Follow-up after treatment for anal cancer
Follow-up after treatment is an important part of cancer care. Follow-up for anal cancer is often shared among the cancer specialists (oncologists), the surgeon and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.
Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:
- bleeding from the anus
- pain, or an increase in pain, especially in the groin, pelvis or abdomen
- any new lump or swelling
Follow-up is especially important during the first 6 months after chemoradiation. During these follow-up visits, doctors check how the cancer responded to treatment. They want to know if the anal cancer is completely gone or if it is still shrinking (tumours can continue to shrink several months after chemoradiation is finished). This helps them decide if they need to give more treatment.
The chance of anal cancer recurring is greatest within 2 years, so close follow-up is needed during this time.
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The first follow-up visit usually happens 8–12 weeks after chemoradiation to check how the cancer responds to treatment.
Follow-up visits after treatment is finished are usually scheduled every 3–6 months for 5 years.
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During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping.
Your doctor may do a physical exam, including:
- digital rectal exam (DRE)
- feeling the lymph nodes in the groin
Tests are often part of follow-up care. You may have:
- anoscopy or proctoscopy to check if any cancer was left behind or came back after treatment
- CT scan of the chest, abdomen and pelvis
- biopsy to confirm that any cancer found is anal cancer
Anoscopy or proctoscopy is usually done at the same time as a physical exam. A CT scan is usually done every year for 3 years if the primary tumour was large or cancer had spread to lymph nodes.
If a recurrence is found, your healthcare team will assess you to determine the best treatment options.
Alberta Health Services . Anal Canal Cancer Clinical Practice Guideline GI-001 . version 4 ed. 2013 : https://www.albertahealthservices.ca/.
American Cancer Society. Anal Cancer. 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003083-pdf.pdf.
American Society of Clinical Oncology. Anal Cancer. 2014: http://www.cancer.net/cancer-types/anal-cancer.
BC Cancer Agency (BCCA) . Cancer Management Guidelines: Anus . 2012 : http://www.bccancer.bc.ca/.
Czito BG, Ahmed S, Kalady M, Eng C . Cancer of the Anal Region. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 61:842-856.
National Comprehensive Cancer Network. Anal Carcinoma. version 2 ed. National Comprehensive Cancer Network; 2015: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
Penn Medicine . Anal Cancer: The Basics . University of Pennsylvania ; 2015 : https://www.oncolink.org/.