A rare form of cancer, anal cancer affects the tissues or lining of the anal canal. It is a short tube connecting the anus (the opening where stool leaves the body) to the lower part of the digestive system. There are several symptoms associated with anal cancer, including bleeding from the anus or rectum, pain in the anus area, lumps or masses in the anal canal, itching around the anus, and changes in bowel movements.
The exact cause of anal cancer is unknown. However, there are some factors that may increase the risk of developing it. These include:
Being exposed to human papillomavirus (HPV), a common virus that is passed through sexual contact. HPV can cause changes in the cells that may lead to many types of cancer, including anal cancer.
Having many sexual partners or having sex with someone who has HPV.
Having anal sex.
Having had other types of cancer before, such as cervical, vulvar, or vaginal cancer.
Smoking.
Having certain genetic conditions or inherited syndromes that affect the immune system or DNA repair.
The symptoms of anal cancer may vary depending on the type and stage of the disease. Some common symptoms are:
Bleeding from the anus or rectum, especially during bowel movements123.
Blood in the stool.
Pain in the area of the anus.
A lump or mass in the anal canal
Anal itching
Feeling like you constantly need to poop (tenesmus)
Seeing a change in your bowel movements, such as frequency or consistency of your stools (poop)
Leaking stool
Feeling like you have incomplete emptying of your rectum after a bowel movement
There are many things that can cause these symptoms besides anal cancer. Therefore, having one or more symptoms does not necessarily mean you have anal cancer. If, however, your symptoms persist for more than a few days, you should speak with your physician.
In order to diagnose anal cancer, a doctor performs a combination of physical examinations and tests. The first step is to perform a digital rectal exam (DRE), in which a gloved finger is inserted into the anus and rectum to feel for lumps or abnormalities. In addition to your medical history, the doctor may ask you about your risk factors for anal cancer, including HIV infection, many sexual partners, anal sex, or previous genital cancers.
If the DRE reveals any signs of anal cancer or other problems, the doctor may order more tests to confirm the diagnosis and determine the stage of the cancer. Typically, the stage indicates how far the cancer has spread from its original site. Lower numbers indicate that the cancer is more likely to be cured if it is early-stage.
Some of the tests that may be used to diagnose anal cancer are:
Anoscopy: This is when a doctor uses a thin tube with a light and a camera (an anoscope) to look inside the anus and rectum. The doctor can see any abnormal areas and take samples (biopsies) for further testing.
Rigid proctosigmoidoscopy: This is similar to an anoscopy, but it uses a longer tube that can also see part of the lower colon (sigmoid colon). The doctor may need you to empty your bowels before this test.
Endoscopy: This is when a doctor uses another thin tube with a light and a camera (an endoscope) to look inside your digestive tract. A common type of endoscopy that can see your anus and rectum is called colonoscopy. You may need sedation or anesthesia for this test.
Imaging tests: These are tests that use different methods to create pictures of your body. They can show where the cancer is located and how big it is. Some examples are ultrasound, X-ray, MRI, CT scan, PET scan, and endorectal ultrasound.
Blood tests: These are tests that measure certain substances in your blood that may indicate how advanced your cancer is or how well you respond to treatment.
Using these tests, you can determine whether you have squamous cell carcinoma (SCC), the most common type of anal cancer; adenocarcinoma (AC), which is less common, but more aggressive; sarcomas, which are very rare; lymphomas, which are very rare; or other types.
The treatment options for anal cancer depend on several factors, such as:
The type and stage of your disease
Your overall health and preferences
The availability and cost of treatment
The main goals of treatment are to remove all traces of cancer cells from your body and prevent them from coming back. The main types of treatment are:
As a first-line treatment for early-stage anal cancers, surgery involves removing part or all of the affected area along with some healthy tissue surrounding it. Depending on how much tissue needs to be removed and how far the cancer has spread, different types of surgery are available.
Some common types of surgery for anal cancer are:
Tumor excision: A procedure that removes a small tumor (about 1 cm or less) from the anus or rectum
Abdominoperineal resection: A procedure that removes the entire anus, rectum, and a portion of the colon (large intestine) through an incision in the abdomen
Anoscopy-assisted resection: A procedure that uses an anoscope (a thin tube with a light and camera) to examine and remove a tumor from the anus or rectum
Surgery can cure most cases of anal cancer, but it may also cause side effects such as:
Infection
Bleeding
Pain
Nerve damage
Bowel problems
Sexual problems
Surgery may also affect your ability to have children in the future.
A radiation therapy involves the use of high-energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy can be given externally (from a machine outside your body) or internally (by placing radioactive material inside your body near the tumor).
The use of radiation therapy after surgery is often used to reduce the risk of recurrence (cancer coming back) or as a palliative (relieving) treatment for advanced anal cancers.
Radiation therapy can cause side effects such as:
Skin irritation
Ulcers
Sores
Inflammation
Fatigue
Nausea
Diarrhea
Radiation therapy may also affect your fertility and sexual function.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy can be given orally (by mouth), intravenously (through a vein), or topically (on the skin).
Chemotherapy is often used after surgery to reduce the risk of recurrence or as a palliative treatment for advanced anal cancers that cannot be removed by surgery.
Chemotherapy can cause side effects such as:
Hair loss
Nausea
Vomiting
Diarrhea
Mouth sores
Low blood cell counts
Chemotherapy may also affect your fertility and sexual function.
In immunotherapy, your immune system fights cancer cells using substances made by your own immune system or made in a laboratory. Immunotherapy can be given intravenously or subcutaneously (under the skin).
For some anal cancers that don't respond well to other treatments, such as squamous cell carcinoma that has spread, immunotherapy is being studied.
Immunotherapy can cause side effects such as:
Fever
Chills
Rash
Itching
Fatigue
Immunotherapy may also affect your fertility and sexual function.
Although there is no proven way to completely prevent anal cancer, you may be able to lower your risk by taking some steps. These include:
In addition to genital warts, HPV can cause cervical, vaginal, vulvar, penile, anal, oral, throat, esophageal, and penile head/neck cancer. HPV subtypes 16 and 18 can be protected against by vaccines that are available only before you become sexually active. These vaccines do not protect against other HPV subtypes that may cause anal cancer.
Smoking is a known risk factor for many types of cancer, including anal cancer. Quitting smoking greatly reduces your risk of developing anal cancer and many other cancers.
In order to control HIV infection and prevent it from progressing to AIDS, it is very important to take medicines called antiretroviral therapy (ART). Additionally, ART can reduce your risk of long-term HPV infection as well as anal intraepithelial neoplas . In order to monitor your health and detect early signs of anal cancer, regular check-ups with an HIV specialist are also essential.
Although there is no proven way to completely prevent anal cancer, you may be able to lower your risk by taking some steps. These include:
In addition to genital warts, HPV can cause cervical, vaginal, vulvar, penile, anal, oral, throat, esophageal, and penile head/neck cancer. HPV subtypes 16 and 18 can be protected against by vaccines that are available only before you become sexually active. These vaccines do not protect against other HPV subtypes that may cause anal cancer.
Smoking is a known risk factor for many types of cancer, including anal cancer. Quitting smoking greatly reduces your risk of developing anal cancer and many other cancers.
Antiretroviral therapy (ART) helps control HIV infection and prevents it from progressing to AIDS if you have HIV infection. Additionally, this can lower your risk of long-term HPV infection and anal intraepithelial neoplasia (AIN), which is a condition that increases the risk of developing anal cancer.
If you keep your anus clean and dry, you can prevent infections that can damage the cells lining your anus and rectum. You should wash your anus gently with warm water after a bowel movement or whenever you feel dirty or sweaty. Avoid harsh soaps and perfumed products that may irritate your anus skin.
Some changes in your anus may be normal and harmless, such as itching, burning, or bleeding after a bowel movement. However, some changes may be signs of AIN or anal cancer, such as:
A lump or mass in the anal canal
A sore or ulcer in the perianal skin
Bleeding from the anus or rectum that does not stop
Changes in your bowel habits or stool appearance
Pain or discomfort in the area of the anus
If you notice any of these changes, you should see your doctor as soon as possible for further evaluation and treatment.
A rare but serious form of cancer, anal cancer affects the anal canal lining or tissues. A lump or mass in the anal canal, anal itching, bleeding from the anus or rectum, and changes in bowel movements can be symptoms of it. There are some factors that may increase your risk of developing anal cancer, but the exact cause is unknown.
The main treatment options for anal cancer are surgery, radiation therapy, chemotherapy, immunotherapy, depending on several factors such as:
The type and stage of your disease
Your overall health and preferences
The availability and cost of treatment
The main goals of treatment are to remove all traces of cancer cells from your body and prevent them from coming back.
Although there is no proven way to completely prevent anal cancer, you may be able to lower your risk by taking some steps such as getting vaccinated against HPV, not smoking
