Understanding Anal Cancer And How To Manage It

Your guide to understanding all aspects of anal cancer

“My cancer scare changed my life. I’m grateful for every new, healthy day I have.
It has helped me prioritize my life.”

Olivia Newton-John

Early detection and diagnosis always increase your chances of receiving successful treatment and beating all forms of cancer – including anal cancer. Detecting anal cancer early will significantly boost your odds of survival.

You can read the section that details the various types of cancer before embarking on the journey to understand anal cancer better. Read more

Let’s understand the
anatomy first

The anus is the opening at the end of the large bowel. It helps us pass stools (bowel movements) out of the body. The bowel (colon and rectum) and anus are part of the human digestive system. The anal canal connects the anus to the rectum. The anus also has a ring of muscle called the external sphincter. This muscle helps to control when you pass bowel movements.

What is anal cancer?

Anal cancer is a disease in which malignant (cancerous) cells form in the tissues of the anus. The walls of the anal canal are lined with cells called squamous cells; nearly all anal cancers develop in these cells. Cancer begins when healthy cells in the anal area start mutating or changing. Such mutations cause these cells to grow rapidly and prevent cell death. The accumulation of these abnormal cells forms a malignant mass or tumour. Often, the cancer cells invade nearby tissues and may break off from a tumour to spread or metastasize to other parts of the body.

Types of Anal Cancer

There are three main types of cancer that originate in the anal area

Squamous cell carcinoma

The most common form of anal cancer, this type of cancer originates in the cells that line the surface of the anal canal

Adenocarcinoma

This type of cancer originates in cells of the anal glands. These glands produce the mucus that help the stools (faeces) pass smoothly

Melanoma

This is a rare form of anal cancer and begins in the cells of the skin surrounding the anal area

What causes anal cancer?

Clinical practitioners and researchers do not know the exact causes of anal cancer. There are certain risk factors (detailed below) that can increase your chance of developing it; however, having one or more risk factors does not mean that you will definitely get anal cancer. On the other hand, having no risk factors also does not mean you will not get the disease.

Most anal cancers are caused by the human papillomavirus (HPV), a common viral infection that is passed on through sexual contact. The immune system typically prevents this virus from causing damage and most people with the virus never develop cancer. However, in a small percentage of people, the virus survives for years and may contribute to the mutation of cells, which in turn results in cancer.

What Are The Risk Factors?​​
While most anal cancers are caused by HPV, there are other factors that put people at higher risk. Being associated with a risk factor does not necessarily mean that you will develop anal cancer
  A family history of anal cancer
  Smoking or excessive use of chewing tobacco

  Pre-existing medical conditions, including

  • Anal HPV infection
  • Cervical, vaginal or vulvar cancer
  • HIV/AIDS – this makes it hard for the body to fight off infections and
    increases the risk of HPV infection
  • Having a weakened immune system
What Can be Done to
Lower Your Risk of Getting
Anal Cancer?

Based on your age, overall health and
personal risk factors for anal cancer,
there are some things that can be done
to prevent pre-cancers and conditions
that can lead to pre-cancers

Talk to your doctor about getting an HPV vaccine

  • Vaccines are available to protect young people against certain forms of HPV infections which can lead to anal cancer.

  • It is important to note that these vaccines can only prevent an HPV infection – they cannot be used to treat an HPV infection that is already present in the body.

  • The vaccines require a series of injections (shots). Side effects are usually mild. The most common side effects are short-term redness, swelling, and soreness at the injection site.

Practice safe sex

  • Have an open discussion with your partner about your respective sexual histories. Remember that a person can have HPV for years and still have no symptoms, so it is possible that someone can pass it on without knowing it. Make sure you and your partner get screened regularly for HPV and other sexually transmitted infections.

  • Using a condom can provide some protection against HPV. However, condoms cannot prevent it completely because they don’t cover every possible HPV-infected area of the body (such as the skin of the genital or anal area).
What are the Symptoms?
The Government of India has a number of schemes that offer support to cancer patients living below the poverty line, including

Bloody stools

Bleeding from the rectum or anal area

Changes in the bowel, such as difficulty
controlling bowel movements

Discharge of mucus from the anus

Pain, itching or discomfort in the anal area

Pain or discomfort in the rectum

Feeling full or bloated

Ulcers around the anus

Screening for anal cancer

Anal cancer may occur in both men and women. Unfortunately, no standard or routine screening tests are performed for anal cancer. However, if you experience any of the symptoms listed above or any other inexplicable change, make an appointment with your doctor for prompt evaluation. If you or loved one have a family history of anal cancer, have an open discussion with your doctor about undergoing genetic testing or routine check-ups.

Diagnostic tests for anal cancer

If you experience any of the symptoms listed above or your doctor detects any abnormalities, he or she may recommend follow-up diagnostic tests to confirm if cancer is present. Refer to this section for more information about diagnostic tests for anal cancer. Read more

Staging colorectal Cancer

If your doctor confirms that you have anal cancer, further tests may be done to study the cancer cells and determine

If the disease has spread beyond the anus (i.e. determine the stage of cancer)

How quickly the cancer will grow

How likely it is to spread through the body

What sort of treatments might work

The likelihood of the cancer to recur (come back)

The stage of your cancer is a key aspect in determining your treatment. Refer to this section to understand your cancer diagnosis and for more information about how anal cancer is staged. Read more

Treatment options
for anal cancer
The decision about the best course of treatment is based on these test results and the type, stage, grade and size of your tumour. Treatments like surgery, chemotherapy and radiation therapy are some of the options used for anal cancer. Refer to this section to understand the types of cancer treatments for anal cancer and possible side effects. Read more
Your cancer journey
Everyone deals with a cancer diagnosis and treatment in a different way. Refer to this section, to understand various aspects of your cancer journey and the road to recovery. Read more
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