Anal Cancer

What is Anal Cancer

Anal cancer is a disease where cancer cells form in the tissue of the anus. The anus the last part of the large intestine, where stool leaves the body. The most common type of anal cancer is called squamous cell carcinoma.

What are the causes?

The cause of this condition is not known.

What increases the risk?

You are more likely to develop this condition if:

• You have HPV (human papillomavirus).
• You engage in sexual practices that increase your risk of HPV. These include:
  • Having many sexual partners.
  • Having anal sex.
  • Being male and having sex with other males.
• You smoke cigarettes.
• You have a history of cervical, vaginal, or vulvar cancer.
• You have a weakened immune system due to:
  • Medicines called immunosuppressants.
  • Infection with HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome).
• You have an autoimmune disorder like Crohn disease or psoriasis.
• You have a history of STIs (sexually transmitted infections).

What are the signs or symptoms?

Symptoms of this condition include:

• Pain or pressure around the anus.
• Bleeding from the anus or rectum.
• A lump near the anus.
• A change in bowel habits.
• Itching around the anus.
• Discharge from the anus.
• Swollen lymph nodes around the anus or groin.

How is this diagnosed?

This condition is diagnosed based on a review of your medical history and the results of a physical exam and tests. Exams and tests may include:

• A digital rectal exam. During this exam, a gloved, lubricated finger is inserted into the anus and rectum to check for lumps.
• Anoscopy. During this test, a hollow tube is inserted into the anus and rectum. A health care provider looks through the tube for lumps and signs of disease.
• Proctoscopy. During this test, a lighted, hollow tube is inserted into the rectum. A health care provider looks through this tube to see the lower part of the colon.
• Endoanal or endorectal ultrasound. During this test, a small probe is inserted into the anus or rectum.
• Biopsy. During this test, a tissue sample is taken from the anus and rectum to be examined under a microscope for signs of cancer.

Your health care provider may refer you to an expert who specializes in diagnosing and treating anal cancer. If you are diagnosed with cancer, you may need to have more tests to see if the cancer has spread to other parts of the body. These tests can include:

• X-ray.
• CT scan.
• MRI.
• PET scan.

How is this treated?

Treatment for this condition depends on where the tumor is, the type of cancer, and how much the cancer has spread in the body (the stageof the cancer). Treatment can include any combination of the following:

• Surgery. This may be done to remove the tumor and any lymph nodes that are infected with cancer. If the cancer is severe, surgery may be done to remove the anus, rectum, and part of the colon.
• Radiation therapy. This treatment uses high energy radiation or X-rays to kill cancer cells or stop them from growing.
• Chemotherapy. This treatment involves drugs that kill cancer cells or stop them from growing.

Follow these instructions at home:

Learning about your cancer

• Learn about your cancer and your treatment options. Make sure you understand the potential side effects of treatment.
• Ask about getting a second opinion. This can help you make a more informed decision about your treatment options.

Eating and drinking

• Drink enough fluid to keep your urine clear or pale yellow.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
• Eat a healthy diet. When planning meals:
  • Aim to get 2 ½ cups of fruits and vegetables a day.
  • Choose high-fiber foods like whole-grain breads and cereals.

Activity

• During and after treatment, return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Exercise regularly. Aim for 30 minutes of moderate-intensity exercise 5 days a week, such as walking or yoga.
• Talk with your health care provider before starting any exercise routine. This is important.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

You cannot prevent this condition completely, but you can lower your risk of developing it by:

• Getting the HPV vaccine.
• Avoiding infection with HPV and HIV. You can do this by:
  • Limiting your number of sexual partners.
  • Using protection, like condoms, during all sexual activity. Note that condoms cannot completely protect you from HPV.
• Not smoking. If you need help quitting, ask your health care provider.

Contact a health care provider if:

• You have bleeding or discharge from your anus.
• You have pain or pressure near your anus.
• You have a change in bowel habits or diarrhea.
• You have nausea or vomiting.

Get help right away if:

• You have a fever.
• You have chest pains or shortness of breath.
• You have a severe headache with a stiff neck.
• You have bloody or cloudy urine.
• You are confused.
• You have any swelling in your legs or arms or around a wound.

Summary

• Anal cancer is a disease where cancer cells form in the tissue of the anus.
• You are more likely to develop anal cancer if you are infected with HPV, you smoke cigarettes, or if you have a weakened immune system due to medicines, HIV, or AIDS.
• Treatment for anal cancer can include surgery, radiation therapy, or chemotherapy.
• You can lower your risk for anal cancer by getting the HPV vaccine, not smoking, and avoiding infection with HPV and HIV.