Anal cancer

Overview

Anal cancer forms in the anus, the opening to the rectum that controls the elimination of feces during bowel movements. Two sphincter muscles open and close the anus. Anal cancer develops in a section of the digestive system that doctors can easily see and reach — making it more likely that the disease is found early and responds well to treatment. 

There are several types of malignant (cancerous) anal tumors:

  • Squamous Cell Carcinoma – Begins in cells that line most of the anus and is the most common type of anal cancer
  • Adenocarcinoma – A more rare type of anal cancer that forms in mucous-producing glands and is treated like a rectal cancer
  • Basal Cell Carcinoma – A type of skin cancer that can develop in skin surrounding the anus
  • Melanoma – A skin cancer that begins in pigment-producing cells in the anal lining

Other tumors and abnormal anal growths like warts and polyps are benign (non-cancerous). Some of these could eventually lead to cancer and might require removal. There are several terms for this pre-cancerous condition:

  • Dysplasia
  • Anal Intraepithelial Neoplasia (AIN)
  • Squamous Intraepithelial Lesions (SILs)
  • Carcinoma in Situ
  • Bowen's Disease

Our approach

Anal cancer can cause serious problems, but treatment for the disease is very effective — especially if the cancer is found early.

Northwell Health doctors offer the latest treatments for anal cancer. In many cases, precision radiation therapy and advanced chemotherapy regimens allow the successful treatment of the cancer without surgery. When surgery is necessary, the doctors are careful to preserve muscles that control bowel movements, as well as nearby nerves. They perform minimally invasive procedures whenever possible to speed recovery, reduce pain and return patients to a normal diet sooner.

Northwell Health offers convenient locations throughout Long Island, Manhattan and Staten Island where patients can receive the most advanced care available.

Anal Cancer Team Approach

Successful anal cancer care requires a team of experienced doctors with different specialties working together. The multidisciplinary team at Northwell Health understands that each patient is unique, and they stay in constant contact with each other during the diagnosis and treatment process. They also meet once a week to share ideas and review each step of care.

Risk factors

While the causes of anal cancer are not yet known, researchers believe there is a strong link to infection from some strains of human papillomavirus (HPV) — a virus that is usually sexually transmitted and has also been associated with cervical cancer and some forms of head and neck cancer. It is important to note, however, that people with HPV don’t get anal cancer.

Researchers have identified other risk factors for anal cancer. Risk increases if someone:

  • Is over 50
  • Has many sexual partners and more possible exposure to HPV
  • Frequently receives anal sex
  • Regularly experiences anal redness, swelling or soreness
  • Has anal glands that become infected and then exposed (anal fistulas)
  • Smokes
  • Has lowered immunity from conditions like HIV or from taking medications to suppress the immune system

Symptoms

Sometimes anal cancer does not cause noticeable problems. But other patients may experience one or more of these symptoms in their anus:

  • Bleeding
  • Pain or pressure
  • Itching
  • Unusual discharge
  • Lumps or swelling
  • Change in bowel habits or size of stool

Just because someone has these symptoms doesn’t necessarily mean they have cancer. A doctor should always be seen to best diagnose symptoms.

Diagnosis

If anal cancer seems like a possibility, physicians at Northwell Health will take all the steps necessary to ensure an accurate diagnosis. Tests could include: 

  • Physical Exam – The doctor feels for lumps and other signs of disease
  • Digital Rectal Examination (DRE) – The doctor or nurse uses a lubricated, gloved finger to feel the rectum for signs of disease 
  • Anoscopy – A doctor uses a lighted tube called an anoscope to look at the anus and lower rectum.
  • Proctoscopy – A doctor uses a lighted tube called a proctoscope to look at the rectum
  • Ultrasound – A doctor inserts a probe into the anus or rectum, creating an image by bouncing sounds waves off tissues and organs
  • Biopsy – Cells or tissue are removed and examined under a microscope
  • CT (CAT) scan – X-rays are overlapped from different angles, with dye sometimes injected into veins or swallowed to see delicate, tiny structures
  • PET scan (Positron Emission Tomography) – Radioactive, traceable glucose (sugar) is injected into the veins so a rotating scanner can look for malignant cells throughout the body.
  • MRI (Magnetic Resonance Imaging) – A magnet, radio waves and a computer take detailed pictures of the inside of the body.

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