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Chemotherapy and radiation for anal cancer? Can HIV positive patients get these therapies?
Aug 7, 2001

Are chemotherapy and radiation for anal cancer contraindicated in HIV positive patients?

Response from Dr. Dezube

HIV-positive patients are at an increased risk for developing anal cancer as a consequence of HPV (human papilloma virus infection). We recommend anal PAP smears as a way of catching such lesions early (please see my separate response on Anal PAP smear posted earlier this month). On occasion, precancerous lesions do indeed become cancerous. The cancerous lesions are treated with a combination of chemotherapy (typically 5-fluorouracil, mitomycin) and radiotherapy. Not only are they NOT contraindicated in HIV positive patients, they are the treatment of choice once invasive cancer develops. HIV positive patients often tolerate these treatments less well than HIV negative patients. Nevertheless this is the best treatment for this condition and it has a very good success rate of sparing patients from needing a colostomy bag. Patients who receive this combination of chemotherapy and radiation should NOT be taking AZT (zidovudine, combivir) since this anti-retroviral medication does NOT mix well with chemotherapy. BD.

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