Anal Cancer

Anal cancer is an uncommon cancer in the anal canal, the short tube that connects the rectum to the outside skin of the anus. It’s easy to mistake symptoms of anal cancer for other conditions such as hemorrhoids, which could cause a delay in diagnosis. But early diagnosis is critical. A consultation with a physician is highly recommended if you start to experience any symptoms that could signal anal cancer.

Like all other cancers, anal cancer is caused by abnormal mutations in healthy cells. In other words, these cells do not die at a set time like normal cells. This abnormality causes them to accumulate, causing a mass or tumor to form.

Human papillomavirus (HPV), a sexually transmitted disease, is closely related to anal cancer. Some patients suffer from both disorders.

Some factors may increase your risk for developing anal cancer:

Age

Anal cancer is most common in people over the age of 50.

Sexual Habits

Both men and women who are involved in anal sex are at a higher risk. However, women who have had many partners are at greater risk. You are also at higher risk if you have HPV.

Smoking

Harmful chemicals in cigarettes increase the risk of many cancers including anal cancer.

Compromised Immune System

If you have a weakened immune system due to HIV/AIDS, or take drugs to suppress your immune system, you are at increased risk.

Some symptoms of anal cancer resemble those of other less serious conditions. You should schedule an appointment with your doctor if you are experiencing:

• anal or rectal bleeding
• swollen lymph nodes in the area of the anus or groin
• persistent anal itching
• a lump or mass at the opening of the anus
• mucous or pus draining from the anus
• anal pain

Diagnosis usually starts with a rectal examination. A doctor will insert a lubricated finger into the anus and feel for lumps or abnormalities. Your doctor may also perform a visual inspection using a scope. Later, the doctor may perform a biopsy. A biopsy involves removing a piece of the tumor tissue and sending it to a laboratory to look for cancer cells.

Once the cancer has been identified, the doctor will do X-rays, MRIs, and CT scans to determine what stage the cancer is in. The stages of anal cancer are:

• Stage I—The tumor is about 2 cm or less.
• Stage II—The tumor has exceeded 2 cm but has not spread from the anal canal.
• Stage IIIA—The tumor may be any size and has spread to the lymph nodes or spread to nearby organs such as the vagina or bladder.
• Stage IIIB—The tumor may be any size and has spread to the lymph nodes near the rectum or in the pelvis.
• Stage IV—Cancerous cells have spread away from the pelvic area into other parts of the body.

In most cases, anal cancer is caught early, and treatment is very effective. The cancerous cells are eliminated using a combination of radiation therapy and chemotherapy.

Chemotherapy drugs may be taken orally or injected into the body. The drug kills cells that produce rapidly, like cancer cells. They may also kill healthy cells, which can cause side effects like hair loss and nausea.

Radiation like that used in X-rays, to destroy cancerous cells. The beam of X-ray radiation is pointed directly at the affected areas of the body. It may kill some healthy cells that are in or near the affected area. Side effects from radiation for anal cancer include redness of the skin, and sores in and around your anus.

In the early stages, radiation and chemotherapy may not be required if your doctor can remove the tumor or tumors through surgery. However, depending on the size of the tumor and how much tissue needs to be removed, your physician may suggest chemotherapy and radiation prior to surgery. The treatment may shrink the tumor and prevent the necessity to remove of the anal sphincter, the muscles that control bowel movements.

In the later stages of anal cancer, when the tumor has not responded to drug and radiation therapy, an abdominoperineal resection may be performed. This surgery involves removing the rectum, the anal canal, and some of the colon. The surgeon will then attach the remaining portion of the colon to an opening created in the abdomen. This allows waste to exit the body into a colostomy bag.

Few cancers can be completely prevented. But you can take steps to reduce your risk:

• Get checkups regularly.
• Use condoms during any intercourse to prevent the passing of HPV or HIV.
• Consider getting an HPV vaccine (like Gardasil and Cervarix).
• If you already have HIV or HPV talk to your doctor about setting up regular anal cancer screenings to make early diagnosis easier.
• If you smoke, quit.