Recurrence and doctors recommending APR (NEW UPDATE IN POST)

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65yo female

Diagnosis Squamous Cell Anal Carcinoma 7/24 (cancerversary is tomorrow!) Stage 2b

Nigro protocol chemoradiation ended 10/24

Restaging PET 4/25 shows mets to liver

Liver resection 5/25

ctDNA test 7/25 (waiting for results)

New lesion on anus 7/25 with excision and biopsy shows return of SCC in anus 

Both surgeon and oncologist are recommending APR.  Surgeon suggested getting second opinion from MSK, Mayo, etc.  

I said I probably didn't want APR, but surgeon explained how bad it would get if I DIDN'T have surgery.

Just putting this out there so others have info

*NEW UPDATE- Today 7/28/25 the oncologist said he presented case to Tumor Board and consensus was to first start chemo/immunotherapy (carboplatin/taxol) (Retifanlimab) next week, and postpone surgery and hope for response so we can switch to immunotherapy only.  I also have a call into nearby Cancer Center for a second opinion (suggested by surgeon).  I had wrapped my head around surgery, but glad for this reprieve, hoping it's successful.   

  • Hello Karen

    I am so sorry to hear this.  I am aware that if cancer returns in the anus radiotherapy isn't an option and having APR surgery is the only option.  It is major surgery but there are quite a few people on the forum who have had it done, recovered and are now getting on with their lives.  I am hoping they read this and come back to reassure you. I have no personal experience of this but I do have a stoma due to severe anal stenosis following treatment and that changed my life immeasurably for the better.

    Thinking of you

    Irene xx

     

  • Hello Karen 

    Very sorry to hear your recent diagnosis.

    Because of the staging and position of my cancer the reacurance rate is high, so surgery is likely in the future.

    I am a member of the Macmillan colon/rectal forum and lots of members are discussing surgery after chemoradiotherapy.

    Hope they can provide information and support to help you with your choices.

    Very best wishes, what ever choice you make.

    Ally xx

  • Hello Karen,

    I’m so sorry to hear this and I really hope that you are able to get all of the information and second opinions you need in order to decide the next steps. You have certainly had a tough journey over the last year. 

    I have no experience of APR but hopefully others can share their wisdom and guidance.

    Wishing you strength xx

  • Hi 

    I've had APR in March this year and am still healing 

    It is a long slow process but if it's the only option take it .I've spoken to people on this forum who are a year in front of me and they are getting on with their lives 

    I won't lie it's major surgery but like I said if it's the only option .

    Take Care xx

  • Hi  ,

    I’m so sorry that you’re on this awful rollercoaster! Yes I agree APR surgery wouldn’t be anyone’s first choice but we have a few people on our forum that have had this surgery & are cancer free & now getting on with their lives.

    APR surgery is certainly radical surgery with a considerable recovery time but to achieve a life without this damn disease would I do it? Hell yes! Having said this I completely understand that not everyone makes the same choices & it’s your body & your life, I hope that your medical team support you with your decision & with treatment plans moving forward, just know we’re here to support you whatever choice you make. 

    Nicola 

  • Thank you.  My head is beginning to wrap around the inevitable, and your post is very encouraging.  

  • Thank you so much for the referral to the other group for support.  It is appreciated.

  • Thank you!  I really am grateful to hear about success stories.  My head is slowly wrapping around the inevitable, and my family and friends are already being so supportive.  I appreciate hearing from you experience... prayers for continued healing!!

  • Thank you.  I am already looking forward to getting surgery behind me. (No pun intended!) LOL