Anal Cancer Overview
Learn About 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.
Cancer - anus; Squamous cell carcinoma - anal; HPV - 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 grows 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.
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
Treatment for anal cancer is based on:
- The stage of the cancer
- Where the tumor is located
- Whether the cancer has resisted initial treatment or has come back after initial treatment
In most cases, anal cancer that hasn't spread can be treated with radiation therapy and chemotherapy together. The combination of radiation and chemotherapy achieves better tumor control than the use of radiation alone.
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. This procedure is called a colostomy. Stools moving through the intestine drain through the stoma into a bag attached to the abdomen.
Thomas Hegarty is a Radiation Oncologist in Garden City, Kansas. Dr. Hegarty and is rated as an Experienced provider by MediFind in the treatment of Anal Cancer. His top areas of expertise are Astrocytoma, Atypical Teratoid Rhabdoid Tumor (ATRT), Neuroepithelioma, and Ependymoma. Dr. Hegarty is currently accepting new patients.
Cancer Center Of Kansas PA
Shaker Dakhil is a Hematologist Oncology provider in Liberal, Kansas. Dr. Dakhil and is rated as an Advanced provider by MediFind in the treatment of Anal Cancer. His top areas of expertise are Lung Cancer, Breast Cancer, Myelodysplastic Syndrome (MDS), Bone Marrow Aspiration, and Bone Marrow Transplant. Dr. Dakhil is currently accepting new patients.
St. Catherine Hospital
Hermann Sigbjarnarson is a General Surgeon in Dodge City, Kansas. Dr. Sigbjarnarson and is rated as an Experienced provider by MediFind in the treatment of Anal Cancer. His top areas of expertise are Hernia, Umbilical Hernia, Gallbladder Disease, Gallbladder Removal, and Endoscopy. Dr. Sigbjarnarson is currently accepting new patients.
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.
Anal cancer spreads slowly. With early treatment, most people with anal cancer are cancer-free after 5 years.
You may have side effects from surgery, chemotherapy, or radiation therapy.
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.
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.
All adults with HIV should have the following screening test for anal cancer:
- DARE and assessment for symptoms of for anal cancer at least once per year
- People under the age of 35 who have symptoms or signs of anal cancer during DARE should undergo standard anoscopy.
Adults with HIV should have other tests along with high resolution anoscopy (HRA), rather than standard anoscopy, if they are:
- Men who have sex with men who are age 35 and older
- Transgender women who are age 35 and older
- All other people with HIV ages 45 and older
If HRA is not available, people with HIV should continue to be screened using an assessment of symptoms and DARE. People with any symptoms or signs of anal cancer should have standard anoscopy, without the collection of anal specimens for diagnosis.
Background: Often, metastatic human papillomavirus (HPV) associated cancers cannot be cured. They also do not respond well to treatment. Some forms of colon cancer also have poor responses to treatment. Researchers want to see if a new drug treatment can help people with these types of cancers.
Background: Less toxic and more effective treatments are needed for cancers caused by viruses. These cancers include Hodgkin and non-Hodgkin lymphoma, hepatocellular carcinoma, head and neck cancer, nasopharyngeal carcinoma, gastric cancer, anal cancer, cervical cancer, vaginal cancer, vulvar cancer, penile cancer, Merkel cell carcinoma, Kaposi sarcoma, and leiomyosarcoma. Researchers want to see if a combina...
Published Date: August 15, 2022
Published By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/15/2024.
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.
Clinicalinfo.hiv.gov website. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV. clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/human?view=full. Updated July 9, 2024. Accessed August 2, 2024.
Madoff RD, Melton GB. Diseases of the rectum and anus. In: Goldman L, Cooney K, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 131.
National Cancer Institute website. Anal cancer treatment (PDQ) - health professional version. www.cancer.gov/types/anal/hp/anal-treatment-pdq. Updated January 19, 2024. Accessed August 2, 2024.