understanding and treatment of anal cancer

2. Anal Cancer This is usually squamous cancer and is treated with chemo-radiation. Rectal cancer is adenocarcinoma and is treated with surgery +/- chemoradiation

5. T-oncoanatomy: Anus three-planar views. A. Coronal. B. Sagittal. C. Transverse, male anatomy. D. Transverse, female anatomy. (1) Middle rectal artery. (2) Obturator internus. (3) Inferior rectal artery. (4) External anal sphincter. (5) Anal canal. (6) Rectum. (7) Internal rectal venous plexus. (8) External rectal venous plexus. (9) Internal anal sphincter. (10) Pectin of anal canal. (11) Levator ani. (12) Corpus cavernosum penis. (13) Bulb of penis. (14) Urethra. (15) Ischial tuberosity. (16) Vagina. (17) Rectouterine pouch (of Douglas). (18) Urinary bladder.

6. Sentinel nodes of the anus are inguinal nodes.

10. PET scan showing anal cancer

15. CT scan is obtained at the time of simulation CT images are then imported into the treatment planning computer

16. In the simulation process the CT and PET scan images are used to create a computer plan

17. Computer generated images of anal cancer

18. Tomotherapy for Anal Cancer

19. Tomotherapy for anal cancer, high dose to anus and groin nodes, while avoiding the bladder and femurs

20. In the treatment the lasers are used to line up the beam and the patient receives the radiation treatment

21. Side Effects of Pelvic Radiation Radiation fields Radiation may hit the small bowel causing some cramps, diarrhea and fatigue High dose area

22. 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 area

23. Radiation prescription for # Diagnosis: # External radiation: # Internal radiation: #