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I had APR surgery for a reoccurrence of anal cancer on 8 March. I Had an appointment to see my surgeon yesterday though did not see him as he had been called an emergency. I was advised by the doctor I did see I am healing well and that the cancer has not spread to my lymph nodes thankfully .He did mention however ‘ close borders’ and I am at high risk of another reoccurrence and as such they will keep a close eye on me with a MRI scan 3 months post surgery.

I did ask if it returns what’s the treatment and he said chemo and radiation though obviously he is not an oncologist and as such he hasn’t all the answers I need which I 100% appreciate but now I am in limbo with all sorts of thoughts and I don’t see oncology for another 3 weeks.

My question is when he says borders is he meaning margins and if so why are that not giving me chemo now to be on the safe side so to speak. I understand they don’t want to give me treatment that may not be necessary but given the choice I think in all honesty I’d take it.

Also as I have had chemo radiation in 2019 I was advised APR the only option so how can if it returns chemo radiation then becomes an option again.

Thanks Liz

Helen M - Macmillan over 2 years ago

Hello Liz

Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

Welcome to the online community, I see you have joined several of our online groups and hope you find the community warm and supportive.

I was pleased to read that you are healing well after your abdomino-perineal resection and that your lymph nodes didn’t show any evidence of the cancer – that’s good to hear. However, it was a shame that you weren’t able to see the surgeon that performed the operation to be able to understand the information shared with you and to ask your questions. I think you are right that the ‘close borders’ mentioned relate to the surgical margins. This is a margin of healthy tissue around a cancer that a surgeon will aim, where possible, to remove along with the tumour. Usually margins are referred to in the pathology report as either ‘clear’ or not, so it’s difficult to determine what a ‘close’ margin means for you and why further treatment is not being offered at this point.

Your query around your margins and further treatment should be thoroughly answered when you see your oncologist in a few weeks’ time, but it might be helpful to understand that any treatment offered by oncologists is done so if the benefits outweigh the risks. They are not likely to offer treatment if the risks outweigh any benefits. I hope that makes sense.

You mentioned that you underwent chemoradiation for your anal cancer and that you understand this wouldn’t be repeated. Chemoradiation is a particular type of combination therapy and is unlikely to be repeated, however chemotherapy, as stand-alone treatment, is commonly prescribed when an anal cancer has reoccurred.

In addition, Radiotherapy can be useful as a treatment to help with certain symptoms if the cancer has moved to another part of the body.

Do write all your questions down as you think of them over the next few weeks so you can make the most of your consultation. It’s always helpful, but not always possible, to have another person attend an appointment with you as a second pair of ears. If you are attending alone, you could ask if the oncologist minds you recording the consultation on your phone so you can play back the conversation to ensure you have understood what has been discussed.

I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

Best wishes, Helen

Cancer Information Nurse Specialist

Ref HM/AC

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