KERRY & # 39; S STORY
Kerry was a 42-year old female executive who was in good health. Kerry had After two weeks, the bleeding increased and was accompanied by pain by she noticed blood on the toilet paper after her bowel movements, she first thought that the problem was due to hemorrhoids. Her doctor did not feel any abnormal lymph nodes in her groin. Heized her to a colorectal surgeon who performed a colonoscopy . Examination confirmed the mass seen by her primary doctor but no other lesions. Biopsy revealed a squamous cell carcinoma, anal cancer.
After her diagnosis, Kerry 's surgeon sent her for a PET / CT scan which revealed abnormality only at the anal mass. There was no significant activity to suggest metastatic (distant, incurable) spread of her cancer. Kerry was treated with intensity modulated radiation therapy (IMRT) in order to minimizeize RT dose to (RT) to therapists (RT) and chemotherapy. She received concurrent mitomycin and fluorouracial chemotherapy by IV infusion as an outpatient. Kerry had expected side effects of treatment including severe irritation and redness of the skin in the groin and anus, but she did not require a break during IMRT. She had significan She was part of her chemoRT. She had some loose bowels which was well controlled after adjusting her diet. Near completion of her treatment, there was no evidence of any tumor remaining. Kerry has seen one of her cancer doctors every three to six months for the past five years and she has cancer cancer free!
BASICS
The average age at diagnosis is around 60 years There are still more than 5000 cases of anal cancer diagnosed in the world each year. If the disease is localized, which is the case for 50% of patients, then the cure rate is roughly 80%.
RISKS & CAUSES
This virus is the same kind of that human being papillomavirus (HPV) infection. Activities that put people at risk for HPV, like receptive anal intervention, also put them at risk of later developing anal cancer.
SIGNS & SYMPTIONS
Many patients ignore or downplay the symptoms, often initially attributing them to hemorrhoids. While most people who have these symptoms do not have anal cancer, persistent pain or bleeding should always prompt medical attention A lump can develop in the groin as a result of anal cancer spreading to lymph nodes and intervention them to enlarge.
DIAGNOSIS
These doctors are able to directly look into the anal canal and rectum by proctoscopy Most anal cancers (80%) are squamous cell carcinomas. A thorough (or the colon colon by colonoscopy) with special instruments after they deliver medications to minimize discomfort. Many enlarged lymph nodes are only inflamed, with no evidence of cancer. Blood tests that may be ordered include complete blood count, tests of kidney function, and possibly HIV testing, depending on the patients & # 39; risk factors for the virus.
STAGING
The American Joint Committee on Cancer (AJCC) TNM staging system is used as early stage or has spread to other sites Early stage disease is limited to the anus, while advanced disease This imaging test is included in CT scan of the abdomen and pelvis and a chest X-ray at minimum. Staging may also include a PET / CT scan. to the radiologist as well as the treating cancer specialists to spread to to involve lymph nodes in the groin or pelvis, or metastasized to other sites in the body such as the liver or lungs.
TREATMENT
Since most anal cancers invades the sphincter that controls defecation, surgery to remove such a cancer would require removal of the sphincter and creation of An exception would be very early cancers of the anal margin, on the skin outside the anus.
RT delivered over roughly 6 weeks with concurrent IV fluorouracil (5FU) and mitomycin-C (MMC) chemotherapy providing patients the RT is delivered in daily fragments using either 3D conformal RT or IMRT. The latter technique may be used in order to minimize the amount of normal bowel and / or genitalia receiving full-dose RT (& therefore minimize side effects) .
The main side of the anus and pelvis include skin reaction that may be caused by severe around the anus and creases of the groins, as well as bowel irritation and diarrhea. Most patients will have these acute symptoms resolve within 1 5 FU may also cause bowel irritation, diarrhea, irritation in the mouth or (2) lips, poor appetite, and fatigue. Uncommonly, skin or nail discoloration or severe peeling of hands and feet (hand foot syndrome) or other major side effects can happen. decrease in blood counts, mouth sores, poor appetite, and fatigue. Nausea, vomiting, and urinary irritation may also occur. Rarely, life-threatening lung or kidney damage can occur.
