CancerCompass message board discussion started by Judylauren on 10/3/2007 http://www.cancercompass.com/message-board/message/all,16757,0.htm Tue, 02 Dec 2008 00:00:00 GMT Tue, 02 Dec 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ My friend has Stage 4 rectal cancer with mets to the liver, lung, tail bone and perhaps lymph nodes.He has been on systemic chemo  ( with Avastin) since July; so far, not much change.My question is:Can anything be done to alleviate my friend's most vexing symptom, a persistent burning sensation in the anus?. (FYI : this condition began prior to chemo.) Additionally, he feels tremendous pressure from the rectal tumor and is unable to sit or walk with any degree of comfort. Presumably,short of decreasing tumor size, nothing can be done about the latter symptom, but we have hopes that at least the burning can be addressed more immediately.Any ideas?Also, any comments on radiation? My friend's doctor discouraged it but was not entirely specific as to why.  Paul (my fiend) is consulting another doctor at the end of the week, so perhaps then he'll get more clarified answers.But meanwhile, I would appreciate any guidance on the topic.  Thank you for reading this.Judy   Judylauren Wed, 03 Oct 2007 00:00:00 GMT The nerves in the anal area are extremely sensitive so there can be a lot of pain there.  The burning might very well be from an anal fissure or tear around the anus.  If it is a slight tear it will heal by itself but it can be difficult since everytime you have bowel movement, it can open it up again.  It is similar to one of those cuts you get on your fingertips in the cold winter.  Just when you think they are healed, you do something and wham, the cut opens up again.  If it is a fissure, you can try cocoa butter to help with the skin area.I would be very curious to know why no radiation.  Chemoradiation (a reduced chemo along with radiation) has high success rates for tumor shrinkage.  Oftentimes when a tumor is too large to surgically remove it, the radiation can shrink the tumor small enough so that surgery can be accomplished.  I would want answers as to why that avenue is not be utilized. Jaynee soccermom Thu, 04 Oct 2007 00:00:00 GMT Thanks, Jaynee.I should add that Paul had a colostomy prior to treatment. ( There was concern that his tumor would become so obstructive that an emergency colostomy might be necessary and his doctor wanted to avoid this procedure in the middle of chemo.)  I wonder if the burning might be related (at least in part) to improper healing from his operation.Does the application of topical relief carry with it any risk of disturbing the tumor, perhaps breaking off cells and adding to the spread of cancer?  His current doctor (he of the vague remarks) indicated that radiation might increase the burning sensation, but would not commit to the exact likelihood of this happening. And, as for the benefit end of the risk/benefit ratio regarding radiation -- he simply shrugged it off with little explanation.I'll let you know what the new doctor says.Judy      Judylauren Thu, 04 Oct 2007 00:00:00 GMT  On 10/4/2007 Judylauren wrote:Thanks, Jaynee.I should add that Paul had a colostomy prior to treatment. ( There was concern that his tumor would become so obstructive that an emergency colostomy might be necessary and his doctor wanted to avoid this procedure in the middle of chemo.)  I wonder if the burning might be related (at least in part) to improper healing from his operation.Does the application of topical relief carry with it any risk of disturbing the tumor, perhaps breaking off cells and adding to the spread of cancer?  His current doctor (he of the vague remarks) indicated that radiation might increase the burning sensation, but would not commit to the exact likelihood of this happening. And, as for the benefit end of the risk/benefit ratio regarding radiation -- he simply shrugged it off with little explanation.I'll let you know what the new doctor says.Judy      Are you at a major hospital?  We are at U of M in Michigan and also consulted SLoan-Kettering in New York and both gave us the same treatments.  My hubby was only a Stage 3 but he had all the symptoms you are writing about.  He had radiation and his tumor shrunk considerably and it was quite large.  The tumor did not shrink completely but they told us all the cancer cells were dead when they took them out.   Hubby had anus, rectum, and part of colon removed with a permanent colostomy in May and is finishing up his post-surgical chemo now.  I would definitely get a 2nd opinion.  I dont know what standard treatment is for Stage 4 but from everything I have read the first line of treatment for Stage 3 is chemorradiation pre-surgery, surgery, then more chemo.  Best of luck to ya.   Melanie  Bmxspeedqueen Sun, 07 Oct 2007 00:00:00 GMT  On 10/7/2007 Bmxspeedqueen wrote: On 10/4/2007 Judylauren wrote:Thanks, Jaynee.I should add that Paul had a colostomy prior to treatment. ( There was concern that his tumor would become so obstructive that an emergency colostomy might be necessary and his doctor wanted to avoid this procedure in the middle of chemo.)  I wonder if the burning might be related (at least in part) to improper healing from his operation.Does the application of topical relief carry with it any risk of disturbing the tumor, perhaps breaking off cells and adding to the spread of cancer?  His current doctor (he of the vague remarks) indicated that radiation might increase the burning sensation, but would not commit to the exact likelihood of this happening. And, as for the benefit end of the risk/benefit ratio regarding radiation -- he simply shrugged it off with little explanation.I'll let you know what the new doctor says.Judy      Are you at a major hospital?  We are at U of M in Michigan and also consulted SLoan-Kettering in New York and both gave us the same treatments.  My hubby was only a Stage 3 but he had all the symptoms you are writing about.  He had radiation and his tumor shrunk considerably and it was quite large.  The tumor did not shrink completely but they told us all the cancer cells were dead when they took them out.   Hubby had anus, rectum, and part of colon removed with a permanent colostomy in May and is finishing up his post-surgical chemo now.  I would definitely get a 2nd opinion.  I dont know what standard treatment is for Stage 4 but from everything I have read the first line of treatment for Stage 3 is chemorradiation pre-surgery, surgery, then more chemo.  Best of luck to ya.   Melanie Thank you, Melanie.It so happens that the consultation that I mentioned last week  was at Sloan. (Paul is currently being treated at a public hospital in New York.)The Sloan oncologist regards radiation only as a future possibility based on whether or not the liver eventually responds to chemo. If I understand her explanation, giving radiation would necessitate some kind of ratcheting-down of the chemo (eliminating Avastin, I believe, until the radiation is complete) and thereby risk liver failure. Obviously, this is not what we were hoping to hear -- but at least it was a cogent response to our question.Another advantage gained by this visit to Sloan was the recommendation of a drug that might protect the tail bone -- is it Zomedia? -- from further damage. Does anyone have knowledge of this drug or of one that's similar? And while you're at it, can anyone weigh in on the radiation issue, as well?I very much appreciate your responses.Considering our common pain, it's amazingly kind of you to take time from your  problems to help with mine.Judy   Judylauren Mon, 08 Oct 2007 00:00:00 GMT Hi,I also experienced an extreme burning sensation around my anus the last two chemo rounds.  Actually,I do remember it happening once even before I had chemo (I then was suffering from diahrhea).  My theory is that whatever is in the feces is very strong and is burning the skin around the anus.  I was in agony last time.  I tried both aloe vera (it stung), neosporin (because it actually became raw and bleeding), and plain vaseline.  In preparation for this chemo round, I just bought some baby diaper rash ointment to put on as a preventative.  I may also use the neosporin if if becomes raw and bleeding again.  I think that's the way to go.  Put ointment on before the problem starts, in anticipation.Good luck to you and your friend.Lisa   lisaann Wed, 28 Nov 2007 00:00:00 GMT