Anal Cancer
Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body. Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
Most people with anal cancer are treated with a combination of chemotherapy and radiation. Though combining anal cancer treatments increases the chance of a cure, the combined treatments also increase the risk of side effects.
Symptoms
Anal cancer signs and symptoms include:
• Bleeding from the anus or rectum
• Pain in the area of the anus
• A mass or growth in the anal canal
• Anal itching
When to see a doctor
Talk to your doctor about any signs and symptoms that bother you, especially if you have any factors that increase your risk of anal cancer.
Causes
Anal cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumour). Cancer cells invade nearby tissues and can separate from an initial tumour to spread elsewhere in the body (metastasize).
Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority of anal cancers. HPV is thought to be the most common cause of anal cancers.
Risk factors
Several factors have been found to increase the risk of anal cancer, including:
• Older age. Most cases of anal cancer occur in people age 50 and older.
• Many sexual partners. People who have many sexual partners over their lifetimes have a greater risk of anal cancer.
• Anal sex. People who engage in receptive anal sex have an increased risk of anal cancer.
• Smoking. Smoking cigarettes may increase your risk of anal cancer.
• History of cancer. Those who have had cervical, vulvar or vaginal cancer have an increased risk of anal cancer.
• Human papillomavirus (HPV). 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.
• Drugs or conditions that suppress your immune system. People who take drugs to suppress their immune systems (immunosuppressive drugs), including people who have received organ transplants, may have an increased risk of anal cancer. HIV — the virus that causes AIDS — suppresses the immune system and increases the risk of anal cancer.
Complications
Anal cancer rarely spreads (metastasizes) to distant parts of the body. Only a small percentage of tumours are found to have spread, but those that do are especially difficult to treat. Anal cancer that metastasizes most commonly spreads to the liver and the lungs.
Prevention
There is no sure way to prevent anal cancer. To reduce your risk of anal cancer:
• Practice safer sex. Practicing safe sex may help prevent HPV and HIV, two sexually transmitted viruses that may increase your risk of anal cancer. If you choose to have anal sex, use condoms.
• Get vaccinated against HPV. A vaccine to protect against HPV infection is available. It's recommended for adolescents, including both boys and girls, but may be given to adults, too.
• Stop smoking. Smoking increases your risk of anal cancer. Don't start smoking. Stop if you currently smoke.
Diagnosis & Treatment
Diagnosis
Tests and procedures used to diagnose anal cancer include:
• Examining your anal canal and rectum for abnormalities. During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
• Visually inspecting your anal canal and rectum. Your doctor may use a short, lighted tube (anoscope) to inspect your anal canal and rectum for anything unusual.
• Taking sound wave pictures (ultrasound) of your anal canal. To create a picture of your anal canal, your doctor inserts a probe, similar to 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 evaluates the picture to look for anything abnormal.
• Removing a sample of tissue for laboratory testing. If your doctor discovers any unusual areas, he or she may take small samples of affected tissue (biopsy) and send the samples to a laboratory for analysis. By looking at the cells under a microscope, doctors can determine whether the cells are cancerous.
Determining the extent of the cancer
Once it's confirmed that you have anal cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.
Tests may include:
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
Your doctor uses the information 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 distant areas of the body.
The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you.
Care at Chartwell Hospital
Chartwell Digestive Health is committed to increasing awareness of Cancer symptoms as early diagnosis really can save lives.
We urge all patients to see a GP or Healthcare Professional if they feel that something is wrong.
Our gastroenterology doctors can provide compassionate, personalised care and will work with you to review all of your options and choose the treatment that best suits your needs and goals, or they may refer you to someone who can.
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