Perianal Invasive Squamosh Cell Carcinoma - Re-Excision or Chemo/Radiation Therapy

Lovekitties said:

Hi Fran

I would want to discuss this with the surgeon.  There must have been a reason for not getting clean margins with the first surgery.

The size of the tumor, while important, is not the only determiner on what can be done during surgery.  The location is also important.  If in order to get clear margins, they have to take what amounts to significant tissue, the need for a colostomy can occur.

Did you and your surgeon discuss the possibility of a colostomy before the surgery? 

I had the choice of chemo/radiation prior to surgery to shrink the tumor to try to avoid a colostomy.  I chose the surgery as that was the only "sure bet" to get everything that was needed to be gotten.  Not a recommendation, just sharing my choice.

I have had a colostomy for 6 years and am doing ok.  Definately something to get used to, but very managable.

See what your surgeon has to say on the subject and go from there.

Wishing you the best,

Marie who loves kitties

The Surgeon stated "I have never seen anything like this before, but, I am going to treat it as cancer and do a biopsy." He removed the entire tumor, although, did not remove to the healthy Perianal skin margin. The biopsy is in the size of an oval to the right of the line, if this makes sense. There is plenty of skin that could have been removed. He's a young surgeon. I don't think he was aware to biopsy to the healthy Perianal skin margin. The Surgeon never discussed colostomy. 

So, now, I still have SCC on the radial margin. I am not even sure how much SSC is still on the Perianal skin. I see the radiologist for the first time, next week. I am not sure, if she can tell me how much SSC is still there. 

The Onocologist said my PET/CT scan shows I am a very healthy woman inside.  I am now concerned with chemo/radiation, I will now become somewhat unhealthy from side effects. 

Thank you so much for responding and for reading my message. It's really appreciated. 

Sincerely, 

Fran

John23 said:

Second opinions!!

Second opinions!!

You are entitled to a second (and more) opinions from physicians.

The second opinion(s) should come from colorectal surgeons that ARE NOT of the same group or organization.

Radiation radiates; it does not "stop" at the target cells. Surrounding cells, and those in front of and behind the target are damaged. Any damaged cell can become a cancer cell if you are prone to cancer. Muscle and bone damage occurs and neither are redeemable once damaged by radiation. You may read "good reports" here, but those without after effects from radiation therapy are far and few between.

Although chemical therapy may or may not be of value (it can not target specific bad cells without damaging good cells), surgical removal of cancer is always the preferred way.

Please take your time and get another opinion from a decent colorectal surgeon? Ask nurses and staff for their opinion regarding "good surgeons"; they see patients before and after treatment and can offer a decent objective opinion regarding physicians.

Whatever you do from this point on is going to be life-changing. Take your time and try to learn as much as you can.

Oh..... and having an Ostomy isn't the "end of the world". It's a life-changing event, but not one that is as damaging as one may feel prior to having one. I have had an Ileostomy since 2006, and others here will tell you that it's quite livable and easily adjusted to.

The most important thing right now, is to get that cancer out of your body. You can address containment or any further fight against cancer by any other means later.

Get another opinion or three ASAP. And not from surgeons of the same group or organization; go out of town if you have to!

Good luck and best wishes for best health!

John

Thank you for replying to my message. I will make sure to get second and third opinions and not from the same group of physicians. Your message is greatly appreciated. 

Sincerely,

Fran

beaumontdave said:

Hammer it Fran, you can read

Hammer it Fran, you can read the down side of not being aggressive all over this blog, this stuff is unforgiving, luck to you ..............................Dave

Hello, Thank you the message. I plan to hammer it, although, most people on this blog have anal canal cancer, which I do not have, I have Perianal Squamosh Cell Carcinoma in the outer margin area, which is quite different than anal canal cancer. My PET/CT came back clean. No cancer anywhere inside my body. I do realize that the SCC can travel inside my body, if I'm not careful. 

I just want to make sure I'm having the correct treatment for my situation. My tumor size was a 0.4 cm, which I am happy was caught early enough in the game. 

Sincerely, 

Fran

John23 said:

Squamous Cell Carcinoma of the Anal Margin

 

Squamous Cell Carcinoma of the Anal Margin

Re:
“most people on this blog have anal canal cancer, which I do not have”

The say that “if it walks like a duck and quacks like a duck.....”

http://www.cancernetwork.com/review-article/squamous-cell-carcinoma-anal-margin-1

It's close enough for jazz... And nothing that should be addressed without all consideration to future ramifications. Anal cancer scares the hell out of me, not that it needs to scare anyone more than any other cancer; it is what it is.

The best thing to do, is get it out of your body. Surgery is the best way to do that, regardless of having a colostomy, Ileostomy or not. The inconvenience of having an Ostomy is far outweighed by the worry of some other therapy not working as well as they told you it would.

Get other colorectal surgeon's opinions. The Oncologist can wait.

Best hopes for you!

John

 

 

 

Hello, Thank you for the article. It was of great help. I have placed a call to my primary asking for a second opinion. 

I hope life is treating you well. Thank you again for all your suggestions.

Sincerely, 

Fran