Disease: Anal cancer
Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body.
Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
Most people with anal cancer are treated with a combination of chemotherapy and radiation. Though combining anal cancer treatments increases the chance of a cure, the combined treatments also increase the risk of side effects.
Anal cancer signs and symptoms include:
- Bleeding from the anus or rectum
- Pain in the area of the anus
- A mass or growth in the anal canal
- Anal itching
When to see a doctor
Talk to your doctor about any signs and symptoms that bother you, especially if you have any factors that increase your risk of anal cancer.
Anal cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).
Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority of anal cancers. HPV is thought to be the most common cause of anal cancers.
Tests and procedures used to diagnose anal cancer include:
- Examining your anal canal and rectum for abnormalities. During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
- 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.
- Taking sound wave pictures (ultrasound) of your anal canal. To create a 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 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 whether the cells are cancerous.
Determining the extent of the cancer
Once it's confirmed that you have anal cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.
Tests may include:
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
Your doctor uses the information from the procedures to assign your cancer a stage. The stages of anal cancer are indicated using Roman numerals ranging from 0 to IV, with the lowest stages indicating that the cancer is small and confined to the anus. By stage IV, the cancer has spread to distant areas of the body.
The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you.
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.
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.
- Get vaccinated against HPV. Two vaccines â Gardasil and Cervarix â are given to protect against HPV infection. Both boys and girls can be vaccinated against HPV.
- Stop smoking. Smoking increases your risk of anal cancer. Don't start smoking. Stop if you currently smoke.
Alternative medicine treatments can't cure anal cancer. But some alternative medicine treatments may help you cope with the side effects of cancer treatment. Your doctor can treat many side effects, but sometimes medications aren't enough. Alternative treatments can complement your doctor's treatments and may offer additional comfort.
Options for common side effects include:
- Anxiety â massage, meditation, hypnosis, music therapy, exercise or relaxation techniques
- Fatigue â gentle exercise or tai chi
- Nausea â acupuncture, hypnosis or music therapy
- Pain â acupuncture, massage, music therapy or hypnosis
- Sleep problems â yoga or relaxation techniques
While these options are generally safe, talk with your doctor first to be sure that alternative medicine options won't interfere with your cancer treatment.
Coping and support
A cancer diagnosis can be overwhelming and frightening. You can help yourself to feel more in control by taking an active role in your health care. To help you cope, try to:
- Learn enough about anal cancer to make decisions about your care. Ask your doctor about your anal cancer, including the stage of your cancer, your treatment options and, if you like, your prognosis. As you learn more about anal cancer, you may become more confident in making treatment decisions.
- Keep friends and family close. Keeping your close relationships strong will help you deal with your anal cancer. Friends and family can provide the practical support you'll need, such as helping take care of your house if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by cancer.
Find someone to talk with. Find a good listener with whom you can talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Or check your phone book, library or a cancer organization, such as the National Cancer Institute or the American Cancer Society.
Several factors have been found to increase the risk of anal cancer, including:
- Older age. Most cases of anal cancer occur in people age 50 and older.
- Many sexual partners. People who have many sexual partners over their lifetimes have a greater risk of anal cancer.
- Anal sex. People who engage in anal sex have an increased risk of anal cancer.
- Smoking. Smoking cigarettes may increase your risk of anal cancer.
- History of cancer. Those who have had cervical, vulvar or vaginal cancer have an increased risk of anal cancer.
- Human papillomavirus (HPV). HPV infection increases your risk of several cancers, including anal cancer and cervical cancer. HPV infection is a sexually transmitted infection that can also cause genital warts.
- Drugs or conditions that suppress your immune system. 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. HIV â the virus that causes AIDS â suppresses the immune system and increases the risk of anal cancer.
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