How Do I Know if I Have Anal Cancer?

Anal cancer or anal carcinoma is a rare type of cancer that starts in the cells lining the anus, the opening that connects the lower part of the large intestine (rectum) to the outside of the body through which waste passes. There are four different types of anal cancer. They are:

• Squamous cell carcinoma:
  • This is the most common type of anal cancer. Around 8 out of 10 anal cancers are of this type.
  • These cancers develop from the small flat cells that line the anal canal and the anal margin.
• Adenocarcinoma:
  • These develop from the cells that produce mucus within the anal canal.
• Basal cell carcinoma:
  • This is a type of skin cancer that may develop in the skin around the anus.
• Malignant melanoma:
  • This is another type of skin cancer that may affect the cells called melanocytes.

The exact cause of anal cancer is unknown. 9 Possible risk factors of anal cancer are:

1. Human papillomavirus (HPV) infection is the most common cause. It affects the moist membranes or lining of the body. Having anal sex may usually increase the risk of developing an HPV infection.
2. Having a history of other cancers, such as cervical cancer, or vaginal or vulval cancer.
3. Smoking is often considered a risk factor for developing almost any type of cancer.
4. People who take drugs to suppress their immune systems (immunosuppressive drugs), including people who have received organ transplants may have an increased risk of anal cancer. Diseases, such as human immunodeficiency virus (HIV) infection, may also suppress the immune system and increase the risk of anal cancer.
5. The risk of developing anal cancer increases with age. 50 percent of anal cancer cases diagnosed are in people aged 65 years or older. 
6. More common in women than men. However, more African-American males get anal cancer than females.
7. The presence of anal fistulas or abnormal openings in the anus and frequent swelling in or around the anus or rectum.
8. People who have had anal warts are more likely to get anal cancer. These are noncancerous growths that may occur just outside the anus and in the lower anal canal. They are caused by infection with human papillomavirus (HPV).
9. Other things that can increase the risk for anal cancer include having multiple sex partners and poor social or living conditions.

The treatment of anal cancer varies depending on factors, such as the stage of anal cancer and the patient’s general health and preferences.

Surgery

Surgery is often a primary treatment for anal cancer. Depending on the location, type, and size of your tumor, the surgeon will most likely decide between one of two surgeries

1. Local resection: If the tumor is small and has not spread, the surgeon may choose to remove the tumor and some of the tissue surrounding the anus. The muscles surrounding the area are spared (if possible) to allow control of bowel movements after recovery.
2. Abdominoperineal resection: In this procedure, a surgeon removes the anus, rectum, and part of the colon. The intestine is redirected to an opening in the abdomen, called a stoma. A special bag is attached to the stoma to collect waste in place of the body’s normal bowel movements. During surgery, the surgeon may also remove lymph nodes surrounding the area to determine whether they contain cancer. This type of surgery is often required for large tumors or those that have grown into the abdominal wall.

Radiation therapy

The anal cancer treatment uses high-energy X-rays to reach and destroy cancer cells. There are two types of radiation therapy used for anal cancer treatment:

1. External radiation therapy: It uses a machine outside the body to send radiation toward the cancer site.
2. Internal radiation therapy: Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer site.

Chemotherapy

It uses specialized drugs to stop the growth of cancer cells either by destroying the cells or by preventing them from making new cells.

The five-year survival rate

Anal cancer is a serious disease. However, treatments are effective, and most people can be cured. About 50 percent of anal cancers are diagnosed before cancer has spread beyond the anus.

The five-year survival rate for localized anal cancer is 80 percent.