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Living with cancer· Appointment prep

Appointment sheet: Metastatic and recurrent anal squamous cell carcinoma

One page to bring and write on: your details, the questions for Metastatic and recurrent anal squamous cell carcinoma plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Metastatic and recurrent anal squamous cell carcinoma

Prepared with OnCo (onco.cc/prep/metastatic-anal-cancer/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

15 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example HPV and p16 status, PD-L1, Circulating HPV DNA, HIV status and CD4 count, Mismatch repair and tumour mutational burden), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
First line
  1. 5.For my situation (first line), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Retifanlimab, and what side effects should I expect?
After platinum chemotherapy
  1. 7.For my situation (after platinum chemotherapy), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Nivolumab, Pembrolizumab, Fluorouracil (5-FU), and what side effects should I expect?
Oligometastatic disease
  1. 9.For my situation (oligometastatic disease), which of the standard options do you recommend and why?
Isolated pelvic recurrence
  1. 10.For my situation (isolated pelvic recurrence), which of the standard options do you recommend and why?
Any stage
  1. 11.Are there clinical trials I could join, for example of Retifanlimab, Circulating tumour HPV DNA (ctHPV-DNA), Nivolumab, Pembrolizumab?
  2. 12.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 13.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 14.I read that “Median survival remains under two years even with a PD-1 antibody added to chemotherapy”. How does that affect my plan?
  5. 15.I read that “No second-line standard exists after chemo-immunotherapy”. How does that affect my plan?

The words I may hear

  • Re-irradiation: Giving radiotherapy again to a region that has already been treated, once thought impossible because normal tissues remember the first dose.
  • HPV-positive (p16) head and neck cancer: Throat cancers caused by the human papillomavirus, identified by a p16 stain.

Tests and results to bring

Biomarker results to ask for: HPV and p16 status, PD-L1 (not required for retifanlimab), Circulating HPV DNA (investigational monitoring), HIV status and CD4 count, Mismatch repair and tumour mutational burden (rarely relevant).

Scans and tests linked to this cancer: Circulating tumour HPV DNA (ctHPV-DNA).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call