Anal cancer not cured with chemotherapy and radiation. Desperate to find alternative to colostomy

Thank you for taking the time to read our story.

My husband is 51-years old and was diagnosed in November with anal cancer stage IIIA.  There was cancer in one lymph node.  He underwent about 35 radiation treatments and chemotherapy 24/7 for two weeks of 5-FU and Mitomycin.  Follow-up scan post-treatment demonstrates no spread through the abdomen or pelvis and the lymph node was clear.  A mass remains, decreased in size by approximately 1.0 cm.  Treatment recommended is surgery to remove anal canal with placement of colostomy followed by another round of radiation.  I am desperate to find an alternative to the colostomy and I am hoping someone out there might have some helpful information.  I have searched tirelessly but despite all of my research and dedication to understanding his disease, most of the information I come across with respect to clinical trials is so overwhelmingly complicated. 

Thank you again.  Any information is helpful and very appreciated.

Comments

  • mp327
    mp327 Member Posts: 4,440 Member
    Fighting_4_Mike

    I'm very sorry to hear of your husband's diagnosis and residual tumor.  I can certainly understand your desire to find a treatment alternative to the colostomy.  Unfortunately, that is the standard procedure when there is a recurrence or residual tumor and I am unaware of any other options.  However, I have not researched current clinical trials.  In your husband's situation, I would probably contact Dr. Eng at MD Anderson in Houston, Dr. Berry at University of California San Francisco, or Dr. Martin Weiser at Memorial Sloan Kettering. 

    My heart goes out to your husband and you.  I can only imagine how difficult this is.  I hope you'll keep us posted. 

  • Fighting_4_Mike
    Fighting_4_Mike Member Posts: 2
    mp327 said:

    Fighting_4_Mike

    I'm very sorry to hear of your husband's diagnosis and residual tumor.  I can certainly understand your desire to find a treatment alternative to the colostomy.  Unfortunately, that is the standard procedure when there is a recurrence or residual tumor and I am unaware of any other options.  However, I have not researched current clinical trials.  In your husband's situation, I would probably contact Dr. Eng at MD Anderson in Houston, Dr. Berry at University of California San Francisco, or Dr. Martin Weiser at Memorial Sloan Kettering. 

    My heart goes out to your husband and you.  I can only imagine how difficult this is.  I hope you'll keep us posted. 

    Thank you so much for your

    Thank you so much for your feedback.  You are absolutely correct, surgery seems to be the only option but he is having a hard time accepting that and I want to make sure I leave no stone unturned.  I will absolutely check out the treatment centers you listed.  Thank you so much for replying. I am new to this website but I am quickly learning it's almost like a family of patients and caregivers.  Thanks again and take care.

  • pializ
    pializ Member Posts: 508 Member

    Thank you so much for your

    Thank you so much for your feedback.  You are absolutely correct, surgery seems to be the only option but he is having a hard time accepting that and I want to make sure I leave no stone unturned.  I will absolutely check out the treatment centers you listed.  Thank you so much for replying. I am new to this website but I am quickly learning it's almost like a family of patients and caregivers.  Thanks again and take care.

    Hi there! 

    I am sorry about your situation. It's not what any of us want to hear. I understand that a colostomy is the next stage if the chemo radiotherapy has only partially worked. However, I also understand that radiotherapy continues to work for about 6 months, & that it is after this time that a colostomy would be performed. If that is necessary for your husbands survival, there are a couple of people at least here who would be of support I am sure. I think you will find a colostomy group on this site. 

    Again, I am sorry that you are both in this situation, but  the statistics indicate a good success rate with salvage surgery. 

    Best wishes

    Liz 

     

  • z
    z Member Posts: 1,414 Member
    Fighting4Mike

    Hello, Im sorry for the residual tumor.  I agree with both Martha and Liz comments.  I was wondering if an additional biopsy had been done on the residual tumor?  I would certainly have a second opinion from the experts in anal cancer.  I wish you and your husband well. Lori

  • sandysp
    sandysp Member Posts: 868 Member
    Second opinion

    At MSKCC where I was treated, they were very cautious since the scar tissue resembles the tumor so closely. So I would definitely recommend a second opinion and like the suggestion of a biopsy, if possible. But maybe another scan and another doctor reading the scan. I was told that three oncologists had to approve my scan before they declared the mass that remained to be scar tissue.

    Good luck,

    Sandy

  • eihtak
    eihtak Member Posts: 1,473 Member
    Hi......

    You are wise to "turn over those stones" ........ and even if the outcome is the same you will not feel as you didn't do all you could.  I agree with the advice given in that another opinion is in order and that the radiation will be continuing to "cook" for a while yet.

    I was stage 3b with lymph node involvement about 3yrs ago. I had a received a colostomy in the days prior to starting chemo/radiation and it was initially to be reversed within a year after. Unfortunately the radiation caused so much damage to the sphincter that reversal was not an option and it is now permanent. I won't get into ostomy issues at this time as it may not be your husbands path after all, but.....take some comfort in knowing that after a period of adjustment it is not even half as bad as whatever you may be imagining in your mind. I am healthy now, active, swim, do yoga, and back in college at 55yrs old. There are many helpful support groups to help with managing any concerns that may arise, (but lets cross that bridge ONLY if necessary).

    It is wise to be prepared, and a reality that with recurrance and certain locations of tumor/stage that your options are limited, but as said earlier, do try to get at least another opinion first.

    katheryn

  • lp1964
    lp1964 Member Posts: 1,239 Member
    Dear Friend,

    I am a 49 year old male with rectal cancer after radiation, chemo, surgery and permanent colostomy. When my cancer was removed 10 weeks after the end of radiation, there were no living cancer cells in the specimen. The radiation and the chemo destroyed them all. I read it in many places that you should wait at least 10 weeks after radiation. On my MRI it looked like nothing changed, but all the cancer was dead. Anal cancer usually responds even better. Get biopsies and other opinions, before deciding about surgery and don't let yourself pressured early into it. I am young, recently married and a colostomy is not the end of the world if it has to be. Life is precious in any shape and form.

    Laz

  • magillilnb
    magillilnb Member Posts: 39 Member
    Fighting_4_Mike

    I had a very large tumor from squamous cell carcinoma of the anus which had created a fistula in my vagina, and it was greatly reduced by a chemo clinical trial called TIP. Can you ask if this would be an option for your husband?  My med oncologist suggested it and both the colorectal surgeon and rad oncologist were pleasantly surprised by how it worked for me. After the TIP reduced the size, the regular chemo and radiation got rid of it completely, and I am scheduled to have my colostomy reversed this week. There may be other trials that he might benefit from, too. 

    http://www.hindawi.com/journals/cherp/2011/163736/

    http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Combinationregimen/TIP.aspx

  • StruTanToot
    StruTanToot Member Posts: 126 Member
    I'm so very terrified of

    I'm so very terrified of recurrence and came across this info. The original link was posted by Martha.

     

    http://www.advaxis.com/news/detail/194/advaxis-announces-phase-12-trial-of-adxs-hpv-in-anal

  • Helen321
    Helen321 Member Posts: 1,459 Member
    As a person who has had the

    As a person who has had the surgery (my rectal cancer was on top of my anus), I wish I could tell you an alternative but I can't and so I will tell you this.  . . Life doesn't stop because you have a colostomy, life does stop if you don't stop the cancer.  One year out of the surgery, I am happy, healthy and living my life as I normally would.  It's just something you get used to.  At first, it's depressing.  The first week home you want to rip the bag off and you spend a lot of time feeling sorry for yourself, then you go through a period of depression.   Then one day, you go outside, you realize hey I'm okay, I'm alive, I'm out having a good time and no one knows and life moves on.  It took me three months to get to this point.   I don't even think about the bag anymore.  Through experimentation with different bags and accessories, I've mastered the necessary supplies to make life function (there are two piece bags that are easy peasy, they let you just change and go).  The only problem I am having is pain when I sit.  My job requires me to sit a lot and things are very painful sometimes due to over sitting.  I hear it takes five years for it to go away and sometimes it doesn't go away.  Your husband is going to be fine.  Don't beat yourself up overthinking it.  The best part is, he'll be here so you can see him and touch him.  That's what counts, not how he poops.

  • eihtak
    eihtak Member Posts: 1,473 Member
    Helen321 said:

    As a person who has had the

    As a person who has had the surgery (my rectal cancer was on top of my anus), I wish I could tell you an alternative but I can't and so I will tell you this.  . . Life doesn't stop because you have a colostomy, life does stop if you don't stop the cancer.  One year out of the surgery, I am happy, healthy and living my life as I normally would.  It's just something you get used to.  At first, it's depressing.  The first week home you want to rip the bag off and you spend a lot of time feeling sorry for yourself, then you go through a period of depression.   Then one day, you go outside, you realize hey I'm okay, I'm alive, I'm out having a good time and no one knows and life moves on.  It took me three months to get to this point.   I don't even think about the bag anymore.  Through experimentation with different bags and accessories, I've mastered the necessary supplies to make life function (there are two piece bags that are easy peasy, they let you just change and go).  The only problem I am having is pain when I sit.  My job requires me to sit a lot and things are very painful sometimes due to over sitting.  I hear it takes five years for it to go away and sometimes it doesn't go away.  Your husband is going to be fine.  Don't beat yourself up overthinking it.  The best part is, he'll be here so you can see him and touch him.  That's what counts, not how he poops.

    Helen321.....

    Hi, I don't remember seeing an earlier post from you so if I missed it sorry! Welcome, it sounds as though you are doing well. I also have a colostomy (3yrs now) and agree......easy peasy, and life does go on once you let it!

    There is an adjustment period, and some people deal with related issues that make that more difficult, but I too am fortunate to be doing well and living an active healthy life. Until you are living with an ostomy though it is really hard to wrap your head around the whole idea since we have been programmed since birth to learn one way to poop! Lol Glad to hear from you and I wish you continued health.

    Oh, I often still sit on a soft pillow btw.

    katheryn

  • Helen321
    Helen321 Member Posts: 1,459 Member
    eihtak said:

    Helen321.....

    Hi, I don't remember seeing an earlier post from you so if I missed it sorry! Welcome, it sounds as though you are doing well. I also have a colostomy (3yrs now) and agree......easy peasy, and life does go on once you let it!

    There is an adjustment period, and some people deal with related issues that make that more difficult, but I too am fortunate to be doing well and living an active healthy life. Until you are living with an ostomy though it is really hard to wrap your head around the whole idea since we have been programmed since birth to learn one way to poop! Lol Glad to hear from you and I wish you continued health.

    Oh, I often still sit on a soft pillow btw.

    katheryn

    Hi Katheryn. I am from the

    Hi Katheryn. I am from the colorectal board since I had rectal cancer but I cross over to the anal and gynelogical boards because most colorectals don't end up with colostomies.  The gyno boards are great for vaginal issues from radiation.  My rectal tumor was right on top of the anus so I lost the whole area.  My turning point was when I switched to a two piece system and now the discovery of barrier strips. Food is still an issue but things are getting better. Slowly I'm adding back fiberous foods. A year ago I never thought I'd be in such a good place.

     

    Thanks for the welcome! 

  • eihtak
    eihtak Member Posts: 1,473 Member
    Helen321 said:

    Hi Katheryn. I am from the

    Hi Katheryn. I am from the colorectal board since I had rectal cancer but I cross over to the anal and gynelogical boards because most colorectals don't end up with colostomies.  The gyno boards are great for vaginal issues from radiation.  My rectal tumor was right on top of the anus so I lost the whole area.  My turning point was when I switched to a two piece system and now the discovery of barrier strips. Food is still an issue but things are getting better. Slowly I'm adding back fiberous foods. A year ago I never thought I'd be in such a good place.

     

    Thanks for the welcome! 

    Helen321.....

    Hi, you are wise to float between boards to get well rounded advice. I also read posts on other sites, but seldom post. I was treated for breast cancer as well so post occasionally there.

    A helpful site for people with ostomies is   C3Life   there are links to manufactureres for free samples and some really great and encouraging people that post there. I do attend an ostomy support group in person and it is so helpful to be part of a group of people who I can talk to face to face in the same boat as I. Also the UOAA (United Ostomy Association of America) holds meetings all over the country and has some great on-line support too. I usually use a two piece system as well and LOVE the barrier strips from Coloplast. They, Coloplast, just came out with a new system this late spring called MIO and the wafer is very much like the strips......I just sent for a sample but have used the smaller "cap" version before.

    What I eat seems often not as much an issue as when I eat, although there are some foods I avoid. I have always followed a somewhat disciplined diet anyhow so now use that same philosophy to control my output as not to disrupt my day too much.

    Clothing is the thing that frustrates me the most I think, as I have also had a double mastectomy with no reconstruction.....thankfully I am creative!

    Hope this post was not too "off topic" for others but we all have similar yet unique concerns.

    katheryn 

  • I_am_blessed
    I_am_blessed Member Posts: 2
    Fighting for Mike

    I am so sorry to hear of your husbands response to his treatment. I just recently completed my chemo and radiation for anal cancer. So far the outcome has been good. I want to stress to you how fortunate your husband is to have you as his mate. My fiance didn't make it thru my treatments, life happens. I make it thru the day by counting my blessings no matter how small. I too have worried about a colostomy. In conversations with my team of doctors they at this point consider a colostomy to be the only viable alternative. I'm 59 years old and when I start to feel sorry for myself, I think about the children who are dealing with cancer. They haven't had a real chance at life. It is a real reality check for me!

     I hope your husband is able to realize his life won't end because of a colostomy. He will still have you, family and friends.  He will get thru it, he is truly blessed to have you fighting for him. I must confess I envy that. Good luck and take care. Smile