Cancer of the Anal Canal
Although anal squamous cell carcinoma (ASCC) is an uncommon malignancy, its incidence has been rising over the last two decades owing to the widespread prevalence of human papillomavirus infection in the US population. Anal cancer provides a paradigm for organ preservation in the management of cancer. The well-established standard of care for localized anal cancer consists of the combination of 5-fluorouracil-based chemotherapy and mitomycin C, concurrent with pelvic radiation therapy. Multiple studies have evaluated the optimal chemotherapy agents, radiation dose, and radiation technique in order to further improve outcomes and minimize toxicity in patients with anal cancer. This chapter focuses on the background and multidisciplinary management of squamous cell carcinoma of the anal canal. Squamous cell cancer of the anal margin, adenocarcinoma of the anal canal, and melanoma of the anorectal region are also reviewed.
