This photo was taken inside the rectum with the scope retroflexed, or turned back upon itself. It is a view from the inside looking towards the outside. You can see the black colored scope entering the colon from the anal canal. In addition, you can see a cancer of the anus which is wrapped around the scope. This patient went on to have radiation therapy and chemotherapy and did not need to lose her rectum. It has been 6 years and, so far, she is doing well with no evidence of recurrent disease. Anal cancer is just a bit different from colon cancer in general. Because of its accessiblity, radiation therapy is often quite successful and surgery is avoided. In some cases, surgery is needed to be sure that all of the cancer is removed. If the anus and rectum are removed, a new opening, or colostomy, must be created to expel the waste. For more information about caring for a colostomy, take a look at the Hollister company website.