Anal cancer occurs when abnormal cells grow within the anus or anal canal and form a benign or malignant tumor. Squamous cell carcinoma, which includes basaloid, epidermoid, cloacogenic, or mucoepidermoid, is a common form of anal cancer. Rare types of anal cancer often include gastrointestinal stromal tumors (GIST) and melanoma. Depending on the cancer’s severity level or progression, a combination of treatment options may be considered to successfully manage or treat anal cancer.
According to the American Society of Colon and Rectal Surgeons, the human papilloma virus (HPV) is often linked to anal cancer as a potential cause. Although HPV has been associated with anal cancer, most patients with HPV do not get anal cancer. Cancer of the cervix, vagina, or vulva may also lead to anal cancer.
In the United States, anal cancer is relatively uncommon and affects approximately one in 600 people each year. Nevertheless, there are certain risk factors that may increase the likelihood of this cancer. People over the age of 55 are generally at risk of developing anal cancer. Additionally, those who smoke, have a weakened immune system, long-standing anal fistula, HPV, or have had previous pelvic radiation therapy are at risk.
Roughly 20% of patients will not experience symptoms of anal cancer, especially if it’s found early. Regardless, symptoms of anal cancer may include:
- Bleeding from the rectum or anus
- A mass near the anal opening
- Persistent, recurring pain or itching in the anus
- Drainage from the anus
- Swollen lymph nodes in the anus or groin
- Narrowing of stool
- Increased or decreased frequency of bowel movements
- Increased straining during bowel movements
Some patients that are considered high risk (HPV positive, anal dysplasia, AIN I-III), will likely need close surveillance by Colorectal Surgeon routinely for anal exam to make sure there is no new lesions or any progression to Anal Cancer. Also Colonoscopy would be indicated at shorter intervals to make sure there is no associated Colorectal Cancer.
Generally, there are two different treatment methods used to mitigate or effectively cure Anal Cancer. Chemotherapy and Radiation combined has a synergistic response and usually works well to treat or cure. Surgery can be used as alternative if there is recurrent anal cancer or chemoradiation is contraindicated.
Small, early stage tumors are typically removed during a surgical operation to limit the risk of metastases (the spread of cancer to other areas of the body). Major surgery is often necessary for extensive anal cancer tumors. Should you require major surgery to remove your anus and rectum, your surgeon will attach a permanent colostomy to a stoma created out of your large intestine.
Chemotherapy uses specific medications, delivered either orally or intravenously (most common), to kill cancer cells in the anus. 5-fluorouracil or 5-FU, mitomycin C, and cisplatin are common medications used to treat anal cancer. Radiation therapy uses high-powered x-ray devices to kill cancer cells.
According to the American Society of Colon and Rectal Surgeons, Anal Cancer typically responds well to Chemoradiation therapy.
Radiation therapy uses high-powered x-ray devices to kill cancer cells. According to the American Society of Colon and Rectal Surgeons, anal cancer typically responds well to radiation therapy.