Treatment for Anal Cancer

Anal cancer is a malignant condition that begins in the anal tissues. The most common sign of anal cancer is a lump or growth in the anus. Though the exact cause of anal cancers is unknown, most result from a Human Papilloma Virus (HPV) infection. Being diagnosed with this cancer can be difficult, but prompt treatment can improve anal cancer life expectancy

A biopsy may be performed to confirm an anal cancer diagnosis. The tissue sample collected during the diagnostic phase is also used to stage and grade cancer. This helps the doctor and your multidisciplinary healthcare team determine how to treat anal cancer.

Anal Cancer Treatment Options

Anal cancer treatment options depend upon several factors such as the location of cancer, its type, stage, and overall health and fitness of the patient. During your cancer treatment, your preferences of treatment options will be discussed with you and considered. Most anal cancers are usually treated using a combination of two or more treatment options from the following:

  • Surgery

For anal cancer, surgery is often the first line of treatment. It aims to remove the tumour entirely. Sometimes, some surrounding healthy tissue may also be removed in the process. A surgical oncologist determines the extent of the surgery. 

Early-stage anal cancers usually do not require any treatment after the complete removal of cancer. However, you may be required to visit for a follow-up regularly to allow your doctor to monitor the presence of any abnormal cells.

In other stages of anal cancer, surgery is usually followed up by chemotherapy or radiation therapy or a combination of both. Surgery is also the treatment of choice when chemotherapy and radiation are not possible in a patient or cancer recurs after treatment.

It is natural to have concerns before undergoing surgery for your anal cancer. Speak to your doctor about any queries that you may have. You must seek a second opinion before beginning your treatment. 

  • Chemotherapy

This treatment uses potent drugs to kill cancer cells and stop their growth. The type of drugs used for your chemotherapy depends upon your cancer type. They may be given orally or injected into a vein. For anal cancer, chemotherapy involves the use of more than one drug and is often combined with radiation therapy (in low doses). 

Chemotherapy is known to cause side effects like fatigue, lowered blood cell counts, increased risk of infections, nausea, vomiting, loss of appetite, diarrhoea, among others. Feel free to ask your doctor about the medications they will be using for your treatment, expected side effects and interactions with any medications you may be taking currently.

  • Radiation therapy

Radiation therapy uses high-energy x-rays to kill or stop cancer cells. It is one of the most commonly used treatment options for anal cancer and is often used with chemotherapy. Radiation therapy is recommended when there is a risk of cancer recurrence after surgery. Radiation therapy is of two types– external and internal. You may experience some side effects following your radiotherapy sessions. Speak to your doctor about the same.

Immunotherapy, a type of biological therapy, uses drugs to stimulate a patient’s immune system to fight or kill cancer cells. This is a relatively newer therapy used for anal cancers.

Stage-Wise Treatment for Anal Cancer

Anal cancer can be grouped into the following stages– Stage 0, Stage 1, Stage 2, Stage 3 and Stage 4.

Stage 0 anal cancers

This stage of anal cancers is treated by surgery, during which the entire cancerous tissue is removed with some surrounding healthy tissues surrounding it. Radiation therapy and chemotherapy are usually not needed post-surgery.

Stage 1 and Stage 2 anal cancers

Stage 1 and 2 anal cancers are limited to the anal tissues and have not spread to nearby organs. The standard treatment choice for these stages of anal cancers is surgical resection of the cancerous tissue without damaging the anal sphincter. 

Chemoradiotherapy (a combination of radiotherapy and chemotherapy) may be required after surgery. More treatment may be necessary for the following months depending upon cancer recurrence.

Stage 3 anal cancers

Stage 3 anal cancer usually spreads beyond the anus to nearby tissues and lymph nodes but not to distant parts of the body. The first line of treatment for stage 3 anal cancer is radiation therapy or chemoradiation. Affected lymph nodes may be surgically removed.

Stage 4 anal cancers

Stage 4 anal cancers are advanced-stage cancers characterised by the spread of cancer cells to distant parts of the body, including the liver, lungs, bones and lymph nodes located far away. Treatments for stage 4 anal cancer cannot cure it but help control the disease progression, relieve symptoms and prolong life. 

Chemotherapy is the standard treatment of care for this cancer stage, and it may sometimes be combined with radiation therapy. If anal cancer spreads to the spinal cord, bones or the brain, radiation therapy is the treatment of choice. Advanced stage anal cancers may require newer treatments like immunotherapy or joining a clinical trial program.

Second Opinion for Anal Cancer

A second opinion with another doctor gives you a different take on your diagnosis and the available treatment options and may make you more confident about your treatment plan. It is natural to think if you have enough time for a second opinion, especially if your anal cancer requires immediate treatment. However, you must take some time to think and discuss your options before beginning treatment.

Here are some reasons why you must get a second opinion for your anal cancer:

  • To get different views about your anal cancer diagnosis and treatment plan
  • Explore the various treatment options
  • To be more confident about your diagnosis and anal cancer treatment options
  • You are unable to understand the complexity of your cancer from your primary doctor

Carry all your diagnostic test results when you visit another specialist for a second opinion on your anal cancer. Speak to your doctor about any concerns regarding your treatment options, side effects of chemotherapy and anal cancer and prognosis. Feel free to seek a second opinion at any time during your treatment journey.

Unfortuantely this test is not suitable.
You should see your GP directly