HEALTH - ANAL CANCER (CANCER OF THE ANUS) SYMPTOMS & TREATMENT
What is Anal Cancer?
Anal cancer is found in or on the anus. Anus is the end of the large intestine, below the rectum, through which stool (solid waste) leaves the body. The anus is formed partly from the outer skin layers of the body and partly from the intestine. Two ring-like muscles, called sphincter muscles, open and close the anal opening to let stool pass out of the body. The anal canal, the part of the anus between the rectum and the anal opening, is about 1½ inches long.
The skin around the outside of the anus is called the perianal area. Tumors in this area are skin tumors, not anal cancer.
The anus is part of the gastrointestinal tract and is the opening at the end of the large intestine, below the rectum, where bowel movements leave the body. The anus is made up of different types of cells, and each type can become cancerous. Therefore, there are several different types of anal cancer:
- Squamous cell carcinoma is the most common type of anal cancer. This cancer begins in the outer lining of the anal canal.
- Cloacogenic carcinoma accounts for about one-quarter of all anal
cancers. This cancer arises between the outer part of the anus and the
lower part of the rectum. Cloacogenic cell cancer likely starts from
similar cells as squamous cell cancer and is treated similarly.
- Adenocarcinoma arises from the glands that make mucous, located under the anal lining.
- Basal cell carcinoma is a type of skin cancer that can appear in the perianal (around the anus) skin.
- Melanoma begins in cells in the skin or anal lining that darken the skin.
A tumor of the anus can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other areas of the body). There are also growths that can occur in or around the anus, such as polyps or warts. While these growths are not cancerous, some may become cancerous over time.
Health: Risk Factors of Anal Cancer (Anus)
The following factors may raise a person’s health risk of developing anal cancer:
Human papillomavirus (HPV) infection. HPV causes bumps on the skin around the anus commonly called venereal warts. There are different types or strains of HPV, and some strains are more strongly associated with anal cancer than others. HPV is most often spread through sexual contact, particularly anal intercourse. People with many sex partners have an increased health risk of contracting HPV.
Age. Most cases of anal cancer are diagnosed in people between 50 and 80.
Frequent anal irritation. Frequent anal redness, swelling, and soreness may increase the health risk of developing anal cancer.
Anal fistula. An anal fistula is an abnormal tunnel between the anal canal and the outer skin of the anus that often drains pus or liquid, which can soil or stain clothing. An anal fistula may irritate the outer tissues or cause discomfort. An anal fistula may increase the risk of developing anal cancer.
Cigarette smoking. As an health concern, cigarettes can cause harm throughout the body, because chemicals from cigarettes can enter the bloodstream and affect nearly every organ and tissue in the body. Smokers are about eight times more likely to develop anal cancer than nonsmokers.
Lowered immunity. People with diseases or health conditions affecting the immune system, such as HIV or organ transplantation, and people who take immunosuppressive drugs that make the immune system less able to fight disease, are more likely to develop anal cancer.
Even though some people who have no risk factors develop anal cancer, there are ways to prevent or reduce your risk of developing anal cancer.
- Avoid anal sexual intercourse, which carries an increased risk of HPV and HIV infection.
- Limit the number of sex partners, because having many partners increases the health risk of HPV and HIV infection.
- Use a condom. However, even though condoms can protect against HIV, they cannot fully protect against HPV.
- Stop smoking.
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Health: Symptoms of Anal Cancer (Anus)
Possible symptoms of anal cancer include bleeding from the anus or rectum or a lump near the anus.
These and other symptoms may be caused by anal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
- Bleeding from the anus or rectum.
- Pain or pressure in the area around the anus.
- Itching or discharge from the anus.
- A lump near the anus.
- A change in bowel habits.
Health: Diagnosis of Anal Cancer (Anus)
The following tests may be used to diagnose anal cancer:
Digital rectal examination (DRE). During this test, the doctor inserts a gloved finger into the anus to feel for lumps or abnormalities. General cancer health guidelines suggest men have a DRE annually after the age of 50 and women have one during routine pelvic examinations. If you are at higher risk for developing anal cancer, your doctor may perform a DRE more often.
Anoscopy. If the doctor feels a suspicious area during a DRE, an anoscope (a thin, lighted, flexible tube) may be inserted into the anus to see the abnormality. Similarly, a proctoscope can be used to view the rectum (a procedure called a proctoscopy).
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). The type of biopsy performed will depend on the location of the cancer. For instance, an excisional biopsy can remove the entire lump if it is small and does not extend into other tissues. Lymph nodes may also be examined in a biopsy.
Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. In an anal ultrasound, an ultrasound wand is inserted into the anus to obtain the pictures.
Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.
Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.
Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.
X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help determine if the cancer has spread to the lungs.
Health: Staging of Anal Cancer (anus):
Stage 0 (Carcinoma in Situ)
In stage 0, cancer is found only in the innermost lining of the anus. Stage 0 cancer is also called carcinoma in situ.
Stage I
In stage I, the tumor is 2 centimeters or smaller.
Stage II
In stage II, the tumor is larger than 2 centimeters.
Stage IIIA
In stage IIIA, the tumor may be any size and has spread to either:
- lymph nodes near the rectum; or
- nearby organs, such as the vagina, urethra, and bladder.
Stage IIIB
In stage IIIB, the tumor may be any size and has spread:
- to nearby organs and to lymph nodes near the rectum; or
- to lymph nodes on one side of the pelvis and/or groin, and may have spread to nearby organs; or
- to lymph nodes near the rectum and in the groin, and/or to lymph nodes on both sides of the pelvis and/or groin, and may have spread to nearby organs.
Stage IV
In stage IV, the tumor may be any size and cancer may have spread to lymph nodes or nearby organs and has spread to distant parts of the body.
Recurrent anal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the anus or in other parts of the body. Anal cancer rarely spreads (metastasizes) to distant parts of the body. Only a small percentage of tumors are found to have spread, but those that do are especially difficult to treat. Anal cancer that metastasizes most commonly spreads to the liver and the lungs.
Tests and procedures used to diagnose anal cancer include:
- Examining your anal canal and rectum for abnormalities. During a digital rectal exam (DRE), your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths. DRE isn't used to diagnose anal cancer, but it can give your doctor an indication of what further testing might be appropriate.
- Visually inspecting your anal canal and rectum. Your doctor may use a short, lighted tube (anoscope) to inspect your anal canal and rectum for anything unusual. Your doctor inserts the lubricated tube into your rectum to examine your anal canal and rectum. You may feel pressure during anoscopy, but it shouldn't hurt. You may be required to take laxatives or an enema in order to clean your rectum before the procedure.
- Taking sound wave pictures of your anal canal. In order to create a sonogram picture of your anal canal, your doctor inserts a probe, similar to a thick thermometer, into your anal canal and rectum. The probe emits high-energy sound waves, called ultrasound waves, which bounce off tissues and organs in your body to create a picture. Your doctor evaluates the sonogram picture to look for anything abnormal.
- Removing a sample of tissue for laboratory testing. If your doctor discovers any unusual areas, he or she may take small samples of affected tissue (biopsy) and send the samples to a laboratory for analysis. By looking at the cells under a microscope, doctors can determine if the cells are cancerous. Biopsy samples are typically removed during anoscopy. You may feel a pinch and experience some bleeding during a biopsy procedure.
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Natural Alternative Treatment: NATURAL CANCER TREATMENT
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Health: Conventional Treatment for Anal Cancer (Anus)
Three types of standard treatment are used for anal cancer (anus)
Surgery
The type of surgery for anal cancer depends on the stage of the cancer. Anal carcinoma in situ or early-stage cancer can often be treated by removing the abnormal cells and a small area of the surrounding normal tissue (called a margin). Afterward, patients should receive regular follow-up screening to identify and remove any new abnormal cells.
Most patients with later stages of anal cancer were treated surgically before effective chemotherapy and radiation therapy were developed for anal cancer. However, studies have shown similar cure rates between surgical treatment and the combination of radiation therapy and chemotherapy. Now, most patients will have a biopsy (which may require some level of surgery; followed by chemotherapy and radiation therapy without further surgery. Many patients can avoid major surgery with this type of combined treatment.
In cases where a patient cannot have chemotherapy or radiation therapy, surgery may be recommended. Surgery may also be recommended if the cancer remains after initial treatment or returns after treatment has been completed. A persistent or recurring tumor may be treated with an abdominoperineal resection, which is the surgical removal of the anus, rectum, and part of the colon. This procedure results in a colostomy (an opening on the abdominal wall to allow feces to be collected in a bag). Lymph nodes may also be removed during this procedure.
Radiation therapy
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.
Side effects of radiation therapy may include fatigue, mild skin reactions, upset stomach, temporary anal irritation, loose bowel movements, and discomfort when having a bowel movement. Scar tissue may form from damage to anal tissue, which may interfere with bowel function. Most side effects go away soon after treatment is finished.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. It is particularly valuable for treating anal cancer when given in combination with radiation therapy. The combined treatment allows the use of lower radiation doses and improves the likelihood of completely destroying the tumor. Chemotherapy for anal cancer usually consists of a combination of drugs. The main chemotherapy drugs given for anal cancer are fluorouracil (5-FU, Adrucil) and mitomycin C (Mutamycin), or fluorouracil and cisplatin (Platinol). The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.
Having the human immunodeficiency virus can affect treatment of anal cancer.Cancer therapy can further damage the already weakened immune systems of patients who have the human immunodeficiency virus (HIV). For this reason, patients who have anal cancer and HIV are usually treated with lower doses of anticancer drugs and radiation than patients who do not have HIV.
Recurrent anal cancer
The treatment of recurrent anal cancer depends on the original treatment. For example, a patient who initially had chemotherapy and radiation therapy may be treated with surgery if the cancer recurs.
Health: Prevention of Anal Cancer (Anus)
There is no sure way to prevent anal cancer. In order to reduce your risk of anal cancer:
- Practice safer sex. Abstaining
from sex or practicing safe sex may help prevent HPV and HIV, two
sexually transmitted viruses that may increase your risk of anal
cancer. If you choose to have anal sex, use condoms, as a preventive health measure.
- Get vaccinated against HPV. The Food and Drug Administration approved a vaccine against HPV in early 2006. The HPV vaccine is approved only for girls and women. Doctors hope the vaccine will help prevent HPV-related cancers in women, including cervical cancer and anal cancer. Further study may reveal that the vaccine may also be appropriate for boys and men, but it isn't currently approved for that use.
- Stop smoking. Smoking increases your risk of anal cancer. Don't start smoking. Stop if you currently smoke, as a preventive health measure.
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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.
Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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