Anal Cancer

Anal cancer is cancer around the anal opening or within the anal canal. Cells that are just becoming malignant but haven’t invaded below the surface are called pre-cancerous (carcinoma in-situ) or Bowen’s disease. Most anal cancers are squamous cell carcinomas.

Symptoms of anal cancer include:

• a lump or mass by the anal opening;
• pain, bleeding, or itching from the anus or rectum;
• change in bowel habits including a mucous discharge;
• narrowing of stools; and/or
• swollen glands or lymph nodes in the groin/inguinal area.

Anal cancer accounts for only one to two percent of all gastrointestinal cancer. Rates, however, are rapidly increasing. People with other risk factors for anal cancer include individuals:

• over the age of 50;
• who have had an anal warts infection with HPV (human papilloma virus);
• who have anal receptive intercourse (both male and female);
• infected with HIV;
• who smoke;
• with chronic inflammation or fistulas; and/or
• who have had pelvic radiation for rectal, prostate, bladder, or cervical cancer.

Screening for high risk groups, especially people who have anal receptive intercourse, anal warts, or HIV positive patients is recommended.

Risk for anal cancer can be reduced by having regular check-ups, using condoms to avoid skin to skin contact when having anal receptive intercourse and avoiding sexual contact when your partner has anal warts.

Small cancers found early can be treated with excision. For larger, more advanced cancers, chemotherapy and radiation may be used.

For early cancers, or cancers that respond to chemotherapy and radiation, a colostomy is usually not needed. For more advanced or recurrent cancer, permanent colostomy may be needed due to removal of the entire anal area.

Early detection is important in the treatment of anal cancers. A rectal exam and a routine anoscopy (a physical exam which uses a lubricated, lighted instrument to aid in visualization of the entire anal canal), can assist in early detection. Anal pap smears may also be used to detect abnormal cells in the anal canal. Another technique, called HRA or high resolution anoscopy, can also assist doctors is better viewing the entire anal canal and anal area. Biopsy may accompany any of these exams for accurate diagnosis.

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