Complete response after chemo and MRI. Had surgery histology also confirmed complete response. Why have radiotherapy?

 Hi Caitlin , 

My name is Amy and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line. Welcome to our online community, and thanks for posting your question.

We understand the thought of going through more treatment can be very conflicting when all the information is suggesting a complete response from the treatment you have had. And you are right to question and consider all your options.

What we do know is that even when a cancer has been fully removed, and scans/ histology suggest a complete response there is usually still a benefit to having the treatment that was initially planned. This is to help reduce the risk of the cancer coming back. Sometimes single stray cancer cells or cells that are too small to be detected on the scan can be left behind.   

At the time of diagnosis, the treatment plan is tailored to each person depending on the cancer type, how it’s behaving and high-risk features to help determine risk of recurrence (things like size, grade, protein or hormone expressed are considered). Some people may have a plan that isn’t fixed and depends on the results from surgery, whilst others the plan is clear from the beginning that all treatment is needed, in what your consultant describes as the 3 step protocol.

It would be worth speaking to them about your concerns again, to help you fully understand why this is still necessary.  Ask them to explore the long-term goals with having this treatment vs how they feel this may affect you if you don’t have treatment. You can also explore how to better manage the symptoms you are experiencing now and how radiotherapy is likely to impact these moving forward.

It might also help to ask if a referral to a colorectal specialist could help to manage and monitor your anal fissure symptoms. They may suggest waiting until treatment has finished before doing this.

We often find we can help more by exploring these questions over the phone. It gives us the opportunity to ask more questions and explain our answers in more detail. If this is something you think would help, then please don’t hesitate to get in touch via our support line on 0808 808 0000. We are available 7 days a week, 8am-8pm.

I hope this helps.

Best wishes, 

Amy C, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref: AC/AMc

Ok so my treatment was planned from the beginning hence Im on a 3 step protocol and I need to wait til after my chemo herceptin has ended before visiting a colorectal specialist?

Thanks for getting back to us Caitlin .

It would be best to speak to your consultant about how to manage the anal fissure, explore what is working or not working and then they can decide if a referral for specialist review is appropriate now, or if you should wait until treatment has completed.

It may well be that the treatment is why it is taking longer to heal.

NICE (National Institute for Health and Clinical Excellence) have guidance on managing unhealed or recurrent anal fissures you might find helpful to read.

You know where we are if you need any further support. And please feel free to give us a call if it would help more to chat through things in person. Our support line is available 7 days a week, 8am-8pm on 0808 808 0000.

I hope this helps.

Best wishes, 

Amy C, Cancer Information Nurse Specialist 

Ref: AC/HeP