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Decisions, decisions............

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Hello Ladies. I have a very complicated situation going on regarding future treatment for my invasive anal cancer.

My prior radonc in NJ talked to the radonc in FL today. The FL radonc has agreed despite my prior 3000 rads of radiation back in 91, that a new course of treatment (5000 rads) plus chemo is a reasonable course of treatment before proceeding to an APR (abdominoperitoneal resection with colostomy).

Here is my dilemma. Since I have had prior radiation and also most recently numerous laser ablation surgeries for recurrent AIN, the tissue down there is very sensitive. As an example, in doing the prep for a colostomy last year, the entire area was broken down and bleeding w/in 24 hours resulting in involuntary shaking of my entire body from the severe pain. I can only image how severe this is going to be after even a week of radiation therapy let alone five weeks. There is a high risk that this radiation will result in loss of sphincter control and need for an APR anyway BUT this additional radiation will make that tisssue even more damaged and potentially complicate the APR surgery because it will be very difficult to close that tissue, increase possibility of would dehiscence (sutures opening up) resulting in infection etc.

Also and something which cannot be forgotten, is that I may still have in situ lesions outside of the radiation field and chemo has no effect on in situ lesions so there is also the chance that I might be fine for another 15 years however there is also a chance that because I will still have the virus, I could have a recurrence in five months!

When I had recurrent vulvar lesions for four years despite numerous lasers and other therapies, the only thing which prevented any recurrence again was having a vulvectomy and removing all the HPV laden tissue. It would be much the same in this circumstance. Removal the anus, perianal tissue and anal canal (and a bit further up) will remove the HPV laden tissue again thus reducing the possibility of a recurrence to a negligible possibility.

It's difficult to think straight as this is such an emotional issue for me and I was wondering what you ladies think. I appreciate your input and have appreciated all your support and prayers these past few months. As such, you thoughts would be very useful to me at the juncture. Thanks

Explore topics in this discussion:

Cancer Surgery Anal cancer Radiation therapy Morphine Pain HPV Valium

3 replies

Sounds like a catch 22....however I would go with the option that offered me the BEST chance at a LOOOOOOOONG and fulfilling life...even if that mean't some life altering changes to your body as you know it.

There are several meds available to you to control your pain and make your journey easier during your chosen treament plan----- whatever that may be.....

Good Luck to you and may your treatments kick cancer to the curb for good!

Bonnie - can't they tell if there are other in situ lesions outside the radiation area? I know your options are not good, but your kids need you - even though they are older. Don't you want to be around to see future grandchildren? Do what you need to do to stay alive, imho.

Hi I can only give you want I no will be a choose I have to make at some point, I will have to make those chooses since it seems I am having surgery..etc ever so often in the past few years..but I would do whatever it takes to live, of course..I no the pain is unbearable but I found these wonderful pain killers which are called diludin which is basically pure morphine and that has helped me with all of the pain. I would recommend asking for those and also asking for valium since sleeping thru the pain is a Godsend also. I pray for your speedy recovery, God bless you.

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