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Anal canal cancer web


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Anal canal cancer web

  1. 1. Cancer of the anus or anal canal Understanding the disease Treatment options Side effects of treatment
  2. 2. Anal CancerThis is usually squamous cancer and istreated with chemo-radiation.Rectal cancer is adenocarcinoma and istreated with surgery +/- chemoradiation
  3. 3. Sentinel nodes of the anus are inguinalnodes.
  4. 4. More advancedcase of analcancer that hasspread on PETscan to para-aortic lymphnodes
  5. 5. PET scan showing anal cancer
  6. 6. There are different guidelines for anal canaland anal margin , for canal more chemotherapyplus radiation therapy (RT)
  7. 7. For anal margin, surgery may be all that isnecessary for early stages
  8. 8. CT scan is obtained at the time of simulation CT images are then imported into the treatment planning computer
  9. 9. In the simulationprocess the CTand PET scanimages are usedto create acomputer plan
  10. 10. Computer generated images of anal cancer
  11. 11. Tomotherapy for Anal Cancer
  12. 12. Tomotherapy for anal cancer, high dose to anus and groinnodes, while avoiding the bladder and femurs
  13. 13. In the treatmentthe lasers areused to line upthe beam and thepatient receivesthe radiationtreatment
  14. 14. Side Effects of Pelvic Radiation Radiation fields Radiation may hit the small bowel causing some cramps, diarrhea and fatigue High dose area
  15. 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. 16. Survival in a large series of patients
  17. 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%