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I have seen all your reports (attachment removed to protect patient identity), suggesting adenocarcinoma of text, which is 3 cm from anal verge with infiltrating surrounding lymph nodes. As I will tell you they did chemotherapy to reduce the extension of cancer cells surrounding the anal canal. As it is now very important to resection of that tumorpart, to prevent further extension. As good news is that this kind of cancer response is good for the surgery, so surgery must be done to treat this condition. So, your doctor has advised correctly.