Has anyone seen a gynecologist after CRC treatment?

I was not told to see my gynecologist. In Belgium, I know that patients with CRC are told to get checked for skin cancer and for breast cancer.
I saw my gynecologist because I had to have my annual pap smear and because I had recurrent vaginal infections after the radiotherapy. I ended up self-diagnosing a rectovaginal fistula for which I had a surgery with a coloractal surgeon.

If you hadn’t seeked out your gynecologist on your own you wouldn’t have found the fistula?! That’s lame, and it’s the same here. I now have a tumor on the shared back vaginal wall with the rectum. And it’s positive for my CRC cancer. Nothing has shown up in any of the scans I had just a month earlier. I knew there was a problem because I had a lot of sporadic discharge, and last week it became bloody. This should have been part of our follow-up care after our treatment ended. I’m overwhelmingly disappointed and scared and sick to my stomach. Seeing a gynecological oncologist on Thursday to get fully informed.

I had a rectal polyp on the anterior wall of the rectum. It was pre-cancerous at the biopsy taken during the colonoscopy in Oct. 2022. This polyp was removed by a transanal resection in Dec. 2022, from which the biopsy indicated positive margins. So I had radiotherapy in Feb.-March 2023. I started seeing brownish and fishy-smelling discharges in April 2023. Got three courses of treatment, and it got better for a little while. In June I had renewed discharges, went back with my gynecologist who took a sample and send it to the lab to identify the exact pathogen. It was candida. Treatment worked, but I kept having brownish discharges and the smell was getting more like feces. I also had a lot of vaginal gases not related to sexual activity the whole while. I went on line to find what could provoke the gases and found on the Mayo Clinic website that such vaginal gases could be due to a rectovaginal fistula and that such rectovaginal fistula could be a rare secondary effect of rectal radiotherapy. I mentioned my suspicion to my oncologist at my control in August: he asked me for the full history of my symptoms and coincided that I had a rectovaginal fistula which was confirmed by an MRI. The gynecologist had not seen the fistula in June, maybe because it was still small. The colorectal surgeon (not the same as the one who did the transanal resection) who operated to remove the fistula and a new polyp that appeared on the posterior wall facing it, believes that the combination of the radiotherapy and a rectal wall debilitated by the resection is the reason why the fistula could develop.

I'm sorry that your rectal cancer has extended to your vagina. Keep us posted on what the gynecological oncologist tells you on Thursday, what treatment they will offer. Sending a hug.

Thanks so much for
sharing your journey with me.
I have a good team and looking forward to moving forward! I’ll let you know what Thursday’s outcome is.

@cjay How did your appointment with the gynecological oncologist go, if I may ask?

I had an MRI first, and then met with her. Not a lot of new information, but the size of the tumor is about 3 cm and thin and long, and pushed through the wall between. I’m going back on Wednesday to see my surgeon. It’s not really a vaginal thing, so the gyno oncologist will only be involved if my surgeon wants her assist on a possible surgery. No one is sure if I can have any radiation, or if I already have received the maximum. They want me to have a PET scan, so hopefully that will be scheduled for Wednesday also. I’ll update after that appointment. Since it never showed up on the MRI from March 15, and now 2.5 months later it’s 3 cm, I think it’s pretty fast growing.
Anxious and scared would sum up my current emotional state.

With my rectovaginal fistula, the colorectalsurgeon also said he would only call a gynecologist if he found the vaginal tissue was too difficult to manage to remove the fistula on that side and do a proper flap. But I had been taking Tibolone for 9 months (HRT not FDA approved in the US; I live in Mexico) and applying Premarin for a couple of months in my vagina, so the tissue was elastic enough for him to do what was necessary.

I can very will imagine your anxiety and your feeling scared. What helped me was to practice guided meditation with an app (the anxiety "course" on Headspace) and seeing a psychotherapist trained in clinical situations.

Sending a hug of comfort.