Anal Squamous Cell Carcinoma: Multi-disciplinary Model of Su
In order to establish a Survivorship care model for Anal Squamous Cell Carcinoma (ASCC) patients, a multi-disciplinary team of experts recently performed a comprehensive literature review and summarized best practices for the multi-disciplinary management of this unique patient population.

Following definitive chemoradiation for anal squamous cell carcinoma (ASCC), patients face a variety of chronic issues including: bowel dysfunction, accelerated bone loss, sexual dysfunction, and psychosocial distress. The increasing incidence of this disease, high cure rates, and significant long-term sequelae warrant increased focus on optimal survivorship care following definitive chemoradiation.

The principle domains of survivorship approach which were reviewed are: (1) management of chronic toxicities; (2) sexual health; (3) HIV management in affected patients; (4) psychosocial wellbeing; and (5) surveillance for disease recurrence and survivorship care delivery.

Radiation treatment to the pelvis and anus can affect pelvic floor muscles, fascia, and nerves, resulting in pelvic floor dysfunction. Specifically, significant pelvic floor muscle weakness is common after pelvic radiation. Pelvic insufficiency fractures (PIFs) are the most commonly discussed chronic bone toxicity of pelvic radiation.

Additionally, pelvic radiation has short term consequences including inflammation, erythema, and desquamation that can cause significant vaginal pain and dyspareunia in women. Whereas, men who have received external radiation therapy for prostate cancer, erectile dysfunction (ED), orgasmic dysfunction, and pain are the most common domains of sexual dysfunction following pelvic radiation.

Also, Diarrhea is the most cited gastrointestinal concern that impacts quality of life following treatment for ASCC. Diarrhea can alternate with constipation and be accompanied by abdominal cramping, rectal bleeding, or pain.

This study provides recommendations for the optimization of survivorship care for Anal Squamous Cell Carcinoma patients through a multi-disciplinary approach that supports physical and psychological wellness.

Source: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-019-6053-y
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