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treatment questions

horsepad's picture
horsepad
Posts: 147
Joined: Apr 2012

A friend is beginning her fight.  She asked me to go with her to appointments.  Initially, surgeon recommended chemo, radiation and surgery if needed.  When we spoke to the radiologist he stated that is not normal protocal, and he was not sure the insurance would pay for it.  The medical oncologist recommended a second opinion because surgery is always done first.  After going with second opinion, surgery was performed to remove tumor.  Surgeon stated pathology reports tumor is T2 and because the location is next to spinchter muscle she will need colostomy.  Dr. stated chemo and radiation won't work because there is no test to tell if all the cancer is gone.

 

Has anyone been in this situation, any recommendations, suggestions?

 

 

 

abita's picture
abita
Posts: 830
Joined: Dec 2017

I am not sure I understand what it is that you are asking.

Tueffel
Posts: 108
Joined: Feb 2020

I dont understand your question either. Maybe you should specify a little. Why the doctor says no chemo because it wont work? How were the lymphnodes? What stage is your friend? What did the CT show?

You know these questions are important why which treatment is recommended or not. 

Chemotherapy and radiation sometimes depend. If the surgeons finds affected lymph nodes she will definetelyneed chemo after the surgery. Even without lymphnode involvement they sometimes give chemo to be sure they got everything. Sometimes they apply chemo before the surgery to shrink the tumor. In my dads case he had 4 chemos already before he might have surgery on his liver. There are many different approaches for cancer you can discuss unfortunately we will need for information  from you what is happening to your friend. 

 

horsepad's picture
horsepad
Posts: 147
Joined: Apr 2012

My question is has anyone had a tumor located close to anus, next to spinchter muscle of anal area, that surgery was done to remove tumor and then had to have a colostomy.  She is a T2, stage 1.  She was told by surgeon that there is no test to determine if there is any cancer left and the only way to know for sure that the cancer is gone is to have a colostomy.  I am not sure she understood doctor.  I find it hard to accept there is no test to clarify where tumors are located.  I am a stage 4 anal cancer survivor.  I had pet scans, cat scans for years to make sure cancer didn't come back.  I know her cance is different but .........

 

I would think protocal would be chemo/radiation before colostomy surgery.  I was wondering how other survivor's treatment plans were for them.  I assume it depends on the location of tumor or tumors but did you have surgery, chemo/radiation.  Is colostomy normal treatment?

Tueffel
Posts: 108
Joined: Feb 2020

Okay that are some more information. 

First I am not a cancer survivor. I just have it in my family with my dad now the newest member. But I am a med student so I gathered some knowledge before and after. 

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The reason she needs a colostomy is not the cancer but the location of it. If you remove tge tumor you want to have clean margins means you will cut away more. Unfurtunately your friends tumor is close to the sphincter so normal defecation will not be possible anymore because it needs to be removed. My great grandfather had this case. It was close to the sphincter, had to be removed and then he had a bag until the end of his life. 

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As for the colostomy bag: my dad has stage 4 and a bag because they wanted to start his treatment against the mets asap (chemo) and the surgery would need a long recovery and they could not leave it like that because it was nearly obstructing the whole colon. I think it is common treatment. 2/3 colon cancer people in my family had it. 

Annabelle41415's picture
Annabelle41415
Posts: 6549
Joined: Feb 2009

Actually pathology can tell if the surgery was successful in that all the margins were clear.  Surgery isn't always done first either.  Mine was chemo/radiation in the same location, then surgery, then more chemo.  Sometimes the radiation can shrink the tumor to such a point where clean margins are much more easily obtained after the chemo/radiation was done.  It's best that she does get a second opinion as it doesn't sound like she is very comfortable in the response from the first doctor.

Kim

lhduffer
Posts: 86
Joined: Oct 2015

I had a rather large tumor very low near the sphincter muscles.  I had many tests to determine the stage prior to treatment.  I was T3, N1, M1 (stage 4).  I had chemo, then chemo and radiation, then surgery and then more chemo.  Before surgery I was marked for both a colostomy and a temporary ileostomy as they were unsure which I would wind up with until they got in to do the surgery.  I woke up with the temporary ileostomy which I had reversed after completing my adjuvant chemo.  I had an amazing surgeon and even some of the other doctors were surprised he was able to do the sphincter saving surgery.

Each situation is different and the course of treatment does depend on the stage.  As others have stated, if your friend has any doubts or concerns with what they are being told or are uncomfortable with the prescribed course of treatment, they should definitely get a second opinion.

horsepad's picture
horsepad
Posts: 147
Joined: Apr 2012

I am hoping she can see the doctor soon.  We have alot of questions.  I spoke with her yesterday and she is in alot of pain from the surgery to remove the tumor.  She has very loose bowels and her skin is raw.  When I went through radiation I used aquaphore cream but it didn't really help my burns.  Any suggestions on what she can do to relieve the pain, heal the skin?  Obviously alot of pain in area of surgery.  She is also on anti-biotics because she may have an infection.

Trubrit's picture
Trubrit
Posts: 5222
Joined: Jan 2013

I had weeping, open sores after radiation, and tried several unctions. What worked for me was organic Witch Hazel. I dabbed it on, and it dried it all up and I healed. 

Tru

lhduffer
Posts: 86
Joined: Oct 2015

After my reversal surgery I had very loose bowels and had raw skin as well from that and compounded by my prior radiation.  I purchased both calmoseptine ointment and Boudreaux's butt paste.  I used both (at different times) and they both helped.  The calmoseptine is what I use on the rare occasion that I need it now.  Wishing her the best.

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