Fast Five Quiz: How Much Do You Know About Anal Cancer?

Elwyn C. Cabebe, MD

Disclosures

October 30, 2017

Patients with local recurrence require surgical treatment with abdominoperineal resection . If inguinal recurrence is found, inguinal dissection with possible chemotherapy is indicated. If distant metastasis is found after treatment, a cisplatin-based chemotherapeutic regimen is recommended.

Surgery plays a limited role in the treatment for anal cancer. National Comprehensive Cancer Network (NCCN) guidelines recommend that lesions in the anal margin, which starts at the anal verge and includes the perianal skin over a 5-cm to 6-cm radius from the squamous mucocutaneous junction, can be evaluated for local excision with adequate margins and subsequent observation, with no additional cancer- specific treatments. However, this approached is reserved for patients with locally advanced disease, refractory disease, pretreatment incontinence, or other specific factors.

For most patients diagnosed with anal squamous cell carcinoma, treatment consists of radiation therapy combined with radiosensitizing chemotherapeutic agents. For localized disease, NCCN guidelines recommend 5-fluorouracil , mitomycin, and radiation therapy.

IMRT is also a consideration and may be preferred in anal cancer treatment, because it produces similar results with decreased breaks in therapy and decreased long-term complications. IMRT requires specialized equipment and expertise, however, and therefore may increase the cost of treatment.

For more on the treatment of anal cancer, read here.

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