Anal Cancer (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Anal cancer facts*
- Anal anatomy
- What is anal cancer?
- What are the different types of anal cancer?
- What are other types of anal masses or growths?
- What are anal cancer statistics?
- What causes anal cancer?
- What are the risk factors for anal cancer?
- What are the symptoms and signs of anal cancer?
- What's involved with anal cancer screening (early detection)?
- How do health care professionals make a diagnosis of anal cancer?
- How do health care professionals determine anal cancer staging?
- What types of health care professionals diagnose and treat anal cancer?
- What is the medical treatment for anal cancer?
- Surgery for anal cancer
- Radiation therapy for anal cancer
- Combination chemotherapy and radiation therapy for anal cancer
- What are treatment options for stage IV anal cancer or metastasis?
- Is it possible to prevent anal cancer?
- What is the prognosis for anal cancer?
- Where can one find information about clinical trials or research for anal cancer?
- Find a local Oncologist in your town
Radiation therapy for anal cancer
Radiation therapy alone for localized anal cancer may confer a greater than a 70% likelihood of 5 year survival. The high doses of radiation used (over 60 Gy [Gy is a unit of energy absorbed from ionizing radiation or 1 joule/Kg of matter.]) can lead to significant tissue damage and scarring sometimes necessitating colostomy surgery for control and repair. This approach is not favored today.
Combination chemotherapy and radiation therapy for anal cancer
Today the optimal primary therapy for stage I, II, IIIA, and IIIB anal cancers that are too large for potentially curative local resection is the combination of lower doses of radiation therapy (45 to 60 Gy) combined with the chemotherapy medicines, 5-FU and mitomycin C. The combination treatment results in 5-year colostomy free survival of over 75% of stage I, 65% of stage II, and 40% to 50% of stage 3 anal cancer cases. Anal cancers that are located in an area where they cannot be resected may benefit from combination therapy.
Salvage chemotherapy with an alternative regimen of the medicines 5-FU and cisplatin combined with a radiation boost can be used for residual or recurrent local disease to avoid radical surgery. Radioactive seed implants can be used to establish local control for residual or recurrent disease to avoid radical surgery.
Learn more about: cisplatin
What are treatment options for stage IV anal cancer or metastasis?
Today there is no standard chemotherapy with curative potential for metastatic disease. Local symptom control, referred to as palliative care, is extremely important.
Rare patients with stage IV disease have truly localized metastatic disease for which surgery to remove the metastasis could theoretically be curative. This option should be considered in those unusual cases. The disease is rare enough that there are no studies specifically supporting or refuting this approach.
Patients with stage IV disease are excellent candidates for clinical research trials if they are well enough and give truly informed consent. A clinical trial is a research study investigating new approaches to treatment which may benefit the patient and help develop treatments for those patients who develop this disease in the future.
Thus for most patients with stage IV disease the treatment options include:
- Palliative surgery
- Palliative radiation therapy
- Palliative combined chemotherapy and radiation
- Clinical trials
Get the latest treatment options.