Anal Flashcards
(32 cards)
How common is anal cancer compared to colon or rectum cancer?
Anal cancer is fairly rare and much less common than cancer of the colon or rectum.
Who is more likely to develop anal cancer?
Anal cancer occurs more often in women and people aged 60 years and older.
What is the chief risk factor for anal cancer?
HPV is the chief risk factor for anal cancer.
What are some additional risk factors for anal cancer?
Additional risk factors include genital warts, genital infections, anal intercourse, intercourse before age 30, HIV, smoking, and immunosuppression.
What is the most common presenting symptom of anal cancer?
Rectal bleeding
This symptom is often the first indication of anal cancer.
What are other signs and symptoms of anal cancer?
Pain, change in bowel habits, palpable mass, rectal discharge
What is the most common histology for anal cancer?
Squamous Cell Carcinoma
What staging system is used for anal cancer?
TNM staging system
What is the first step in the diagnostic work up for anal cancer?
Physical exam
What specific exams are included in the physical exam for anal cancer?
DRE (digital rectal exam) and palpation of the inguinal lymph nodes
What procedures are performed for biopsy in anal cancer diagnosis?
Proctoscopy/Anoscopy with biopsy
What imaging technique is used in the diagnostic work up for anal cancer?
Transrectal US
What laboratory tests are included in the diagnostic work up for anal cancer?
CBC, creatinine and liver function test
What imaging is done to evaluate the liver and lymph nodes in anal cancer?
CT of pelvis and abdomen to evaluate the liver and perirectal, inguinal, pelvic, and paradortic nodes
How does anal cancer primarily spread?
Anal cancer spreads most frequently via direct extension into the adjacent soft tissue.
What is the most common lymphatic spread location for anal cancer?
The most common lymphatic spread occurs to the inguinal lymph nodes.
What are the types of lymph nodes involved in the spread of anal cancer?
The types of lymph nodes involved include:
- Superficial inguinal
- Perirectal
- Internal iliac
- Inferior mesenteric
Is hematogenous spread common in anal cancer?
Hematogenous spread to the liver or lungs is less common.
What are other lymph nodes that can be involved in the spread of anal cancer?
Other lymph nodes that can be involved include:
- Periaortic nodes
- Common iliac nodes
- External iliac nodes
What is the treatment of choice for anal cancer?
Combination radiation therapy and chemotherapy is considered the standard of care for most patients.
What are the standard chemotherapy agents for anal cancer?
5FU and/or mitomycin C.
Is surgery typically used in the treatment of anal cancer?
Surgery is not typically used due to functional outcome.
What are the radiation therapy fields for anal cancer?
AP/PA fields
Includes electron fields to the inguinal nodes.
What technique is used for boosting the tumor bed in anal cancer radiation therapy?
A perineal electron field or another multifield technique.
