Chemoradiation for anal cancer
This treatment combines a course of radiation therapy with some chemotherapy sessions. The chemotherapy makes the cancer cells more sensitive to the radiation therapy.
For anal cancer, a typical treatment plan might involve a session of radiation therapy every weekday for several weeks, as well as chemotherapy on some days during the first and fifth weeks. This approach allows for lower doses of radiation therapy.
Learn more about:
- Radiation therapy
- Side effects of chemoradiation
- Video: What are chemotherapy and radiation therapy?
Also known as radiotherapy, this treatment uses targeted radiation, such as x-ray beams, to kill or damage cancer cells. Treatment is carefully planned to do as little harm as possible to the normal body tissue around the cancer.
During a treatment session, you lie under a machine that delivers radiation to the treatment area. It usually takes 10–20 minutes to set up the machine, but the treatment itself takes only a few minutes and is painless. You will be able to go home afterwards
This is the treatment of cancer with anti-cancer (cytotoxic) drugs. It aims to kill cancer cells while doing the least possible damage to healthy cells. For anal cancer, the drugs are usually given into a vein through an intravenous (IV) drip.
Side effects of chemoradiation
Both radiation therapy and chemotherapy can have side effects. These can occur during or soon after the treatment (early side effects), or many months or years later (late side effects).
Early side effects
These usually settle down in the weeks after treatment. They may include:
- appetite loss, nausea and vomiting – nausea and vomiting are usually prevented with medicines
- bowel changes, such as diarrhoea and more frequent, urgent or painful bowel movements
- passing urine more often, experiencing pain when urinating, or leaking urine (incontinence)
- skin changes, with redness, itching, peeling or blistering around the anus, genital areas and groin – your team will recommend creams for this
- pain in the anal region – talk to your treatment team about a pain management plan
- increased risk of infection – if you have a temperature over 38°C, contact your doctor or go to a hospital emergency department
- loss of pubic hair.
Late side effects
These can occur several months, or even years, after treatment ends. They vary a lot from person to person, but may include:
- bowel changes, with scar tissue in the anal canal or rectum leading to ongoing frequent, urgent or painful bowel movements
- dryness, shortening or narrowing of the vagina (vaginal stenosis) – can be prevented or minimised by using vaginal dilators regularly
- impacts on sexuality, including painful intercourse, difficulty getting erections or loss of pleasure
- effects on the ability to have children (fertility).
Effects on sexuality and fertility
Chemoradiation for anal cancer can have a range of effects on sexuality and may also affect fertility. Ask your doctor about ways to manage these changes, as early treatment and support can help.
Podcast: Making Treatment Decisions
Dr Chip Farmer, Colorectal Surgeon, The Alfred, The Avenue and Cabrini Hospitals, VIC; Tara Faure, Lower GI Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Dr Debra Furniss, Radiation Oncologist, GenesisCare, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Max Niggl, Consumer; Julie O’Rourke, CNC Radiation Oncology, Cancer Rapid Assessment Unit, Cancer and Ambulatory Support, Canberra Health Services ACT; Dr Satish Warrier, Colorectal Surgeon, Peter MacCallum Cancer Centre, VIC.
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