Question: I have a friend of mine who was recently diagnosed with IV-Stage-IV Anal Malignant Melanoma; He is a 55-year old man of middle east background - he has been having anal pain since 11/2014 - he has had pain and pressure in his lower pelvis and anal region. The pain is worse when he sits down and puts pressure on the anal and coccygeal regions.
The pain does not radiate. He has normal bowel movements; he occassionally notices small streaks of blood on his stool but no large volume of bright red blood per rectum. He had a restaging CT of the chest, abdomen, and pelvis on 11/20/2014; He had metastatic anal melanoma; he has recently had progression of disease with pain in the anococcygeal region that has not improved with 2 cycles of Yervoy. He might benefit from some palliative effect locally from the radiation.
The patient cancer is quite rare; the fraction sizes range from small fractions of approximately 2 Gy each to large fractious of 6 to 8 Gy each. Because there is some tethering of the mass, fistula formation might be of concern;
Tomorrow, I'm driving him to Emory University to meet with a sub-specialist for further consultations; So could you please help me out with the following; So I can be prepared tomorrow when we meet with the subspecialist at Emory University, what are the questions I should ask the oncologist on behalf of my friend about future prognosis, care plan, medications, treatments, etc. Any insight is welcome.
Prof. B.