About Anal Cancer

The anus is the lowermost opening of the intestines connected to the rectum via the anal canal. It helps the passage of stools from the rectum outside the body. The anal canal comprises multiple layers, glands and ducts. The innermost lining of the anal canal is called the mucosa, and it is in this layer, most anal cancers originate. Anal cancer is rare cancer, and nearly half of the cases are diagnosed before cancer has spread to other nearby sites. Anal cancers are more common in adults over 60 years of age, with a higher predisposition in men. Early diagnosis of anal cancer increases the prognosis of the condition, making them highly treatable cancers. Anal cancer life expectancy or 5-year survival rate after diagnosis is around 69%.

Symptoms

The most common symptom of anal cancer is bleeding from the anus or the rectum. Other symptoms that may occur in anal cancer include:

  • A lump near the anus.
  • Unusual discharge from the anus.
  • Pain, pressure or discomfort in the anal region.
  • Itching of the anus.
  • A change in bowel habits.

Diagnosis

Most people who experience symptoms of anal cancer may find it embarrassing to talk about them with their family members or even their healthcare provider. If you experience one or more of the above symptoms, reach out to us at the earliest.

 

Diagnostic tests for anal cancer include:

 

  • Medical history 

Your doctor provider will take a complete medical history that includes your health, past or current illnesses, list of medications, lifestyle and other habits to understand your risk for developing anal cancer. 

 

  • Digital Rectal Examination (DRE)

During a DRE, the healthcare provider inserted a well-lubricated gloved finger into the rectum to feel for lumps or changed texture of tissues in the area.

 

  • Anoscopy

A short, thin tube (endoscope) is inserted into the rectum and the anus to examine the area.

 

  • Endoanal or endo-rectal ultrasound

High-energy ultrasound waves bouncing off the internal organs form a picture called a sonogram.

 

  • Proctoscopy

A thin, tube instrument with a lens and light at its tip is inserted into the anus and rectum to view the suspected area. A proctoscope may have an additional attachment that allows the collection of tissue samples for viewing under the microscope.

 

  • Biopsy

If your healthcare provider notices a change in tissue or growth during an ultrasound or endoscopy, they might collect a sample of the anal tissue for further evaluation. This process is called a biopsy.

 

Other tests that your healthcare provider may recommend to you include a CT scan, an MRI (when they suspect lymph node involvement) and blood tests to detect HIV.

Treatment

Anal cancer treatment involves a multidisciplinary team of experts who create a treatment plan personalised for you. Your anal cancer treatment plan will depend upon several factors such as stage, size, age, and overall health. 

 

Anal cancer treatment options include:

  • Surgery: Used to remove cancerous tissues and their margins entirely and is the preferred treatment option for small tumours.
  • Radiation therapy: Radiation treatment may be used in combination with chemotherapy, before or after surgery in slightly advanced cancers. 
  • Chemotherapy: Used in all stages of anal cancer in combination with other treatment modalities, and is the primary treatment given stage 4 anal cancer.
  • Immunotherapy: Some anal cancers respond to immunotherapy drugs.

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