Anal cancer: Symptoms, Causes, and Treatment

Anal cancer is a rare form of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool exits your body.

Treatment of anal cancer consists of a combination of chemotherapy and radiation. Combining anal cancer treatments increases the chance of a cure, though the combined treatments also increase the risk of side effects.

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Symptoms of Anal cancer

Anal cancer signs and symptoms include:

  • A growth in the anal canal
  • Pain in the area of anus
  • Bleeding from the anus or rectum
  • Anal itching

Causes of Anal cancer

Most anal cancers are caused by human papillomarirus (HPV). Anal cancer occurs when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate and dies at a set time. However, abnormal cells grow and multiply uncontrollably, and they don’t die. The accumulating abnormal cells form a mass or a tumor.

Risk factors

Several factors increases the risk of anal cancer. They include:

  • Most cases of anal cancer occur in people who are 50 and older.
  • People with many sexual partners over their lifetimes have a high risk of developing anal cancer.
  • Anal cancer mostly affects people who engage in anal sex.
  • People who smoke cigarettes may increase your risk of anal cancer.
  • Those who have had cervical or vaginal cancer have an increased risk of developing anal cancer.
  • Human papillomavirus (HPV) infection increases your risk of several cancers, including anal cancer and cervical cancer. HPV infection is a sexually transmitted infection that can also cause genital warts.


Anal cancer rarely spreads to distant parts of the body. Only a small percentage of tumors are found to have spread, but those that do are hard to treat. Anal cancer that metastasizes mostly spreads to the liver and the lungs.

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There is no sure way to prevent anal cancer. In order to reduce your risk of anal cancer:

  • Get vaccinated against HPV: Gardasil and Cervarix are given to protect against HPV infection.
  • Practice safer sex:Complete abstinence from sex or practicing safe sex may help prevent HPV and HIV.
  • Quit smoking.Smoking increases your risk of anal cancer. Don’t start smoking. Stop if you currently smoke.


Tests and procedures used to diagnose anal cancer include:

  • Examining your anal canal and rectum:Your doctor inserts a gloved, lubricated finger into your rectum during a digital rectal exam to check for abnormalities such as growths.
  • Visually inspecting your anal canal and rectum:This involves using a short lighted tube called anoscope to inspect your anal canal and rectum for abnormalities.
  • Taking ultrasound of your anal canal: Your doctorinserts a probe that looks like a thick thermometer into your anal canal and rectum. The probe emits high-energy sound waves, called ultrasound waves, which bounce off tissues and organs in your body to create a picture. Your doctor examines the picture to check for anything unusual.
  • Removing a sample of tissue for laboratory testing: Your doctor may take small samples of the affected tissue (biopsy) for analysis in a lab.

Your doctor may recommend other tests to check whether your cancer has spread to your lymph nodes or to other parts of your body. Tests may include:

  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)

Your doctor uses the results from the procedures to assign your cancer a stage. The stages of anal cancer are indicated using Roman numerals ranging from 0 to IV, with the lowest stages indicating that the cancer is small and confined to the anus. By stage IV, the cancer has spread to affect other parts of the body.


Treatment for anal cancer depends on the stage of your cancer, your general health and your own preferences.

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Combined chemotherapy and radiation

Doctors usually treat anal cancer with a combination of chemotherapy and radiation. These combined treatments improve chances for a cure.

  • Chemotherapy drugs taken orally or intravenously. The chemicals travel throughout your body, destroying rapidly growing cancer cells. Unfortunately they also damage healthy cells that grow rapidly, such as your hair follicles and gastrointestinal tract, causing side effects such as nausea, vomiting and hair loss.
  • Radiation therapy.This uses high-powered beams, such as X-rays and protons, to destroy cancer cells. During radiation therapy, you’re positioned on a table and a large machine moves around you, directing radiation beams to specific areas of your body to target your cancer. Radiation may damage healthy tissue near where the beams are aimed. Side effects may include skin redness and sores in and around your anus, as well as hardening and shrinking of your anal canal.


Doctors typically use different procedures to remove anal cancer based on the stage of the cancer:

  • Surgery to remove early-stage anal cancers: This procedure can remove small anal cancers. The surgeon removes the tumor and a small amount of healthy tissue that surrounds it.

Because the tumors are small, early-stage cancers can sometimes be removed without damaging the anal sphincter muscles that surround the anal canal.

  • Surgery for late-stage anal cancers or anal cancers: This procedure can also be used to remove cancers that hasn’t responded to chemotherapy and radiation, or if your cancer is advanced, your doctor may recommend a more extensive operation called abdominoperineal resection, which is sometimes referred to as an AP resection, which involves your surgeon removing the anal canal, rectum and a portion of the colon. The surgeon then attaches the remaining portion of your colon to an opening (stoma) in your abdomen through which waste will leave your body and collect in a colostomy bag.


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