Anal Cancer: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Anal Cancer?
An oncologist, a cancer doctor, treats anal cancer with help from a radiation doctor and a surgeon who works on the colon and rectum. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is anal cancer?
Anal cancer is cancer that forms in the tissues of the anus. The anus is the opening at the end of the large intestine, where stool leaves the body. The most common type is squamous cell carcinoma.
Symptoms
Signs of anal cancer can include:
- Bleeding from the anus or rectum.
- A lump near the anus.
- Pain or pressure around the anus.
- Itching or discharge from the anus.
- Changes in bowel habits, such as narrower stools, going more often, or leaking stool.
Causes and who gets it
Most anal cancers are linked to infection with human papillomavirus, or HPV. HPV is a virus that spreads through sexual contact. About 95% of anal cancers are linked to HPV.
Your risk is higher if you:
- Have a weak immune system, from HIV or from medicines taken after an organ transplant.
- Have had cervical, vaginal, or vulvar cancer.
- Have many sexual partners.
- Have anal sex.
- Smoke cigarettes.
How doctors diagnose it
First, the doctor asks about your symptoms and your family health history. Then the doctor may do a digital rectal exam. That is an exam where a gloved finger feels the anus and rectum for lumps.
Other tests include anoscopy, a short lighted tube used to view the anus and lower rectum, and proctoscopy, a thin tube with a light and a lens to look inside the rectum. Doctors may also use endo-anal ultrasound, a probe placed in the rectum that makes pictures with sound waves. Doctors may take a biopsy, a small tissue sample, during these exams.
Then doctors learn the stage of the cancer. The stage tells how far the cancer has spread and guides the treatment plan.
Treatment
Chemotherapy with radiation, given together at the same time, is the main treatment for most anal cancers. Doctors call this mix chemoradiation. Cancer experts call it the standard treatment for stage I to III anal cancer. Chemotherapy uses drugs to kill cancer cells. The drugs travel through the bloodstream and can be taken by mouth or injected into a vein. Radiation uses high-energy X-rays. It can come from a machine outside the body or from material placed inside the body near the cancer.
Surgery is used only in some cases. Local resection cuts out the tumor and some healthy tissue around it. It may be an option when the cancer is small and has not spread. If cancer remains or comes back after chemoradiation, doctors may do an abdominoperineal resection. This surgery removes the anus, the rectum, and part of the sigmoid colon. It creates a stoma, an opening on the belly where stool drains into a bag.
Other options when cancer remains or returns include more chemoradiation, chemotherapy alone, or immunotherapy, a treatment that helps the immune system fight cancer. For stage IV anal cancer, care may include palliative surgery, palliative radiation, or chemotherapy. Palliative care relieves symptoms and improves quality of life.
When to see a doctor
See a doctor if you have any bleeding from the anus or rectum, a lump near the anus, or pain or itching around the anus. These signs need a checkup. Call 911 or your local emergency number right away for bleeding that will not stop, severe abdominal pain or pressure, fainting, or trouble breathing. If you are an adult with HIV, ask about yearly anal cancer screening. It includes a digital rectal exam.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can check symptoms, do the first exams, and refer you to cancer specialists when needed.
Common questions
What is the main treatment for anal cancer?
Chemotherapy with radiation, given together at the same time, is the main treatment for most anal cancers. Surgery is used only in certain cases, such as when the cancer is small or when it remains after chemoradiation.
Is anal cancer linked to HPV?
Yes. About 95% of anal cancers are linked to HPV. HPV is a virus that spreads through sexual contact.
Can I lower my risk of anal cancer?
You may lower your risk by getting an HPV vaccine and not smoking. If you smoke, your doctor can help you quit.
Will I need a colostomy?
Not usually at first. A colostomy is made only if surgery is needed, such as when the cancer remains or comes back after chemoradiation.
Sources
- MedlinePlus - Anal Cancer
- National Cancer Institute - Treatment for Anal Cancer
- National Cancer Institute - Anal Cancer Treatment (PDQ)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
