For the first time today i met a 63 years female, known HIV positive patient who lost on follow up with Anal cancer.. By looks ,it's scaring but patient need to be guided on progress of the condition.. The risk of disease Metastasis is very high.. Persistent disease – Re-evaluate with imaging after 4 weeks, as treatment response can continue for up to 26 weeks after completion of therapy. If disease progression is seen at re-evaluation, treatment is as for progressive disease. If re-evaluation shows regression or no progression of disease, patients are monitored for continuing response at 3-month intervals, using the imaging studies utilized for initial work-up of anal carcinoma.