A cancer diagnosis or being at higher risk for cancer can bring up a whole host of questions. AHN sees you as a person first and is here to offer compassionate care.
What is anal cancer?
Anal cancer is a type of cancer that develops in the tissues of the anus, the opening at the end of the digestive tract. While it's less common than other types of cancer, it's a serious condition that can be life-threatening if not detected and treated early.
You may be at increased risk of anal cancer if you’ve been diagnosed with high-risk HPV exposure or have a weakened immune system. Knowing the signs, having open dialogue with a compassionate provider, and getting screened regularly can help spot the disease early.
Anal cancer can often be asymptomatic in the early stages. It can be easily mistaken for other conditions, such as hemorrhoids. These symptoms may include:
- Bleeding during bowel movements.
- Pain or discomfort during bowel movements.
- Itching or irritation around the anus.
- A lump or swelling near the anus.
- Changes in bowel habits.
If caught early on, anal cancer survivor rates are promising. The American Cancer Society estimates that people diagnosed with anal cancer between 2012 and 2018 had a relative five-year survival rate of 83% after being first diagnosed.
Colon and Rectal Center of Excellence
The AHN Colon and Rectal Center of Excellence offers some of the newest and most groundbreaking care for the diagnosis and treatment of colon, rectal and anal cancer. As a nationally certified Rectal Cancer Center of Excellence through the National Accreditation Program for Rectal Cancer (NAPRC ), we create individualized care plans for each patient.
Our expert health care professionals include a carefully coordinated team including:
- Surgical subspecialists.
- Medical and radiation oncologists.
- Radiologists.
- Pathologists.
- Geneticists.
Your treatment plan may include chemotherapy, radiation treatments, and surgery, as well as survivorship programs. Throughout this plan you can also count on:
- Advanced practitioners.
- Nurse navigators.
- Financial counselor.
- Palliative care providers.
- Dietitians.
- Physical therapists.
- Non-traditional practitioners.
Anal cancer symptoms and signs
Anal cancer can be asymptomatic in the early stages, so it’s important to see your health care provider regularly for any necessary screenings. Many early symptoms of anal cancer can be similar to hemorrhoids and other anorectal conditions, there are others to be aware of and monitor.
As the cancer grows, symptoms may include:
- Bleeding from the anus or rectum.
- Blood in your stool.
- Pain in the area of your anus.
- A mass or growth in the anal canal.
- Itchy anal area.
- Having to go to the bathroom more often.
Anal cancer risk factors
Certain types of human papillomavirus (HPV) infection increase the risk of developing anal cancer. With an increased number of sexual partners, the likelihood of HPV infection grows, thus raising the risk of anal cancer. Knowing your risk factors can help you be on the lookout for potential changes to your health that you can bring up to your doctor, so issues can be found sooner.
Individuals who may be at increased risk include:
- People living with HIV.
- Men who have sex with men.
- Transgender women.
- People living with an organ transplant, or who take medications that can weaken the immune system.
- Women with a history of high-risk changes on Pap smears, or vulvar/vaginal dysplasia.
- People who smoke.
Anal cancer screening and diagnosis
Staying on top of regular preventive care and getting age-appropriate screenings is key to early detection. Because anal cancer can be asymptomatic, regular screenings are crucial. Anal cancer screening usually entails a physical exam, including an internal exam. If either of these result in abnormal findings, you may be referred for a more in-depth exam which entails a physical exam, a more in-depth internal exam, and potential biopsies of suspicious tissue.
At AHN, we are committed to providing comprehensive, inclusive care. To determine if you may have anal cancer, a colorectal specialist performs a physical exam and discusses your overall health and prognosis. From there, diagnostic tests are performed as needed to ensure we have a whole view of your health and can design a treatment plan that fits your needs.
Other procedures, including an anoscopy, are used for looking at just a portion of the anal canal and lower rectum. With an anoscopy, your doctor can examine the entire area for abnormalities including polyps and suspicious tissue.
It's important to consult with your primary care provider or colorectal specialist to determine whether anal cancer screening is indicated as part of your preventive care.
If you receive an anal cancer diagnosis, the news can feel overwhelming. We see you — and a path forward. Your oncology team will be with you every step of the way and put together a plan that’s specific to your precise diagnosis.
To get to that precise diagnosis, your care team may order more tests and procedures to ensure they have a full understanding of the disease.
High-resolution anoscopy
Your gastroenterologist or a colorectal surgeon may order an anoscopy. This procedure uses a specialized instrument called an anoscope to visualize the anal canal in detail. It allows for a more thorough examination than a visual inspection and can detect precancerous lesions or early-stage cancer.
This procedure helps identify changes in rectal and anal tissue on a cellular level. The anoscope tool is smaller than that used for a colonoscopy and does not go as far into the body.
Imaging
Your care team may need more details that will help provide all the information on your specific prognosis. Additional imaging or tests may be needed. That could include:
- Computed tomography (CT) scan: A CT scan can provide a valuable role in anal cancer diagnosis and management. With a CT scan , the cancer stage can be better determined, treatment planning is more detailed because images can help radiation oncologists understand the tumor better, and your care team can use the images to monitor treatment response and any tumor recurrence.
- Positron emission tomography (PET) scan: Similar to a CT, a PET scan gives detailed images that inform your care team on the cancer stage and treatment planning. A PET scan can also detect areas of increased metabolic activity that may be associated with cancer cells.
Biopsy
If we sample an atypical area of tissue during a high-resolution anoscopy, we can perform a biopsy, a minimally invasive procedure, at the same time. The physician guides a tiny wire loop into the colon to remove the polyp. A specially trained doctor called a pathologist examines the cells under a microscope to determine if they are cancerous.
Types of anal cancer
Understanding the type and stage of anal cancer can be helpful for you to make informed choices with your care team and emotionally prepare for any treatments or surgeries.
Squamous cell carcinoma
Squamous cell carcinoma is the most common type of anal cancer. This type of anal cancer is sometimes treated with chemotherapy and radiation, and sometimes requires surgery.
Other types of anal cancer
- Adenocarcinoma: This is a type of cancer that starts in the glandular cells of the rectum or anus. Treatment depends on the location, stage and health of the patient but can include therapies to target the tumor or surgery.
- Basal cell carcinoma: Anal basal cell carcinoma (BCC) is a rare type of skin cancer that occurs in the anal canal, the passageway between the rectum and the outside of the body. It's a slow-growing cancer that can be treated with surgery, radiation, or even topical medications.
- Melanoma: Sometimes called rectal melanoma, this is a rare form of skin cancer that occurs in the anal cavity.
- Gastrointestinal stromal tumor (GIST): A gastrointestinal stromal tumor (GIST) is a rare type of cancer that arises from the cells in the wall of the digestive tract, specifically the cells called interstitial cells of Cajal (ICC). These cells are responsible for regulating muscle contractions in the digestive system.
Anal cancer treatment
Treating anal cancer requires advanced medical oncology therapies. Your care team will review your specific diagnosis and configure an effective treatment plan.
Our advanced medical oncology therapies include:
- Chemotherapy: Using chemotherapy, your medical oncologist will administer drugs to target the cancer cells and reduce their ability to grow. This approach will be tailored to the specific patient and the stage of their cancer.
- Targeted therapy: This is a relatively new way to treat anal cancer. Targeted therapy focuses on specific rapidly dividing cancer cells to block the signals that tell the cancer to grow.
- Immunotherapy: Immunotherapy works by either boosting the immune system's ability to recognize and attack cancer cells, or by blocking specific proteins on cancer cells that help them evade the immune system, allowing the body's natural defenses to fight the disease.
Surgery for anal cancer
Your care team will be the best resource for determining if surgery for anal cancer is necessary. Surgery is usually not the first step in treatment, and major surgery is typically reserved for advanced anal cancer, or cancer that does not respond to other treatments. AHN takes a measured, thoughtful approach to major surgeries and wants those we care for to have the best options available.
Abdominoperineal resection
An abdominoperineal resection (APR) is a major surgery for anal cancer. During an APR , the surgeon removes the rectum, anus, and surrounding tissues. There are varying techniques and your surgeon will talk through the best option for you.
Rehabilitation after anal cancer treatment
At AHN, we know that rehabilitation post-surgery is as important as the surgery itself. To regain function, manage side effects, and improve quality of life, a personalized rehabilitation plan is created. This plan involves creating physical rehabilitation plans and also psychological and occupational rehabilitation.
Life after surgery
AHN uses the most minimally invasive procedures and surgical techniques so you can return to your life as soon as possible. Comprehensive rehab and your compassionate care team will help you adjust to any new changes.
We also offer specialized oncology rehab services in your own home, if needed, through our Healthcare @ Home service.
Learn more about our rehabilitation program.
The team assisting your complete rehabilitation includes:
- Anesthesiologists.
- Pain management specialists.
- Infection control specialists.
- Physical therapists.
- Nutritionists.
- Ostomy nurses.
Contact us
Call the AHN Cancer Help Line anytime at (412) NURSE-4-U (412) 687-7348 to schedule a cancer-related appointment or to just talk with our nurses about diagnoses, treatments, and side effects.
Schedule a colonoscopy
Talking with your personal doctor or colorectal specialist will help you know which type of anal cancer screening is best. Regular colonoscopies, for those who are at high risk or those over the age of 45 can help spot colorectal issues before they become more problematic.
Referral to oncology
If you’ve received a referral to schedule with medical oncology, radiation breast cancer oncology, or another breast cancer oncology group, call (412) 578-HOPE (412) 578-4673 to connect with a nurse navigator and schedule an appointment.
Second opinions
If you have cancer, you have a team of oncology specialists ready to review your medical records and offer you a second opinion. After completing their review, they’ll talk with you about your goals to determine a course of treatment that’s right for you. To get started, fill out our Second Opinion Request form. A nurse navigator will contact you within the next 24 to 48 hours to discuss next steps and schedule.