When treating anal squamous cell carcinoma, how does your radiotherapy regimen change when there is a bleeding anal fissure?  

I wouldn't delay tx. The simple non-surgical things used to try to manage an anal fissure (Metamucil, warm water soaks, and a topical cream like Anusol) also help to get a patient through the acute effects of RT. I would be very uncomfortable with any surgical attempts to manage the fissure. Cutting...