Anal cancer

Question 1

Surveillance post definitive therapy 1) anoscopy schedule 2) imaging

Answer 1

• DRE and inguinal exam every 3-6 months for 5 years
• anoscopy every 6-12 months for 3 years
• CT torso annually for 3 years

Question 2

anal cancer local recurrence mgmt

Answer 2

salvage surgery (typically APR but sometimes exenteration) and permanent colostomy (Can have long-term control, 5 yr OS 30-40%)
*w/ groin dissection if positive inguinal nodes found

Question 3

First line for metastatic anal

Answer 3

carbo/taxol

Question 4

second line for metastatic anal

Answer 4

checkpoint inhibitors

Question 5

anal cancer RF’s

Answer 5

• HPV
• HIV
• being immunocompromised
• smoking history

Question 6

How long do you wait before further workup/salvage APR

Answer 6

26 weeks