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Anal Cancer


Disease: Anal Cancer Anal Cancer
Category: Digestive diseases
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Disease Definition:

One of the uncommon types of cancer is the anal cancer, which occurs in the anal canal. The short tube at the end of the rectum through which stool leaves the body is called the anal canal.

The incidence of anal cancer is increasing, though it isn't clear why.

Most people with anal cancer are treated with a combination of chemotherapy and radiation. Cases are diagnosed at an early stage ــ when treatment provides the best chance for cure.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Signs and Symptoms of anal cancer may include:

  • Pain in the area of the anus.
  • Bleeding from the anus or rectum.
  • Itching in the area of the anus.
  • A mass of growth in the anal canal.

Some people mistake these signs and symptoms for a more common condition known as hemorrhoids, because the signs and symptoms of anal cancer aren’t specific to this disease. A person should consult a doctor in the case of experiencing any bothering symptoms, especially if they have any factors that increase their risk of having anal cancer. Treatment is more likely to succeed if the cancer is found at an early stage.


Anal cancer occurs when something happens that creates a genetic mutation within a cell, but its exact cause is still not known.
Cancer usually begins with a genetic mutation that turns normal, healthy cells into abnormal ones. The healthy cells grow and multiply at a set rate, and eventually die at a set time, whereas the abnormal cells grow and multiply out of control and don’t die. These abnormal cells accumulate and form a tumor. They invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).



Only in rare cases does the anal cancer spread, and when it does, it usually spreads to the liver and the lungs. Even though only a small percentage of tumors are found to have spread, those that do are particularly difficult to treat.


Treatment for anal cancer depends on the stage of the cancer, the patient’s preferences and their overall health.
Usually, radiation and chemotherapy are combined together to enhance each other and improve chances for a cure.

These drugs, which are either injected or taken as pills, travel throughout the body and kill rapidly growing cells, such as cancer cells. The problem with this treatment is that they also damage healthy cells that grow rapidly, like those in the gastrointestinal tract and in hair follicles. Its side effects are nausea, vomiting and hair loss.

In radiation therapy, high-powered beams are used in order to kill cancer, such as X-rays. During the therapy, the patient will be positioned on a table and a large machine will move around him/her, directing radiation beams to specific areas of their body in order to target the cancer. Radiation therapy also has the same problem as chemotherapy that it damages healthy tissue near the place where the beams are aimed. Its side effects are hardening and shrinking of the anal canal as well as redness and sores in and around the anus.

The usual period of time for radiation therapy is five to six weeks and in the case of chemotherapy it is usually administered during the first week and the fifth week. Based on the characteristics of the cancer and the patient’s overall health, the doctor will specifically design a treatment schedule to suit the condition of the patient.
Even though the combination of chemotherapy and radiation increases the effectiveness of the treatment, it also makes the occurrence of side effects more likely. Before undergoing this treatment, the patient should discuss all of this with their doctor.
Someone with anal cancer may be recommended lower doses of chemotherapy and radiation if they have HIV because this treatment can weaken their already fragile and vulnerable immune system. Because of this, people with HIV are more likely to experience side effects when undergoing chemotherapy and radiation.

Based on the stage of the cancer, different procedures are used to remove it, some of which are:

Surgery to remove early-stage anal cancer:
When the cancer is very small and hasn’t spread beyond the anal canal, it can be removed with surgery. During this surgery, the tumor is removed along with a small amount of healthy tissue that surrounds it. Sometimes, early-stage cancers could be removed without damaging the anal sphincter muscles that surround the anal canal in case the tumors are small. These muscles control bowel movements, so doctors work to keep the muscles intact. The patient may also be recommended chemotherapy and radiation after surgery, depending on their cancer.
They may be recommended trying a combination of chemotherapy and radiation first, in case their cancer can’t be removed without damaging the anal sphincters because this combined therapy may shrink the cancer to a size that it could be removed with surgery without damaging the sphincter.

Surgery for late-stage anal cancers or anal cancers that haven’t responded to other treatments:
The patient may be recommended an extensive operation called abdominoperineal resection, which is sometimes referred to as an AP resection. This method will be recommended if the cancer is advanced or if it hasn’t responded to chemotherapy and radiation. During this procedure the anal canal, rectum and a portion of the colon will be removed, and then the remaining portion of the colon will be attached to an opening in the abdomen (stoma), through which waste will leave the body and gather in a colostomy bag.


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