Learn About Anal Cancer

What is the definition of Anal Cancer?

Anal cancer is cancer that starts in the anus. The anus is the opening at the end of your rectum. The rectum is the last part of your large intestine where solid waste from food (stool) is stored. Stool leaves your body through the anus when you have a bowel movement.

Anal cancer is fairly rare. It spreads slowly and is easy to treat before it spreads.

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What are the alternative names for Anal Cancer?

Cancer - anus; Squamous cell carcinoma - anal; HPV - anal cancer

What are the causes of Anal Cancer?

Anal cancer can start anywhere in the anus. Where it starts determines the kind of cancer it is.

  • Squamous cell carcinoma. This is the most common type of anal cancer. It starts in cells that line the anal canal and grow into the deeper tissue.
  • Cloacogenic carcinoma. Almost all the rest of anal cancers are tumors that start in cells lining the area between the anus and rectum. Cloacogenic carcinoma looks different than squamous cell cancers, but behaves similarly and is treated the same.
  • Adenocarcinoma. This type of anal cancer is rare in the United States. It starts in the anal glands below the anal surface and is often more advanced when it is found.
  • Skin cancer. Some cancers form outside the anus in the perianal area. This area is mainly skin. The tumors here are skin cancers and are treated as skin cancer.

The cause of anal cancer is unclear. However, there is a link between anal cancer and the human papillomavirus or HPV infection. HPV is a sexually transmitted virus that has been linked to other cancers as well.

Other major risk factors include:

  • HIV/AIDS infection. Anal cancer is more common among HIV/AIDS positive men who have sex with other men.
  • Sexual activity. Having many sexual partners and having anal sex are both major risks. This may be due to the increased risk for HPV and HIV/AIDS infection.
  • Smoking. Quitting will reduce your risk for anal cancer.
  • Weak immune system. HIV/AIDS, organ transplants, certain medicines, and other conditions that weaken the immune system increase your risk.
  • Age. Most people who have anal cancer are age 50 or older. In rare cases, it is seen in people younger than age 35.
  • Sex and race. Anal cancer is more common among women than men in most groups. More African American males get anal cancer than females.
What are the symptoms of Anal Cancer?

Rectal bleeding, often minor, is one of the first signs of anal cancer. Often, a person mistakenly thinks the bleeding is caused by hemorrhoids.

Other early signs and symptoms include:

  • A lump in or near the anus
  • Anal pain
  • Itching
  • Discharge from the anus
  • Change in bowel habits
  • Swollen lymph nodes in the groin or anal region
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What are the current treatments for Anal Cancer?

Treatment for anal cancer is based on:

  • The stage of the cancer
  • Where the tumor is located
  • Whether you have HIV/AIDS or other conditions that weaken the immune system
  • Whether the cancer has resisted initial treatment or has come back

In most cases, anal cancer that hasn't spread can be treated with radiation therapy and chemotherapy together. Radiation alone can treat the cancer. But the high dosage that's needed can cause tissue death and scar tissue. Using chemotherapy with radiation lowers the dose of radiation that's needed. This works just as well to treat the cancer with fewer side effects.

For very small tumors, surgery alone is typically used, instead of radiation and chemotherapy.

If cancer remains after the radiation and chemotherapy, surgery is often required. This may involve removing the anus, the rectum, and part of the colon. The new end of the large intestine will then be attached to an opening (stoma) in the abdomen. The procedure is called a colostomy. Stools moving through the intestine drain through the stoma into a bag attached to the abdomen.

Who are the top Anal Cancer Local Doctors?
Highly rated in
Radiation Oncology

University of Texas System

Physicians Referral Service

1515 Holcombe Blvd 
Houston, TX 77030

Emma Holliday is a Radiation Oncologist in Houston, Texas. Dr. Holliday has been practicing medicine for over 11 years and is rated as an Elite doctor by MediFind in the treatment of Anal Cancer. She is also highly rated in 10 other conditions, according to our data. Her top areas of expertise are Anal Cancer, Stomach Cancer, Fibrolamellar Carcinoma, and Pancreatic Cancer. She is licensed to treat patients in Texas. Dr. Holliday is currently accepting new patients.

Highly rated in
Internal Medicine

Mount Sinai Health System

Mount Sinai Medical Center

17 E 102nd St 
New York, NY 10029

Keith Sigel is an Internal Medicine doctor in New York, New York. Dr. Sigel has been practicing medicine for over 19 years and is rated as an Elite doctor by MediFind in the treatment of Anal Cancer. He is also highly rated in 9 other conditions, according to our data. His top areas of expertise are Anal Cancer, HIV/AIDS, Lung Cancer, and Hepatitis C. He is licensed to treat patients in New York.

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Highly rated in

National Institute For Health Research

Leeds, GB 

David Montefiore-Sebag is in Leeds, United Kingdom. Montefiore-Sebag is rated as an Elite expert by MediFind in the treatment of Anal Cancer. He is also highly rated in 4 other conditions, according to our data. His top areas of expertise are Anal Cancer, Squamous Cell Skin Carcinoma, Renal Oncocytoma, and Radiation Sickness.

What are the support groups for Anal Cancer?

Cancer affects how you feel about yourself and your life. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you feel less alone.

You can ask your provider or the staff at the cancer treatment center to refer you to a cancer support group.

What is the outlook (prognosis) for Anal Cancer?

Anal cancer spreads slowly. With early treatment, most people with anal cancer are cancer-free after 5 years.

What are the possible complications of Anal Cancer?

You may have side effects from surgery, chemotherapy, or radiation therapy.

When should I contact a medical professional for Anal Cancer?

See your provider if you notice any of the possible symptoms of anal cancer, especially if you have any of the risk factors for it.

How do I prevent Anal Cancer?

Since the cause of anal cancer is unknown, it's not possible to completely prevent it. But you can take steps to lower your risk.

  • Practice safer sex to help prevent HPV and HIV/AIDS infections. People who have sex with many partners or have unprotected anal sex are at high risk of developing these infections. Using condoms can offer some protection, but not total protection. Talk with your provider about your options.
  • Ask your provider about the HPV vaccine and if you should get it.
  • DO NOT smoke. If you do smoke, quitting can lower your risk for anal cancer as well as other diseases.
What are the latest Anal Cancer Clinical Trials?
Screening for Anal Cancer in Women With High-grade Vulvar Dysplasia or Vulvar Cancer.
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A Non-comparative Randomized 2:1 Phase II Study of Docetaxel, Cisplatin, and 5-fluorouracil in Combination or Not With Atezolizumab in Patients With Metastatic or Unresectable Locally Advanced Squamous Cell Anal Carcinoma
What are the Latest Advances for Anal Cancer?
Pilot trial of topical MTS‑01 application to reduce dermatitis in patients receiving chemoradiotherapy for stage I‑III carcinoma of the anal canal.
Gross perianal embryonal rhabdomyosarcoma with severe multiple bone metastases throughout the body: a case report.
Tired of the same old research?
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Definitive Intensity-Modulated Chemoradiation for Anal Squamous Cell Carcinoma: Outcomes and Toxicity of 428 Patients Treated at a Single Institution.
Who are the sources who wrote this article ?

Published Date : July 28, 2020
Published By : Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Hallemeier CL, Haddock MG. Anal carcinoma. In: Tepper JE, Foote RL, Michalski JM, eds. Gunderson & Tepper's Clinical Radiation Oncology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 59.

National Cancer Institute website. Anal cancer treatment - health professional version. www.cancer.gov/types/anal/hp/anal-treatment-pdq. Updated January 22, 2020. Accessed October 19, 2020.

Shridhar R, Shibata D, Chan E, Thomas CR. Anal cancer: current standards in care and recent changes in practice. CA Cancer J Clin. 2015;65(2):139-162. PMID: 25582527 pubmed.ncbi.nlm.nih.gov/25582527/.