E-mail pageSurgical Technique Helps Woman Avoid Colostomy
In June 2007, Lena Knezevich began to feel a constant dull ache in her lower back that intensified while she was sitting. She went to her family physician for a physical during which a mass was found in her lower anal canal and Knezevich was ultimately diagnosed with anal cancer.
"And I knew I wanted to be treated at the University of Chicago Medical Center because physicians there have successfully treated my son's brain tumor."
Alessandro Fichera, MDAfter six weeks of radiation and chemotherapy that were used to shrink her tumor, Knezevich was referred to Alessandro Fichera, MD, associate professor of surgery at the University of Chicago Medical Center and an expert in the surgical treatment of diseases of the lower gastrointestinal tract.
"Ms. Knezevich had a cancer located just at the anal canal and these cancers usually respond well to chemotherapy and radiation, sometimes disappearing completely," Dr. Fichera said. "In this case, the tumor shrunk enough so that although Ms. Knezevich still needed surgery, we were able to use sphincter-sparing techniques."
Dr. Fichera removes the tumor and part of the anal canal where the cancer was, and then joined together the remaining ends of the bowel. This approach enabled Dr. Fichera to leave intact the muscles that control the opening and closing of the anus, or the sphincter muscles.
Because that muscle still works effectively, Knezevich was spared the need for a permanent colostomy, a procedure connecting part of the bowel to the outside of the patient's body through an opening called a stoma, allowing feces to exit the body through the abdomen.
"The fact that my physicians worked so well together and took the time to answer all my questions and explain everything meant a lot to me," Knezevich said. "But the most important thing to me is that I have been given a very good prognosis--as far as the physicians are concerned the cancer is gone."
Knezevich will be followed closely to make sure the cancer does not return. For the first year after surgery, Dr. Fichera recommends digital rectal exams and ultrasounds every three months. During the second year, ultrasounds are performed every six months and after that, Knezevich will have yearly exams.
