Anal canal - Cancer - Healed after chemoradiation

Patient: Middle aged woman presented with pelvic pain and rectal bleeding. Problem: Anal cancer diagnosed 5 years ago. Treatment: Chemoradiation done for anal cancer at our center. Followup: Periodic followup examinations revealed favorable outcome. Technique to examine the anal canal: A long cap (cap extending 3-4 mm from the tip) allows to open the anal canal for better examination. Insert the endoscope slowly and take multiple images from the lower end to the top end of the anal canal. Notice a clean scar at the top end of the anal canal at 9 O' clock.