Richard Whittington, MD
Last Modified: February 24, 2002
Dear OncoLink "Ask The Experts,"
My mom is 64 years old and was recently diagnosed with squamous cell carcinoma of the anus T2 tumor, 2cm. Treatment included 5FU and mitomycin along with external beam radiation begun 5 weeks ago. There is a difference of opinions between the doctors on the amount of grays (Gy) (radiation dose) required. Some say 40 Gy others 45 Gy . She has tolerated all of this extremely well until the last 5 days of chemotherapy and radiation. She has severe burns --enough that a plastic surgeon is being called in for an evaluation. (180 grays/25days)
Can the radiation be stopped for 14 or more days to allow healing?
Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds:
The standard dose is not well defined, and this is a problem. At the University of Pennsylvania we use 50.4 Gy and that is pretty much the standard in the Northeast U.S. Almost every patient needs a break during treatment to allow the skin reaction to heal. It does not compromise outcome if the treatment restarts as soon as the skin reaction starts to resolve. It sounds like this patient has received 20 to 25 treatments. If she resumes treatment as soon as the healing starts, she will not have worsening and will continue to heal during these last few treatments.