Learn about this cancer that affects the anal canal and causes bleeding and pain. Treatment is usually with a combination of radiation and chemotherapy.
Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body.
Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
Most people with anal cancer are treated with a combination of chemotherapy and radiation. Though combining anal cancer treatments increases the chance of a cure, the combined treatments also increase the risk of side effects.
Anal cancer signs and symptoms include:
Talk to your doctor about any signs and symptoms that bother you, especially if you have any factors that increase your risk of anal cancer.
Anal cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).
Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority of anal cancers. HPV is thought to be the most common cause of anal cancers.
Several factors have been found to increase the risk of anal cancer, including:
Anal cancer rarely spreads (metastasizes) to distant parts of the body. Only a small percentage of tumors are found to have spread, but those that do are especially difficult to treat. Anal cancer that metastasizes most commonly spreads to the liver and the lungs.
There is no sure way to prevent anal cancer. To reduce your risk of anal cancer:
Tests and procedures used to diagnose anal cancer include:
Once it's confirmed that you have anal cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.
Tests may include:
Your doctor uses the information from the procedures to assign your cancer a stage. The stages of anal cancer are indicated using Roman numerals ranging from 0 to IV, with the lowest stages indicating that the cancer is small and confined to the anus. By stage IV, the cancer has spread to distant areas of the body.
The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you.
What treatment you receive for anal cancer depends on the stage of your cancer, your overall health and your own preferences.
Doctors usually treat anal cancer with a combination of chemotherapy and radiation. Together, these two treatments enhance each other and improve chances for a cure.
Radiation therapy. Radiation therapy uses high-powered beams, such as X-rays and protons, to kill cancer cells. During radiation therapy, you're positioned on a table and a large machine moves around you, directing radiation beams to specific areas of your body to target your cancer.
Radiation may damage healthy tissue near where the beams are aimed. Side effects may include skin redness and sores in and around your anus, as well as hardening and shrinking of your anal canal.
You typically undergo radiation therapy for anal cancer for five or six weeks. Chemotherapy is typically administered during the first week and the fifth week. Your doctor tailors your treatment schedule based on characteristics of your cancer and your overall health.
Though combining chemotherapy and radiation increases the effectiveness of the two treatments, it also makes side effects more likely. Discuss with your doctor what side effects to expect.
Doctors typically use different procedures to remove anal cancer based on the stage of the cancer:
Surgery to remove early-stage anal cancers. Very small anal cancers may be removed through surgery. During this procedure, the surgeon removes the tumor and a small amount of healthy tissue that surrounds it.
Because the tumors are small, early-stage cancers can sometimes be removed without damaging the anal sphincter muscles that surround the anal canal. Anal sphincter muscles control bowel movements, so doctors work to keep the muscles intact.
Depending on your cancer, your doctor may also recommend chemotherapy and radiation after surgery.
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that make them undetectable by the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy treatments are generally reserved for people with advanced anal cancer.
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
Alternative medicine treatments can't cure anal cancer. But some alternative medicine treatments may help you cope with the side effects of cancer treatment. Your doctor can treat many side effects, but sometimes medications aren't enough. Alternative treatments can complement your doctor's treatments and may offer additional comfort.
Options for common side effects include the following:
While these options are generally safe, talk with your doctor first to be sure that alternative medicine options won't interfere with your cancer treatment.
A cancer diagnosis can be overwhelming and frightening. You can help yourself to feel more in control by taking an active role in your health care. To help you cope, try to:
Find someone to talk with. Find a good listener with whom you can talk about your hopes and fears. This may be a friend or a family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Or check with the National Cancer Institute or the American Cancer Society for recommendations.
Make an appointment with your family doctor if you have any signs or symptoms that worry you. If your doctor thinks you have anal cancer, you may be referred to a surgeon or a specialist who treats digestive diseases (gastroenterologist). Once a cancer diagnosis is made, you may also be referred to a doctor who specializes in treating cancer (oncologist).
Because appointments can be brief, and because there's often a lot of information to cover, it's a good idea to be well-prepared. Here's some information to help you get ready.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For anal cancer, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. Your doctor may ask:
August 12th, 2021