Anal Cancer

1 What is Anal Cancer?

Anal cancer is caused by abnormal and uncontrolled growth of cells in the anus. This rare form of cancer causes pain in the anal region and rectal bleeding.

It is more common among women and people who have a weakened immune system. It is also associated with human papilloma virus (HPV) infection.

As cancer grows, the malignant cells may spread to surrounding tissues and other parts of the body.

Diagnosis of anal cancer is based on physical examination and symptoms, and biopsy helps to confirm the diagnosis.

Surgery, radiation therapy, and chemotherapy are the common treatment methods suggested.

More than half of anal cancer cases are diagnosed before the spread of malignant cells. Early treatment of cancer has a good prognosis. 

2 Symptoms

Symptoms of anal cancer resemble that of other common conditions like piles and anal fissures.

The most common symptoms are

  • Bleeding from rectum
  • Itching around anus
  • Pain in and around anus
  • Lumps or growth in anal canal
  • Mucus or other unusual discharge from anus
  • Change in bowel movements like diarrhea, constipation, or thinning of stools
  • Loss of control of bowel movements

Some patients may remain asymptomatic.

It is important to get medical attention if any of the above-said symptoms exist, particularly if you have risk factors for anal cancer.

3 Causes

The actual cause of anal cancer is not clear. Several risk factors are implied in the development of this cancer.

This includes

  • Anal intercourse – those who have anal intercourse have a higher risk of developing anal cancer.
  • Multiple sexual partners – having multiple sexual partner increases the risk of anal cancer as the chances of HPV exposure is high.
  • HPV – about 80% of the anal cancers are associated with HPV.
  • Cancer – having other types of cancer like cervical, vaginal, or penile cancer increases the chance of getting anal cancer.
  • Weak immune system – people who have weak immune system like HIV/AIDS patients, patients who had transplants, or those on immunosuppressant drugs, have increased possibility of developing anal cancer.
  • Smoking – smoking increases the risk of many cancers, including anal cancer. When compared to non-smokers, smokers have higher risk of anal cancer.
  • Benign anal lesions – piles, fistulae, and irritable bowel disease may increase the chance of developing this cancer.

4 Making a Diagnosis

Anal cancers are usually diagnosed during a physical examination or during a minor procedure for removing piles or fistula.

Some of the diagnostic procedures for anal cancer include

  • Anoscopy – this procedure uses a short tube called anoscope to examine the anal canal and surrounding regions.
  • Digital rectal examination – this physical examination is used to identify abnormal growths in the anal canal and rectum.
  • Ultrasound – this imaging technique is used to visualize the anal canal and neighboring tissues for abnormalities. In this technique an ultrasound probe is inserted into the anal canal and rectum. The ultrasound waves produced by the probe helps to create an image of the region.
  • Biopsy – biopsy of the affected tissue aids in identifying abnormal cells in the region. 

Staging is done after definitive diagnosis of anal cancer. Staging is based on images produced by CT scan, MRI, and PET scan.

  • Stage I is characterized by small sized tumors that are equal to or lesser than 2 cm.
  • Stage II is diagnosed by tumors that are larger than 2cm but is localized and not spread to other tissues or organs.
  • Stage IIIA is characterized by cancer that has spread to lymph nodes present near the rectum, or to organs like bladder, urethra, or vagina.
  • Stage IIIB spreads to nearby lymph nodes and areas, or to the lymph nodes in pelvis.
  • Stage IV is characterized by spread of cancer to parts away from pelvic region.

5 Treatment

Treatment of anal cancer depends on the stage of cancer and the health of the patient.

Combined chemotherapy and radiation therapy is the most common treatment method used for controlling anal cancer.

Chemotherapy helps to kill cancer cells. It sometimes affect the healthy cells, resulting in side effects.

Radiation therapy uses high doses of radiation to kill the cancer cells. The schedule of treatment is based on the stage of cancer.

Surgery is recommended for early stage of anal cancer. In a surgery, the small tumors are removed along with a small amount of tissue surrounding it. After surgery, chemotherapy and radiation therapy may be recommended depending on the stage of cancer.

Abdominoperineal resection is a surgical procedure recommended for large tumors that does not respond to conventional treatments. In this procedure, anal canal, rectum, and a small portion of the colon is removed. The remaining portion of the colon is then attached to a small opening in the abdomen. This opening helps to remove waste materials from the body.

6 Prevention

Anal cancer cannot be prevented completely, but avoiding risk factors is the best way to reduce the risk of developing cancer.

Using condoms reduces the risk of exposure to HPV.

Vaccines also reduce risk of HPV infection.

Those who have risk factors for anal cancer should get anal screening done periodically. 

7 Alternative and Homeopathic Remedies

Several alternative and homeopathic remedies are used to control symptoms of anal cancer.

Barley, black tea, calcium, garlic, hydrazine sulphate, oats, olive, soy, and vitamin E supplements are possibly effective in controlling symptoms of anal cancer.

Other herbal remedies suggested for treating anal cancer are curcumin, reishi mushroom, onions, chickweed, parsley, basil, and oregano. 

8 Lifestyle and Coping

Taking good care of the health and having supportive family and friends helps to cope with anal cancer better.

Understanding more about the cancer and its stages helps to take the right decision regarding treatment.

Being a part of the support group helps to discuss the experiences and feelings.

9 Risk and Complications

In some cases, there is a risk of anal cancer spreading to other distant parts of the body.

This form of cancer is difficult to treat and is life-threatening. 

10 Related Clinical Trials