What You Should Know About Anal Cancer

By Causenta Wellness

Cancer generally is an unpleasant subject to ponder, and anal cancer is particularly difficult to discuss. This is not a part of the body that typically arises in polite conversation. However, the risk of being diagnosed with this illness is relatively high for older people, about 1 in 500. This is despite the fact that lifestyle changes and testing can mitigate the risk of contracting this type of cancer. So the consequences of not thinking about it are potentially grave. Here, we hope to give you more of an idea of what the disease is, why it develops, and how to prevent it.

Anatomy

Anal cancer is cancer that develops in the tissues of the anus, the tube-like last part of the digestive tract through which solid waste exits the body. It is about 1-1.5 inches in length and is opened and closed by two tight rings of muscle called the sphincters. The skin around the anus is called the perianal area, and any cancers which develop there can be considered skin cancer rather than anal cancer.

Signs of anal cancer

Anal cancer symptoms include bleeding from the anus or rectum, pressure or pain around the area, itching or discharge, a lump inside the bottom, or a change in bowel habits.

Risk factors

There are a number of lifestyle factors that can increase the risk of anal cancer. Receiving anal sex is one, especially if the patient has multiple sexual partners. The sexually transmitted diseases HPV and HIV also increase risk. Other risk factors are frequent soreness and redness of the anus, hemorrhoids (including external hemorrhoids), contracting fistulas, and smoking.

Tests

There are several tests that doctors can conduct to determine if someone has anal cancer. A physical exam and medical history can check on a patient’s overall health and spot symptoms of anal cancer. A digital rectal examination involves the medical professional inserting a lubricated, gloved finger into the rectum to determine if there are lumps or other irregularities. 

There are optical devices that can be used as well. For instance, in an anoscopy, a short, lighted tube is used to examine the area. A proctoscope can be used to visually examine the area and take samples, if needed. Ultrasound can also be used to form a detailed sonogram of the anus and rectum. A biopsy can be performed to extract and examine tissue, particularly of damaged tissue spotted during anoscopy.

Prognosis

The outlook for a patient with rectal cancer depends on a number of factors. One is the tumor’s location in the anus. The tumor’s size is also a factor, as well as whether the cancer has spread to the patient’s lymph nodes.

All these things influence both the chances of recovery and the treatment options. Treatment options are further affected by whether the patient has HIV, the stage of the cancer, and whether or not this is the first treatment or a recurrence.

Progress of the disease

If medical professionals make a diagnosis of anal cancer, they will quickly run tests to determine whether it has spread to other parts of the body. Cancer can spread, or metastasize, to other parts of the body through blood, lymph, or tissue.

If the disease grows through tissue, it will affect parts of the body surrounding the anus. If it gets into the blood or lymph, it can travel far afield and cause a tumor in a very different part of the body such as the lungs or liver. But wherever it spreads, it is still anal cancer. 

There are several stages of anal cancer, as with other types of cancer:x

• Stage 0 — In this stage, abnormal cells are discovered in the mucosa of the anus. These cells may become cancerous but are not yet.

• Stage I — In this stage, cancer has formed, but the tumor is not yet more than 2 centimeters long.

• Stage II — In this stage, the tumor is roughly between 2 and 5 or more centimeters but has not spread to any other parts of the body.

• Stage III — Here, the cancer may be any size, but has begun to spread. There are sub-stages depending on whether the tumor is still small and where in the body it has spread. The other body parts reached in this stage are the ones near the anus, such as the bladder or urethra.

• Stage IV — The cancer may be any size. Here it will have spread to far-flung areas of the body such as the lungs or the liver.

Even if the cancer is successfully battled into remission, it can still recur at some point. It is best for the patient to schedule regular diagnostic checkups with medical professionals.

Treatment options

There are three types of treatment options for people with anal cancer: radiation, chemotherapy, and surgery. Sometimes more experimental options are available in clinical trials, though whether or not they are available or a prudent move depends on the specifics of the patient’s situation. A frank conversation with a medical professional on the subject would be advisable.

Radiation therapy attempts to kill cancer cells with concentrated X-rays or other high-energy beams. There are two types of radiation therapy: internal and external. External radiation therapy uses a device outside the body to direct the rays, while internal radiation therapy involves the insertion of a catheter, wire, or needle into the body near the cancer to focus the energy. 

Chemotherapy uses drugs to treat anal cancer. The drugs are supposed to either kill the cancer cells or simply stop them from dividing. They can be injected into the blood or administered regionally.

Surgery can involve a local resection or an abdominoperineal resection. For local resection to be an option, the cancer must be small and early stage. It must not have spread to other parts of the body. It is especially effective with tumors from lower in the anus. Local resection aims to retain the sphincter muscles and the patient’s control over bowel movements to the extent possible.

Abdominoperineal resection, on the other hand, is a more radical procedure in which the anus, rectum, and part of the colon are removed through an incision. The end of the intestine is then sewed to a stoma so that waste can be collected in a colostomy bag. All of these treatments produce side effects to varying degrees. It is useful for patients to speak with their doctors so they know what to expect and how to manage it.