What is Anal Cancer?

Anal cancer is an uncommon type of cancer. It occurs in the anal canal, which is a short tube at the end of your rectum through which stool leaves your body.

Anal cancer is common in older adults 60 years and above and is rare in people younger than 35. Anal cancer is less common than the other gastrointestinal system cancers and comprises less than 3% of all gastrointestinal system cancers in the US. On average, 8,000 new cases are diagnosed every year in the US.

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What is Anal Cancer?

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Anal cancer is an uncommon type of cancer. It occurs in the anal canal, which is a short tube at the end of your rectum through which stool leaves your body.

Anal cancer is common in older adults 60 years and above and is rare in people younger than 35. Anal cancer is less common than the other gastrointestinal system cancers and comprises less than 3% of all gastrointestinal system cancers in the US. On average, 8,000 new cases are diagnosed every year in the US.

Symptoms of Anal Cancer

Most patients with anal cancer do not show symptoms. However, as the disease progresses the following symptoms may appear:

  • Changes in bowel habits.
  • Anal or rectal bleeding.
  • Rectal itching.
  • A lump or mass at the anal opening.
  • Abnormal discharge from the anus.
  • Swollen lymph nodes in the anal or groin area.

Symptoms of Anal Cancer

Most patients with anal cancer do not show symptoms. However, as the disease progresses following symptoms may appear:

  • Changes in bowel habits.
  • Anal or rectal bleeding.
  • Rectal itching.
  • A lump or mass at the anal opening.
  • Abnormal discharge from the anus.
  • Swollen lymph nodes in the anal or groin area.

Presence of these symptoms does not necessarily mean you have anal cancer. These symptoms may be caused by many other benign conditions. You doctor will advise if further testing is needed to confirm a diagnosis.

Causes of Anal Cancer

Anal cancer is a disease in which cancer cells form in the tissues of the anus. These cancer cells multiply rapidly out of control. What causes the cells to grow rapidly is still not known but multiple risk factors have been identified.

Risk Factors of Anal Cancer

Risk factors for anal cancer include:

  • Human papillomavirus (HPV) infection.
  • Multiple sexual partners.
  • Anal intercourse.
  • HIV Infection / AIDS.
  • History of other cancers.
  • Smoking.
  • Lowered immunity.

Prevention of Anal Cancer

You can prevent anal cancer by avoiding the above risk factors. These include:

  • Using condoms and barrier contraceptives.
  • Vaccinations against Human Papillomavirus (HPV).
  • Treating HIV.
  • Smoking cessation.

Diagnosis of Anal Cancer

If you have symptoms suggestive of anal cancer, your doctor will ask for a detailed medical history and perform an appropriate examination. You may also be advised for further testing to confirm the diagnosis. Testing may include:

  • Anoscopy / Protoscopy: Your doctor will examine your anal canal (and rectum) with a short speculum. A small tissue sample may also be taken (biopsy) for examination under microscope.
  • Double contrast barium enema: You will be given an enema with a barium solution, following by X-ray imaging. Barium is a chemical that allows the bowel lining to show up on an X-ray.
  • Colonoscopy.
  • CT scans / MRI scans / PET-CT scans.

Treatment of Anal Cancer

If you are diagnosed with anal cancer, your doctor will order further testing to see how aggressive the cancer is and how far it has spread. Treatment options are then discussed,  depending upon stage of the disease. Treatment options include surgery, chemotherapy, and radiotherapy.

  • Surgical Management of Anal Cancer

If your anal cancer is small and localized, your doctor may remove the tumor along with some of the surrounding tissue.

In some cases, the anus, the rectum and part of the colon are removed through an incision in the abdomen called abdominoperineal resection. The one end of the intestine is then attached to an opening in the abdomen. This also is called a colostomy. You will wear a bag over the colostomy to collect bowel movements.

  • Medical Management of Anal Cancer

Medical management is usually chemotherapy.

Chemotherapy is an aggressive treatment used to slow or stop the growth of cancer cells. It may be advised after the surgery or when anal cancer has spread to multiple organs and surgery cannot be performed.

After surgery, microscopic cancer cells may still be present. These cells should be removed for complete cure. If these cells are left without treatment, they will multiply and form cancer again.

Most chemotherapy treatments involve a combination of several drugs provided at different times. Your health care provider will inform you in detail regarding the drugs, the duration of treatment, and the expected side effects.

Follow-up Care

Close follow-up is very important after treatment. Some tumors reappear after treatment, so your doctor will monitor your recovery and check for cancer recurrence at specific intervals by ordering different blood tests, CT scan imaging, or repeating the anoscopy.

Follow-up doctor visits may occur as often as every three months for at least two years, and then possibly reducing in occurrence thereafter. Follow-up exams will depend upon your condition.