Anal Cancer

Written By Guest User

What is anal cancer? 

Anal cancer happens when abnormal cells grow in your anal canal. The anal canal is a short tube positioned at the last section of your intestinal tract. Most anal cancers are your anal canal. A smaller proportion of anal cancers are adenocarcinomas which arise from cells that secrete mucus to lubricate your bowel motion. Its important to understand that anal cancer is different from colon cancer and rectal cancer. These are different diseases which requires different management. 

Risk factor for anal cancer 

These factors may increase the risk of anal cancer:

  • Multiple sexual partners

  • Anal intercourse 

  • Older age 

  • Smoking 

  • History of cancer in female reproductive organs (e.g. cervical, vulvar or vaginal cancer) 

  • Human papillomavirus (HPV) virus infection is a sexually transmitted infection 

  • Immunosuppressive drugs (patients who take medications that suppress your immune system) 

  • HIV infection 

Symptoms of anal cancer 

Bleeding from the anus

A growth in the anus 

Anal itch 

Mucus discharge from the anus 

Pain in the area of the anus 

How is anal cancer treated?

A consultation with your GP and subsequent urgent referral to a colorectal surgeon will ensure that your symptoms are appropriately assessed and treated 

Work up may include: 

Baseline blood test: Full blood exam, electrolyte panel and tumour markers 

Clinical examination: Digital examination of anus 

Examine under anaesthetic + colonoscopy biopsy of the lesion to confirm disease

Once anal cancer is confirmed, additional work up includes:

Imaging with CT, MRI, PET scan for staging of the cancer. This allows your surgeon to use the cancer stage to select appropriate treatment for you

Definitive therapy 

This is usually given in a combination of chemo- and radiation therapy over 5-6 weeks. Together, these treatments enhance each other and improve your chance for a cure. You will be referred to the medical and radiation oncologist for treatment.

Your oncologist will tailor your treatment based on the features of your cancer and your general health status 

Surgery for anal cancer

Surgery is usually reserved for:

  • Very early stage anal cancer or cancers that have not responded to chemoradiotherapy - In these cases, an abdominoperineal (AP) resection will be performed, where the anal canal, rectum and a portion of the large bowel will be removed. The remaining portion of your large bowel will be permanently attached to an opening in your abdomen (stoma) through which faeces will leave for collection in a bag. 

For advance incurable anal cancers 

  • Immunotherapy - these treatment are generally reserved for patients with advance cancers. 

  • Palliative care - focusses on symptom control, pain relief and help maintain a better quality of life. 

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