Receiving a cancer diagnosis is a lifechanging event that requires immediate treatment. While most people are aware of their risk factors for common forms of cancer—skin, breast, prostate, etc.—anal cancer is one that’s not often discussed. Since the name of each cancer derives from where it originates, anal cancer occurs when cells within the anus begin to grow out of control. When left untreated, it can metastasize, or spread to other parts of the body. Although rare, it’s still important to understand your risk factors and see your doctor at the onset of any symptoms. To help you identify these, here’s everything you need to know about anal cancer.
What is Anal Cancer?
As mentioned, anal cancer is when cancerous cells develop at the end of the digestive tract. This can occur anywhere between the rectum and the perianal skin, which is the area of the skin that surrounds the anal opening. When anal cancer metastasizes, it spreads to the surrounding blood vessels and lymph channels, where mutated cells can be carried throughout the body.
Types of Anal Cancer
There are different types of anal cancers that may occur in various regions of the anal canal. However, the presence of a mass does not immediately indicate cancerous cells. There could be benign or precancerous growths present. Regardless, your doctor will work with you to determine the best course of action.
- Squamous Cell Cancer – this is the most common type of anal cancer. It’s diagnosed when carcinoma is formed in the cells lining the anal cavity.
- Carcinoma in Situ – this is used to defined early cancer or precancerous cells. It can be used for any type of cancer, but in this instance they’re usually on the surface-level cells of the anal canal. Sometimes this is referred to as Bowen’s disease.
- Adenocarcinomas – this is a type of anal cancer where a tumor develops inside of the glands surrounding the anus.
- Skin Cancers – basal cell carcinomas (skin cancer) can develop on the perianal skin. They’re most commonly found on areas of skin that are exposed to sun.
Anal dysplasia is a precancerous condition that usually develops before anal squamous cell cancer (SCC) occurs. These symptoms can include pain, pressure, and a persistent anal itchiness called pruritus. If you notice any symptoms of anal dysplasia, it’s important to schedule an appointment with your doctor to determine the extent of abnormal tissue and address it appropriately.
Anal cancer affects just under 9,500 people in the US each year, making it a rare form of cancer. Women are disproportionately more likely to experience anal cancer, but it is highly treatable when caught early. Therefore, it’s important to understand your risk factors and familiarize yourself with symptoms.
Anal Cancer Risk Factors
Like most types of cancer, anal cancer occurs when there is a genetic mutation in cellular turnover. Cells may begin to grow abnormally or out of control and don’t progress through the normal stages of cellular death. Instead, the balance of cells accumulates and form a mass, or a tumor.
Anal cancer is quite rare. The biggest risk factor for developing any type of anal cancer is an infection of the human papillomavirus (HPV). However, there are other factors that may increase your risk of developing anal cancer. Some of these include:
- Older age
- Receiving Anal sex
- Smoking
- History of cancer
- Having several sexual partners
- Immunosuppressants
- Immunocompromised individuals
- Anal fistulas
If you have any of these risk factors, talk to your doctor about undergoing preventative screening. The best way to reduce your risk of serious complications is to catch anal cancer early and begin treatment. You can also reduce your risk of anal cancer by engaging in safe sex, getting the HPV vaccination, and quitting smoking.
Symptoms of Anal Cancer
Signs of anal cancer can go unnoticed or unrecognized for years, which is why yearly appointments with your doctor are important. However, if you do experience any symptoms, they will likely include the following:
- Pain
- A lump or mass
- Rectal bleeding
- Itching
- A change in bowel movements
- Leaking stool
- Constantly feeling like you need to have a bowel movement
Diagnostic Testing for Anal Cancer
If you experience any of the above symptoms of anal cancer, your doctor will recommend diagnostic testing. This will begin with a simple physical exam and medical questionnaire. Your doctor may also perform a visual exam of the anus alongside a rectal exam. This is done to check for any noticeable lumps. While there are several other conditions that may be causing your symptoms, it’s important to make a definitive diagnosis to ensure proper treatment. Therefore, your doctor will likely order one or more of the following tests:
- Anoscopy
- Endoscopy
- Ultrasound
- CT Scan
- MRI
- Chest X-ray
- PET Scan
- Anal Biopsy
Since many people don’t experience symptoms of early signs of anal cancer, it’s important to be proactive about your care. Always be open and honest with your doctor and if you have any concerns, don’t hesitate to bring them up.
Anal Cancer Prognosis
After testing is completed, your doctor will process the results. If the tests confirm an anal cancer diagnosis, your doctor will begin with staging. This is done to determine which stage of anal cancer you’re currently at, thus maximizing the efficiency of treatment. Stages progress through 1, 2, 3, and 4 whereas stage 1 is an early indication or precancerous cells, and stage 4 is more serious, where the cancer has metastasized.
Early stages of anal cancer have a higher remission rate and tend to respond well to treatment. If the cancer has spread to the lymph nodes, it’s important to begin an aggressive treatment to reduce tumors throughout your body and halt any further spread of cancerous cells.
Relative survival rates are used to describe the prognosis of individuals with cancer. People with localized anal cancer are about 80% as likely as people who don’t have anal cancer to live for at least five years after being diagnosed, making the prognosis optimistic. However, early detection and treatment is paramount to this statistic, which is why it’s important to see your doctor regularly and vocalize any symptoms or abnormalities.
Treatments for Anal Cancer
Most of the treatment options for anal cancer do not involve surgery. Instead, your doctor will likely focus on a combination of radiation therapy to target and kill cancer cells. This is often combined with chemotherapy for the most comprehensive treatment. Your doctor will discuss side effects of both radiation therapy and chemotherapy to determine the best course of action for your circumstances.
Other treatment options may include immunotherapy, clinical trials, and surgery. Immunotherapy involves taking prescribed drugs that help to supercharge your immune system. The goal of this therapy is to strengthen your body’s white blood cells so that they can attack the anal cancer cells and eliminate them from your body. While this seems like a natural option, there are still noticeable side effects of immunotherapy. Clinical trials may also be available depending on your doctor and location. Discuss your options for these in detail and always make sure you understand the risks involved.
Finally, surgery for anal cancer is often performed if there are localized tumors in the anal cavity. This is an effective way to completely eradicate cancer cells but is only a temporary treatment option if cancer has metastasized. If you need a local resection, the muscles that operate opening and closing the anus are rarely damaged, meaning you’ll still be able to control your bowel movements. However, if you need an abdominoperineal resection (APR), you’ll need a follow up surgery called a colostomy. This is because the APR will remove the anus and part of the rectum, requiring a new way for you to pass bowel movements. Your doctor will go over this option in more detail if needed.
After undergoing a colostomy, you’ll need an ostomy pouching system. It’s recommended to join a support group to better understand and process this lifestyle change. Browse the list of support groups affiliated with The United Ostomy Associations of America (UOAA) to find a group near you. To help you find the right pouching system, ease discomfort, and improve discretion, Byram Healthcare offers a wide range of ostomy supplies and support systems alongside educational material as needed. Browse our ostomy product guide and get started on your order today.
