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Anal Cancer

By

Minhhuyen Nguyen

, MD, Fox Chase Cancer Center, Temple University

Last full review/revision Mar 2021| Content last modified Mar 2021
CLICK HERE FOR THE PROFESSONAL VERSION
  • Risk factors for anal cancer include certain sexually transmitted diseases.

  • Bleeding with bowel movements, pain, and sometimes itching around the anus are typical symptoms.

  • A manual examination, sigmoidoscopy or colonoscopy, and a biopsy are done to verify the diagnosis.

  • Treatment may involve either surgery alone or a combination of radiation therapy and chemotherapy or radiation therapy and surgery.

Anal cancer develops in the skin cells of the immediate area around the anus or in the lining of the transitional zone between the anus Rectum and Anus The rectum is a chamber that begins at the end of the large intestine, immediately following the sigmoid colon, and ends at the anus (see also Overview of the Anus and Rectum). Ordinarily, the... read more and the rectum Rectum and Anus The rectum is a chamber that begins at the end of the large intestine, immediately following the sigmoid colon, and ends at the anus (see also Overview of the Anus and Rectum). Ordinarily, the... read more (the anal canal). Unlike in the rectum and the large intestine, in which cancers are almost always adenocarcinomas, cancers of the anus are primarily squamous cell carcinomas.

Anal cancer occurs in about 8,590 people in the United States each year and causes more than 1,350 deaths. Anal cancer is more common among women.

Risk factors for anal cancer include the following:

Symptoms of Anal Cancer

People with anal cancer often experience bleeding with bowel movements, pain, and sometimes itching around the anus. About 25% of people with anal cancer have no symptoms. In this instance, the cancer is found only during a routine examination.

Diagnosis of Anal Cancer

  • A doctor's evaluation

  • Sigmoidoscopy or colonoscopy

  • Biopsy

To diagnose anal cancer, a doctor first inspects the skin around the anus for any abnormalities. With a gloved hand, the doctor probes the anus and lower rectum, checking for any portions of the lining that feel different from surrounding areas. A flexible sigmoidoscope (a short viewing tube with a camera on the end) is used to evaluate the anus and rectum. An anoscope (a small rigid tube equipped with a light) may be inserted several inches into the anus to assist with examination.

The doctor then removes a sample of tissue from an abnormal area and examines it under a microscope (called a biopsy).

Treatment of Anal Cancer

  • Combination of radiation with chemotherapy

  • Sometimes surgery

The treatment and prognosis of anal cancer depends on the extent of the cancer.

Radiation therapy combined with chemotherapy is usually done first.

Surgery is done in people whose cancer does not go away after radiation therapy and chemotherapy or goes away and comes back. With surgery, the doctor must be careful not to interfere with the functioning of the muscular ring that keeps the anus closed (the anal sphincter). The anal sphincter stays closed until the person has a bowel movement. A sphincter that does not function properly could lead to loss of control over bowel movements (fecal incontinence Fecal Incontinence Fecal incontinence is the loss of control over bowel movements. Fecal incontinence can occur briefly during bouts of diarrhea or when hard stool becomes lodged in the rectum (fecal impaction)... read more ).

For people whose cancer has not spread, therapy cures many anal cancers, with 70% or more of people surviving longer than 5 years.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSONAL VERSION
CLICK HERE FOR THE PROFESSONAL VERSION
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