Combined Therapy for Cancer of the Anal Canal: A Preliminary Report*

IN COMPARISON with adenocarcinoma of the rectum, anal cancer is uncommon. 2 According to Morson, a one squamous-cell cancer is seen for every 28 rectal adenocarcinomas, an incidence of about .'4.5 per cent. As a consequence, individual experience with anal cancer is limited. Fortunately, several recent collective reviews provide guidelines for treatment. 4, s Surgery has largely supplanted radiation therapy as the primary treatment modality for anal cancer, especially when there is a chance for cure. Local excision is usually done for cancer of the anal margin, while resection of the rectum is the preferred treatment for cancer of the anal canal. Resuhs of surgical treatment o~ cancer of the anal margin are good, since the lesions are usually well differentiated, but this is not the case with cancer of the anal canal. These lesions, which lie in close relationship to the dentate line, are neoplasms with rapid growth characteristics. They are highly anaplastic squamous cancers with various cell types sometimes described in terms such as transitional, basaloid, or cloacogenic. These tunaors generally have a poor prognosis.a