begin the process as I am only 6 days post-op now.
I do have confidence that I am in the hands of a team that will take care of me and be effective and responsive to my needs, questions, etc. My previous experiences with my HMO, who I have had for 25 years, has been very positive (including a melanoma detection and surgery cure 10 years ago) and they are absolutely some of the best in efficiency and knowledge.Hugs to to all,KatI was diagnosed stage 3B anal cancer in April. Do your lab results say squamous cell? that's what my lab showed and, come to find out, as was brought to my attention by one of the angels on here, it responds well to treatment. This won't be a picnic but you can do it. I've had 2 follow ups since treatment ended, and they've been clear!
June
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June0626june said:Hi Kat,
I was diagnosed stage 3B anal cancer in April. Do your lab results say squamous cell? that's what my lab showed and, come to find out, as was brought to my attention by one of the angels on here, it responds well to treatment. This won't be a picnic but you can do it. I've had 2 follow ups since treatment ended, and they've been clear!
June
Hi June,
Yes, it is squamous cell. There is also some mention of lymph tissue space involvement( not the exact words but the jist) in the pathology report and that has me worried. It has been bit of a roller coaster because the first biopsy was diagnosed in situ stage and the thinking was they could excise the tumor and get clear margins but tumor is "deeper than expected" and they can't cut anymore because of sphincter involvment and the margins on what they did excise were not clear. I am praying for early stage but evey pain in my stomach, back, etc. I am, of course, worrying that it's spread. Worrying will not change the outcome and I am trying to find my patience as best I can!
CONGRATS on your clear follow ups, that's wonderful
Kat
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Kat7: staging after the info is in.Kat7 said:June
Hi June,
Yes, it is squamous cell. There is also some mention of lymph tissue space involvement( not the exact words but the jist) in the pathology report and that has me worried. It has been bit of a roller coaster because the first biopsy was diagnosed in situ stage and the thinking was they could excise the tumor and get clear margins but tumor is "deeper than expected" and they can't cut anymore because of sphincter involvment and the margins on what they did excise were not clear. I am praying for early stage but evey pain in my stomach, back, etc. I am, of course, worrying that it's spread. Worrying will not change the outcome and I am trying to find my patience as best I can!
CONGRATS on your clear follow ups, that's wonderful
Kat
There are a number of people on this forum who have been treated for stages III-a, III-b, and even IV, of IV. I was stage III-a for sure due to rectal node involvement, and possibly III-b. (PET scan was mildly suspicious about bilateral inguinal nodes, but they were never biopsied.) Radiation oncologist treated me as though I were stage III-b.
This National Cancer Institute site explains staging: http://www.cancer.gov/cancertopics/pdq/treatment/anal/Patient/page2
Explains the TNM system: http://www.cancer.gov/cancertopics/pdq/treatment/anal/HealthProfessional/page3
So, don't get shook up. (Easy for me to say, right? ) Most people are succesffully treated and continue on.
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An unfortunate welcome to you, Kat7
I, too, was blown away by this diagnosis. I was T2 or 3, N0, M0 (this is how some doctors "stage" this cancer, it is T - turmor size, N - nodes involve, M - metastisis). I am approaching 2 years post treatment. I just had a MRI and it looks good. I have EUA (exam under anesthesia) coming up on Friday.
I did not find this site until after I finished treatment (which I have not decided if that was good or bad) but I have found the information extremely useful and the members very open and caring.
The others have all given you good advice, I would like to add that everyone reacts differently to treatment. Some may have many side-effects and some have fewer and to varying degrees. I did not need pain meds but ate Imodium like they were M&M's. I lost most of my hair, some never lost any. Try not to expect things to happen, deal with them when they do. I you have a question, don't be afraid to ask.
Good luck to you as you begin this process. As it's been said before, this treatment is not easy but it is doable.
Positive thoughts and prayers,
Tracey
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Additional websiteOuch_Ouch_Ouch said:Kat7: staging after the info is in.
There are a number of people on this forum who have been treated for stages III-a, III-b, and even IV, of IV. I was stage III-a for sure due to rectal node involvement, and possibly III-b. (PET scan was mildly suspicious about bilateral inguinal nodes, but they were never biopsied.) Radiation oncologist treated me as though I were stage III-b.
This National Cancer Institute site explains staging: http://www.cancer.gov/cancertopics/pdq/treatment/anal/Patient/page2
Explains the TNM system: http://www.cancer.gov/cancertopics/pdq/treatment/anal/HealthProfessional/page3
So, don't get shook up. (Easy for me to say, right? ) Most people are succesffully treated and continue on.
I would like to add one more website to the two that Ouch has mentioned. The National Comprehensive Cancer Network's website has the most up-to-date protocol for treatment of anal cancer, along with lots of good information on staging, treatment and follow-up. You will need to do a quick registration, but that will allow you access to all of this good information. There website address is:
www.NCCN.org
Martha
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same hereKat7 said:June
Hi June,
Yes, it is squamous cell. There is also some mention of lymph tissue space involvement( not the exact words but the jist) in the pathology report and that has me worried. It has been bit of a roller coaster because the first biopsy was diagnosed in situ stage and the thinking was they could excise the tumor and get clear margins but tumor is "deeper than expected" and they can't cut anymore because of sphincter involvment and the margins on what they did excise were not clear. I am praying for early stage but evey pain in my stomach, back, etc. I am, of course, worrying that it's spread. Worrying will not change the outcome and I am trying to find my patience as best I can!
CONGRATS on your clear follow ups, that's wonderful
Kat
went to doctor for hemi.... missed by this proctologist for a year....finally went to colorectal surgeon and he thought he could excise the whole tumor but stopped because too invasive and he did not want to damage sphincter.... margins not clear also...... had to wait 8 weeks to get to MD anderson because i had to heal up from this huge biopsy.....was staged t2 n0 m0..... i am 5.5 years post tx..... all fine....do take pain meds but be sure you have someone with you that can read instuctions and etc.... i was alone most of the time so did not take meds because needed to be aware.....the only extra advice i give is to ask for Caphosol script for mouth sores.... that is the only thing that worked for me.... i tried the soda water and the pink stuff but did not work for me......keep protein intake high.... you can do this....every one here will help you....sephie
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Kat7TraceyUSA said:An unfortunate welcome to you, Kat7
I, too, was blown away by this diagnosis. I was T2 or 3, N0, M0 (this is how some doctors "stage" this cancer, it is T - turmor size, N - nodes involve, M - metastisis). I am approaching 2 years post treatment. I just had a MRI and it looks good. I have EUA (exam under anesthesia) coming up on Friday.
I did not find this site until after I finished treatment (which I have not decided if that was good or bad) but I have found the information extremely useful and the members very open and caring.
The others have all given you good advice, I would like to add that everyone reacts differently to treatment. Some may have many side-effects and some have fewer and to varying degrees. I did not need pain meds but ate Imodium like they were M&M's. I lost most of my hair, some never lost any. Try not to expect things to happen, deal with them when they do. I you have a question, don't be afraid to ask.
Good luck to you as you begin this process. As it's been said before, this treatment is not easy but it is doable.
Positive thoughts and prayers,
Tracey
Hi Kat,
Being newly diagnosed is an emotional & scarey time. I was lucky enough to find this fabulous site before I started treatment & I am sure that all the advice given made my journey easier. I am almost 2 years out (with a follow up appointment with colorectal surgeon tomorrow).
I browsed previous posts and made note of what had been helpful. It allowed me to make any necessary purchases & also what would be helpful at which stage of treatment.
It'd a tricky time to say the least, but it IS doable. Compared to other cancers, the treatment is of short duration. 6 weeks seems a long time, but think back to what you were doing 6 weeks ago. Doesn't seem so long does it?
Knowledge is power. Inform yourself as best you can, & take it day by day. Any questions, just ask. We are not shy here.
Best wishes
Liz
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Hi again Kat,pializ said:Kat7
Hi Kat,
Being newly diagnosed is an emotional & scarey time. I was lucky enough to find this fabulous site before I started treatment & I am sure that all the advice given made my journey easier. I am almost 2 years out (with a follow up appointment with colorectal surgeon tomorrow).
I browsed previous posts and made note of what had been helpful. It allowed me to make any necessary purchases & also what would be helpful at which stage of treatment.
It'd a tricky time to say the least, but it IS doable. Compared to other cancers, the treatment is of short duration. 6 weeks seems a long time, but think back to what you were doing 6 weeks ago. Doesn't seem so long does it?
Knowledge is power. Inform yourself as best you can, & take it day by day. Any questions, just ask. We are not shy here.
Best wishes
Liz
Liz is rigfht...when you're going through it, it seems that it will never end. I would advise that you just take it a day (no, an hour, a moment) at a time. Enjoy whatever you can because in the midst of the treatment, there will be some goodness. My radiation techs were absolute angels and I grew to love them (even though they were burning my butt!) You will be astounded at the kindness you will receive from unexpected sources. Your perspective will change and any petty and insignificant matters that used to bother you will disappear. So happy you found us!
June
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Martha and allmp327 said:Additional website
I would like to add one more website to the two that Ouch has mentioned. The National Comprehensive Cancer Network's website has the most up-to-date protocol for treatment of anal cancer, along with lots of good information on staging, treatment and follow-up. You will need to do a quick registration, but that will allow you access to all of this good information. There website address is:
www.NCCN.org
Martha
Thank you for your comments and encouragement and information. Being who I am, I of of course, have gathered every bit of info I can find on this cancer over the last month when the first biopsy came back. The NCCN website was one of my first finds and the information is very comprehensive and helpful.
I may have gathered too much information but I am just that type for better or worse ( and definitely for worse at times ). Anyway, I am so happy to have you all here and finding this site is my best info find yet because you have "been there".
I have two appointments set so far for this week besides my follow up with the surgeon: Radiation, CT scan, and I did my blood work on Sat so checking them off the list! Still need the ultrasound and gyn appts and hope those get scheduled soon too. My case manager says we will have them all finished by this week.
Kat
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Kat0626june said:Hi again Kat,
Liz is rigfht...when you're going through it, it seems that it will never end. I would advise that you just take it a day (no, an hour, a moment) at a time. Enjoy whatever you can because in the midst of the treatment, there will be some goodness. My radiation techs were absolute angels and I grew to love them (even though they were burning my butt!) You will be astounded at the kindness you will receive from unexpected sources. Your perspective will change and any petty and insignificant matters that used to bother you will disappear. So happy you found us!
June
I'm glad you are educating yourself on this disease, treatment, etc. I was definitely in the dark about most things when I went through treatment.
I have one more website for you to check out. It's a great one that my friend has. She has compiled all kinds of good information, including how to handle side effects, from her own experience and the experiences of others. The address is:
www.analcancerhelp.info
I hope you'll find lots of good tips there.
I also highly recommend the book "Kicking Cancer in the Butt: Thriving In Spite of Anal Cancer" by Theresa Mayhew, which can be ordered online from Amazon.com.
Martha
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6 weeks or more.pializ said:Kat7
Hi Kat,
Being newly diagnosed is an emotional & scarey time. I was lucky enough to find this fabulous site before I started treatment & I am sure that all the advice given made my journey easier. I am almost 2 years out (with a follow up appointment with colorectal surgeon tomorrow).
I browsed previous posts and made note of what had been helpful. It allowed me to make any necessary purchases & also what would be helpful at which stage of treatment.
It'd a tricky time to say the least, but it IS doable. Compared to other cancers, the treatment is of short duration. 6 weeks seems a long time, but think back to what you were doing 6 weeks ago. Doesn't seem so long does it?
Knowledge is power. Inform yourself as best you can, & take it day by day. Any questions, just ask. We are not shy here.
Best wishes
Liz
pializ wrote: "It'[s] a tricky time to say the least, but it IS doable. Compared to other cancers, the treatment is of short duration. 6 weeks seems a long time, but think back to what you were doing 6 weeks ago. Doesn't seem so long does it?" [6 weeks = ~42 days, including weekends & holidays]
From observation of forum posts here, it seems like the big majority of anal cancer sufferers get throught the six week treatment plan in that six weeks, in spite of nausea, weekness, and radiation burning. I hope that you are able to get through it speedily, also.
However, there are people who have more difficulty. Unfortunately, that is also not unexpected. In my case, I started on April 22nd and finished on July 9th. [= ~78 days, including weekends & holidays] The reasons are because 1.) I was very sensitive to one or both chemo drugs: I quickly developed neutropenc fevers x 3 (therefore three hospitalzations, the last one for 9 days) and 2.) I was in severe pain from the radiation burns of my poor, delicate, gentle, innocent anal tissue (I had to take 3 more breaks in addition to the ones imposed from the hospitalizations).
The main treatment of anal cancer is radiation - doses x ~30 (the chemo supports and enhances the radiation). What counts is the total dose of radiation received, not how fast you get them. Therefore, if you find you must take treatment breaks, don't be concerned; rest, heal, proceed again when you are able. It's not a race!
IMPORTANT TIP: Never put any ointments on the skin of your pelvis, rear end, upper thighs, or into your anus that's not authorized by your radiation oncologist. Some can effect how the radiation enters your tissues.
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slight difference in tx protocolOuch_Ouch_Ouch said:6 weeks or more.
pializ wrote: "It'[s] a tricky time to say the least, but it IS doable. Compared to other cancers, the treatment is of short duration. 6 weeks seems a long time, but think back to what you were doing 6 weeks ago. Doesn't seem so long does it?" [6 weeks = ~42 days, including weekends & holidays]
From observation of forum posts here, it seems like the big majority of anal cancer sufferers get throught the six week treatment plan in that six weeks, in spite of nausea, weekness, and radiation burning. I hope that you are able to get through it speedily, also.
However, there are people who have more difficulty. Unfortunately, that is also not unexpected. In my case, I started on April 22nd and finished on July 9th. [= ~78 days, including weekends & holidays] The reasons are because 1.) I was very sensitive to one or both chemo drugs: I quickly developed neutropenc fevers x 3 (therefore three hospitalzations, the last one for 9 days) and 2.) I was in severe pain from the radiation burns of my poor, delicate, gentle, innocent anal tissue (I had to take 3 more breaks in addition to the ones imposed from the hospitalizations).
The main treatment of anal cancer is radiation - doses x ~30 (the chemo supports and enhances the radiation). What counts is the total dose of radiation received, not how fast you get them. Therefore, if you find you must take treatment breaks, don't be concerned; rest, heal, proceed again when you are able. It's not a race!
IMPORTANT TIP: Never put any ointments on the skin of your pelvis, rear end, upper thighs, or into your anus that's not authorized by your radiation oncologist. Some can effect how the radiation enters your tissues.
just to let you all know..... MD Anderson did say that it matters if we take a break in the radiation..... i was so sick and weak that i was run thru ER to intensive care to regular room..... radiation oncologist came to my room and told me that if i could do it they did not want to take a break on the radiation tx..... they wanted to do it as scheduled in order to be more effective.... i said yes but they had to roll me in to the radiation area on my hospital bed , lift me up on table , and finish the radiation. with both arms hooked to IV's........ so hospitals and docs have different ideas....... thx...sephie
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sephiesephie said:slight difference in tx protocol
just to let you all know..... MD Anderson did say that it matters if we take a break in the radiation..... i was so sick and weak that i was run thru ER to intensive care to regular room..... radiation oncologist came to my room and told me that if i could do it they did not want to take a break on the radiation tx..... they wanted to do it as scheduled in order to be more effective.... i said yes but they had to roll me in to the radiation area on my hospital bed , lift me up on table , and finish the radiation. with both arms hooked to IV's........ so hospitals and docs have different ideas....... thx...sephie
My rad onc offered me a break, but I refused. I wanted to just plow ahead and get it over with.
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slight difference in tx protocolmp327 said:sephie
My rad onc offered me a break, but I refused. I wanted to just plow ahead and get it over with.
as i said , various hospitals and docs have different ideas.... my tx was 2009,,,, one year or so , i think , after yours.... so MD anderson has learned more and more....perhaps now for my stage of cancer and with all the burning of tissue that i had ( really bad after one week), and being in intensive care, they have changed and do not feel the same way about not interrupting the radiation for longer than a weekend..... glad we both have made it this far.... my hope is for others to have info and to know that they can make it through this......sephie
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