The Digestive System - anal

Question 1

aetiology & epidemiology of anal cancer?

Answer 1

1% of bowel cancers

male homosexuals - association with human papilloma virus

Question 2

what are the histology types

Answer 2

squamous cell carcinoma 80%

adenocarcinoma 10%

Question 3

presenting symptoms

Answer 3

bleeding
anal mass
pain
warts
discharge

Question 4

investigations of anal cancer?

Answer 4

FMH
proctoscopy
biopsy 
CT 
chest x-ray
MRI - shows pelvis node involvment

Question 5

what is the management options of anal cancer

Answer 5

No surgery

shincter conservation acheived with RT + synchronised chemo

Question 6

what is the staging of anal cancer

Answer 6

Tis -  carcinoma in situ
T1 - 2cm or less
T2 - 5cm or less
T3 5cm +
T4 - invaded surrounding tissue e.g. bladder

Question 7

what is the target volume for anal cancer ?

Answer 7

primary tumour + first station nodes (pararectal, hypogastric & obturator)

Question 8

what is the patients positioning and immobilisation for RT?

Answer 8

prone
blous to perianal region
anal marker
full bladder

Question 9

what dose and technique is used of ranal cancer RT?

Answer 9

45GY in 25# over 5 weeks with chemo at week 1&5
6 week gap
Brachytherapy
25Gy or 15Gy boost to primary tumour

Question 10

what is the 5 yr survival of anal cancer?

Answer 10

70%