anal canal cancer web
TRANSCRIPT
Cancer of the anus or anal canal
Understanding the disease Treatment options Side effects of treatment
Anal Cancer
This is usually squamous cancer and is treated with chemo-radiation.
Rectal cancer is adenocarcinoma and is treated with surgery +/- chemoradiation
Sentinel nodes of the anus are inguinal nodes.
More advanced case of anal cancer that has spread on PET scan to para- aortic lymph nodes
PET scan showing anal cancer
There are different guidelines for anal canal and anal margin , for canal more chemotherapy plus radiation therapy (RT)
For anal margin, surgery may be all that is necessary for early stages
CT scan is obtained at the time of simulation
CT images are then imported into the treatment planning computer
In the simulation process the CT and PET scan images are used to create a computer plan
Computer generated images of anal cancer
Tomotherapy for Anal Cancer
Tomotherapy for anal cancer, high dose to anus and groin nodes, while avoiding the bladder and femurs
In the treatment the lasers are used to line up the beam and the patient receives the radiation treatment
Side Effects of Pelvic Radiation
Radiation fields
Radiation may hit the small bowel causing some cramps, diarrhea and fatigue
High dose area
Side Effects of Pelvic Radiation
Radiation fields
Radiation may hit the bladder and rectum causing urinary burning or frequency and ano-rectal irritation
High dose area
In pre-menopausal women, radiation is likely to effect ovarian function and should not be used if the woman is pregnant
Survival in a large series of patients
Survival by Stage in a series of 270 patients with anal cancer
5 Year Survival by Stage
T1: 86% N0: 76%
T2: 86% N1: 54%
T3: 60%
T4: 45%