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Anal Cancer Treatment
Mar 2, 2001

I was diagnosed with infiltrative keratinizing squamous cell carcinoma as a result of an anal biopsy. I am HIV+ and had Hodgkins Disease in 1998, with no recurrence. My oncologist first recommended full excision of the perianal region, leaving me with a colostomy. He estimated an 80 cure rate. My radiation therapist said that his experience with chemo and radiation therapy has had a 90 success rate (data for whole population, i.e. not only HIV+ persons). My viral load is nearly undetectable, and my t cell count is about 200. I am a 41 year old male. Given these two options, I have chosen the chemo-radiation, as I would prefer not to have the colostomy. Can you please offer your opinion?

Response from Dr. Dezube

The standard treatment for anal cancer is a combination of chemotherapy (typically with 5-FU and mitomycin) and radiation. This has been the standard of care for well over a decade. In general, there is NO need for a colostomy. The standard treatment of anal cancer is the same whether you are HIV positive or negative. HOWEVER, on a rare occasion and under special circumstances, we do recommend a colostomy. Given that your viral load is undetectable and that your CD4 count is about 200, you should do quite well. The success rate that your radiation therapist quotes is quite accurate. Good luck. BD.


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