Anal Cancer

What Is Anal Cancer?

Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus. The anus is the end of the large intestine, below the rectum, through which stool (solid waste) leaves the body.

Risk Factors

• Being infected with human papillomavirus (HPV)
• Having a condition or disease that causes a weakened immune system such as human immunodeficiency virus (HIV) or an organ transplant
• Having a personal history of vuIvar, vaginal, or cervical cancers
• Having many sexual partners
• Having receptive anal intercourse (anal sex)
• Smoking cigarettes

Signs and Symptoms

• Bleeding from the anus or rectum
• A lump near the anus
• Pain or pressure in the area around the anus
• Itching or discharge from the anus
• A change in bowel habits

Testing

• Physical exam and health history: An exam of the body to check general signs of health including checking for signs of disease such as lumps or anything else that seems unusual.
• Digital rectal examination (DRE): The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.
• Anoscopy: An exam of the anus and lower rectum using a short, lighted tube called an anoscope.
• Proctoscopy: A procedure to look inside the rectum and anus to check for abnormal areas using a proctoscope, a thin, tube like instrument with a light and a lens for viewing.
• Endo-anal or endorectal ultrasound: A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and is used to bounce high energy sound waves (ultrasound) off internal tissues or organs and make echoes.
• Biopsy: The removal of cells or tissues, so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Prognosis Factors

• The size of the tumor
• Whether the cancer has spread to the lymph nodes
• The stage of the cancer.
• Where the tumor is located in the anus.
• Whether the patient has human immunodeficiency virus (HIV).

Treatment Options

Surgery

• Local resection: A surgical procedure in which the tumor is cut from the anus along with some of the healthy tissue around it. Local resection may be used if the cancer is small and has not spread.
• Abdominoperineal resection: A surgical procedure in which the anus, the rectum, and part of the sigmoid colon are removed through an incision made in the abdomen.

Radiation Therapy

• Radiation therapy is a cancer treatment that uses high energy X-rays or other types of radiation to kill cancer cells or keep them from growing.

Chemotherapy

• Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells either by killing the cells or by stopping the cells from dividing.

New Treatments Being Tested in Clinical Trials

• Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.
• lmmunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.

See our Booklet for comprehensive information about Anal Cancer.

This content was last medically reviewed in May 2022 by Sharlotte Manley, MSN, FNP, Erlanger Gastroenterology.