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Anal canal cancer web

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  • 1. Cancer of the anus or anal canal Understanding the disease Treatment options Side effects of treatment
  • 2. Anal CancerThis is usually squamous cancer and istreated with chemo-radiation.Rectal cancer is adenocarcinoma and istreated with surgery +/- chemoradiation
  • 3. Sentinel nodes of the anus are inguinalnodes.
  • 4. More advancedcase of analcancer that hasspread on PETscan to para-aortic lymphnodes
  • 5. PET scan showing anal cancer
  • 6. There are different guidelines for anal canaland anal margin , for canal more chemotherapyplus radiation therapy (RT)
  • 7. For anal margin, surgery may be all that isnecessary for early stages
  • 8. CT scan is obtained at the time of simulation CT images are then imported into the treatment planning computer
  • 9. In the simulationprocess the CTand PET scanimages are usedto create acomputer plan
  • 10. Computer generated images of anal cancer
  • 11. Tomotherapy for Anal Cancer
  • 12. Tomotherapy for anal cancer, high dose to anus and groinnodes, while avoiding the bladder and femurs
  • 13. In the treatmentthe lasers areused to line upthe beam and thepatient receivesthe radiationtreatment
  • 14. Side Effects of Pelvic Radiation Radiation fields Radiation may hit the small bowel causing some cramps, diarrhea and fatigue High dose area
  • 15. 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 areaIn pre-menopausal women, radiation is likely to effectovarian function and should not be used if the woman ispregnant
  • 16. Survival in a large series of patients
  • 17. Survival by Stage in a series of 270 patientswith anal cancer 5 Year Survival by Stage T1: 86% N0: 76% T2: 86% N1: 54% T3: 60% T4: 45%

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