Anal cancer is the classic “hemorrhoids” misdirection—and the shelf loves it. If you miss the risk factors, the lymph node drainage, or the treatment algorithm, you’ll bleed points fast.

In this episode of Surgery Shelf Prep, Chris and Mars break down the high-yield presentation, key risk factors like Human Papillomavirus and Human Immunodeficiency Virus, why the dentate line predicts inguinal node spread, and the must-know management pearl: first-line treatment is combined chemoradiation, not surgery. We also cover staging imaging, when salvage abdominoperineal resection is indicated, and the common distractors that try to trick you on exam day.