Anal Cancer Symptoms, Causes & Treatment Options

Anal cancer is a cancer of the skin cells of the anus. It can be fatal if not treated, but if caught early, it has a good chance of cure with proper treatment and follow up.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Anal Cancer?

Summary

Anal cancer is a rare disease affecting women slightly more frequently than men. It is a cancer of the anal skin cells. The main risk factor for the disease is having a history of human papillomavirus of the skin cells of the anus. This virus is transmitted through anal sexual intercourse. There may be no symptoms at all or you may have some bleeding and itching in the anal area, among others (see below). This makes it challenging to catch the disease early, but if it is caught early, the prognosis for being cured is favorable. The main way to prevent anal cancer is risk factor reduction, including getting the HPV vaccine and practicing safe sex.

Recommended care

Anal Cancer Symptoms

Main symptoms

The following are the most common symptoms experienced:

  • No symptoms at all: On many occasions, you may have no symptoms.
  • Bleeding during or after a bowel movement or intercourse
  • Itching around the anus
  • Feeling a lump in the anus

Other symptoms

The following are additional symptoms that you may experience:

  • Change in your bowel movements: This can include frequency, size, shape, consistency.
  • Becoming incontinent: Stool leaks out when you are not trying to go to the bathroom.
  • The feeling that you always need to have a bowel movement

Anal Cancer Causes

Anal cancer results from the uncontrolled growth of the cells that line the anus, which is a canal approximately 1 – 2 inches long that leads to the rectum. The most common type of cancer in this area is squamous cell carcinoma (SCC). The cancer is caused by mutations to the DNA of the cells in the anus. New anal cancer is found in approximately 8,000 people per year in the United States, with approximately 65% of affected people being female. The disease is also more deadly to females than males. There are approximately 1,280 deaths per year in the United States. One of the main risks for the disease is previous exposure to human papillomavirus (HPV), which is a sexually transmitted disease. If you have been exposed to HPV, it does not mean that you will get anal cancer.

Risk factors for anal cancer

The following are the most common risk factors for developing anal cancer:

  • Exposure to human papillomavirus (HPV): This is a sexually transmitted infection, which is, by far, the most important risk factor for anal cancer.
  • Smoking cigarettes
  • Receiving anal intercourse
  • Having a history of cervical, vaginal, or vulvar cancer
  • History of radiation therapy near the anus
  • Infection with HIV
  • Infection with lymphogranuloma venereum
  • Increasing age
  • Having a fistula: This is an abnormal tunnel that connects the anus to another area in the body.
  • Having immune impairment: This can come from taking immunosuppressants or being HIV positive without being on medication.

Anal Cancer Symptom Checker

Take a quiz to find out if your symptoms point to anal cancer

Treatment Options, Relief, and Prevention for Anal Cancer

Treatment

Diagnosis of anal cancer starts with an examination of the skin around the anus by a doctor. The doctor will insert a lubricated, gloved finger into the anus to palpate for masses. Sometimes, the doctor will use an anoscope which is a small camera that fits into the anus. He or she may also use an ultrasound probe to create images of the anus.

A sigmoidoscopy or colonoscopy can be used to evaluate the anus and rectum visually using a camera that is passed into your anus while you are asleep. The doctor may take a tiny piece of the anus (a biopsy) and send it for analysis under a microscope to determine if it is cancer.

Finally, MRI, CAT, and/or PET scanning can be performed to image the anus and the rest of the body, which can show clear pictures of where any cancer is. With this information, the doctor can provide you with a cancer stage, which indicates how extensive the disease is.

The treatment of anal cancer depends on how advanced the disease is at the time of diagnosis. If the disease is local to the anus, surgery may be performed first. However, in most cases, radiation and chemotherapy will be given first. If the cancer is caught early, these therapies can be curative (they can permanently remove the cancer from the anus). Up to 90% of patients attain a cure from chemotherapy and radiation.

However, sometimes, the cancer is resistant to therapy and requires surgery. The main risk of surgery is damage to the anal sphincter, which may result in fecal incontinence (the inability to stop yourself from going to the bathroom). In some cases, people receiving surgery will need to get a colostomy, which is a bag that collects stool placed on your abdomen. If the cancer has spread to other organs in the body, more extensive chemotherapy and surgery may need to be used.

Prevention

The following risk factor modifications can decrease your chance of getting anal cancer:

  • Get the HPV vaccine (Gardasil): Nowadays, this is standard in pediatric healthcare. Do not deny your child the benefit of the HPV vaccine.
  • Stop smoking
  • Always practice safe sex (use condoms): In the case of anal cancer, this is especially pertinent when performing anal intercourse.
  • If you have HIV, make sure you are treated with highly active antiretroviral therapy.
  • If you have a history of vaginal, cervical, or vulvar cancer, get your anus examined regularly.

When to Seek Further Consultation for Anal Cancer

Seek further consultation if you notice bleeding from your anus, feel a lump in your anus, or have itching. In addition, your anus should be examined by a healthcare professional regularly if you are known to have been exposed to the HPV virus. If you have not yet obtained the HPV vaccine for either yourself or your children, see a healthcare professional to obtain one.