Two Onc Docs Anal Cancer 2025 UPDATE
Nov 17, 2025
Get the latest scoop on anal cancer with key discussions on risk factors like HPV and smoking. Learn about the crucial diagnostic steps, including imaging and node biopsies. The hosts break down staging definitions and the proven Nigro protocol for localized disease. Discover the promising results of the PODIUM-303 trial, featuring the new retifanlimab combo therapy. They also delve into ongoing trials and innovations in treatment strategies, making this a must-listen for anyone interested in the latest in cancer care!
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HPV Drives Anal Cancer Risk
- HPV is the dominant risk factor for anal squamous cell carcinoma, especially HPV-16.
- HPV vaccination prevents anal (and other HPV-related) cancers and is therefore crucial.
Initial Diagnostic Workup Steps
- Perform a DRE and staging imaging (CT chest/abdomen/pelvis or pelvic MRI) for newly diagnosed anal cancer.
- Biopsy suspicious nodes, test for HPV, and discuss fertility preservation before treatment.
Staging Is Size And Spread Driven
- Staging hinges on primary tumor size and nodal/adjacent organ involvement (T1 <2 cm up to T4/N1).
- Stage drives management: localized stages 1–3 versus distant metastatic disease (stage 4).