Oncology

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Any radiology oncologists? Or at least oncologists

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Hello! Any radiology oncologists? Or...

Hello! Any radiology oncologists? Or at least oncologists experienced in anal cancer? NYC Fireman 9/11 survivor here- thought the permanent lung damage was enough but- just got diagnosed with anal cancer. 35.4mm tumor in anal canal- no metastasis or lymph node involvement. I understand I need chemo + radiation, but my research on the radiation side has me very confused which to choose but am being (rightfully) pressured to hurry up and start treatment ASAP!My question for which Id be eternally grateful for experienced advice: which is the better way to go? Proton beam radiation or the "standard of care" X-ray/photon radiation? I like what I read about the side effect profile being much less with proton beam (ie: not having to take forced days off due to too much skin irritation, high intensity radiation into the tumor that doesn't exit the tumor and risk damage to the 40% of the body's bone marrow in the pelvis or healthy surrounding organs, etc)....but my medical oncologist that will be handling the chemo part said that despite the tumor being isolated, the pelvic lymph nodes need prophylactic radiation therefore she questions the benefit of photon beam for this cancer since (her words) "we don't want to miss even one or two cancer cells and have this recur. So I see the value in photon beam for prostate or brain or lung CA but I dont know that photon beam is good for anal cancer since prophylactically we need to get more area than just the tumor itself" but acknowledges her wheelhouse is chemo not radiation.....Please help...?Thank you so much!!

Submitted: 10 months ago.Category: Oncology

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Customer reply replied 10 months ago

Any Anal oncologists?

Answered in 2 days by:

5/7/2020

Oncologist: Dr. David, Doctor (MD) replied 10 months ago

Dr. David, Doctor (MD)

Category: Oncology

Satisfied Customers: 61,635

Experience: Experienced Oncology Physician trained in New York City. I'm ready to help.

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Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Customer reply replied 10 months ago

GREATLY appreciated!!

Oncologist: Dr. David, Doctor (MD) replied 10 months ago

I am a radiation oncologist

you don't need proton beam

photon radiation IMRT intensity modulated radiation is what you need plus chemo

1.8Gy per day to a total dose of 54Gy

they should also test your squamous cell carcinoma of the anus with a P-16 stain

to see if your cancer is associated with HPV virus as well

Customer reply replied 10 months ago

Great I will ask. Can HPV pose other future cancers or health problems to males?

Oncologist: Dr. David, Doctor (MD) replied 10 months ago

most adults can clear HPV out of their bodies in 1-2 years

HPV can linger and lead to anal cancer in men

HPV + anal cancers tend to be more sensitive to radiation and chemotherapy.

so it would be good for you and your doctors to know

Let me know if you have other questions.
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Customer reply replied 10 months ago

is there anything i can do to rid my body of hpv ?
my main ques would be this- Im so confused on where to go. the GI doc that did the colonoscopy/biopsy recommended me to a radiology oncologist that works there at the same hospital-- which is just a standard small hospital. He was planning what you suggested, with 6 weeks of radiation every day M-F and chemo every day M-F the first and last week. Proton therapy bragged less s/e and missed days due to low blood counts, skin breakdown, etc.... OR theres the Univ of Miami- which is NCI designated....do you think that matters? I cant tell the diffrence in speaking to them both, but the radiology oncologist from the smaller hospital (the hospital is not really "known for" anything) keeps calling to get started-- but I dont know if this type of cancer or standard of treatment is one that I should really seek a University hospital that is NCI designated; or of in this case that doesnt matter....could I please get your opinion on that?

Oncologist: Dr. David, Doctor (MD) replied 10 months ago

you don't know if you have HPV

ask your doctor to test your anal cancer for P16 stain to test for HPV virus

anal cancer is close to the skin

and your inguinal lymph nodes are close to your skin

so your skin is going to have side effects of pealing and blistering if you have photon or proton radiation therapy.

so proton radiation is not worth the extra cost.

I think proton centers are money making centers that push proton radiation to way too many indications, most of which can be treated just as well with photon radiation therapy.

anal cancer can be cured at a small community hospital

you don't have to go to an NCI cancer center

I work at a small community hospital and I treat and cure anal cancers all the time

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