Wanting to find a reason to chicken out of anoscope
Hi, I am scheduled for what I think is “regular“ anoscope as opposed to the high resolution anoscope procedure I’ve been reading about. I live near Kansas City. Should I cancel the regular scope and try to find a provider who does the high resolution type? Cancer was large but had not spread to any nodes, CT was good in July. I finished treatment in January 2016. Do you guys get anal Pap tests too? The high resolution test can identify dysphasia by using a weak acid and the bad cells turn white? Is this even included in a regular scope that doesn’t hav high resolution?Or is this just me getting chicke and wanting to avoid tests?
Comments
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Just say "no".
Hello, Mollymaude. If you don't want a procedure done or don't want the person scheduled to do it, just say, "No". Medical care is just like any other consumer service where you pick what's done to your body. If you can find a provider to do as you wish, go for it!
My local colorectal surgeon didn't do an anal pap until I specifically asked him to. I am being treated by Memorial Sloan Kettering Cancer Center in NYC, mainly because I can't abide the local MDs' provincial attitudes.
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Thanks ouch
Thanks Ouch, it is good to be reminded of that. I will ask for anal pap. I did end up canceling my scope for tomorrow and feel relieved. I will wait for more feedback from this site on high resolution anoscope vs regular before I reschedule or look for a provider who does high resolution anoscope.
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I don't know about high
I don't know about high resolution vs regulations and scope, but I didn't find it painful. Just relatively minor discomfort. It was easier than expected. If you can find a good provider , preferably high resolution, it might be a good additional monitoring tool.
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Molly Maude
I've never had an HRA or an anal pap; neither are mentionned in the NCCN Guiudelines, although I think in some places (ie dysplasia clinics at UCSF and other places they are performed) Some of the women that post at Blogforacure.org (the anal cancer forum have had HRA; I believe that they sought them out on their own and it was not prescribed by their doctors.
https://www.analcancerfoundation.org/ the foundation has information on anascopies and a list of Drs who perform them. I have found one or two articles these procedures and the pros and cons of using them for screening.
Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia Kevin C. Long, MD1 Raman Menon, MD1 Amir Bastawrous, MD1 Richard Billingham, MD1 1 Swedish Colon and Rectal Clinic, Swedish Medical Center Department of Surgery, Seattle, Washington Clin Colon Rectal Surg 2016;29:57–64. Address for correspondence Kevin C. Long, MD, Swedish Colon and Rectal Clinic, Swedish Medical Center Department of Surgery, Seattle, Washington Clin Colon Rectal Surg 2016;29:57–64. Address for correspondence Kevin C. Long, MD, Swedish Colon and Rectal Clinic, 1101 Madison Street, Suite 510, Seattle, WA 98104 (e-mail: kevin.long@swedish.org).
Clin Colon Rectal Surg. 2016 Mar;29(1):5764. doi: 10.1055/s00351570394. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia. Long KC , Menon R , Bastawrous A , Billingham R . Abstract The prevalence of anal intraepithelial neoplasia has been increasing, especially in highrisk patients, including men who have sex with men, human immunodeficiency virus positive patients, and those who are immunosuppressed. Several studies with longterm followup have suggested that rate of progression from highgrade squamous intraepithelial lesions to invasive anal cancer is ∼ 5%. This number is considerably higher for those at high risk. Anal cytology has been used to attempt to screen highrisk patients for disease; however, it has been shown to have very little correlation to actual histology. Patients with lesions should undergo history and physical exam including digital rectal exam and standard anoscopy. Highresolution anoscopy can be considered as well, although it is of questionable time and costeffectiveness. Nonoperative treatments include expectant surveillance and topical imiquimod or 5fluorouracil. Operative therapies include wide local excision and targeted ablation with electrocautery, infrared coagulation, or cryotherapy. Recurrence rates remain high regardless of treatment delivered and surveillance is paramount, although optimal surveillance regimens have yet to be established. anal intraepithelial neoplasia; carcinoma; human papillomavirus
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Thank you
Thanks for everyone’s feedback. I did end canceling my scope but I think it was more that I was just too stressed with other things to have the stress/anxiety of a scope when it was scheduled. I felt so relieved after I canceled it so I knew that’s what it was more than questioning which scope I should get. I waited a week and now have a call in to get it rescheduled. Thanks again for the replies, it put me more at ease.
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