Finding anal cancer in the early stages and diagnosing it accurately can help improve your chances for successful therapy. We have the most advanced and accurate technology, as well as specialized experts to interpret results.
Anal Cancer Diagnosis
If you have symptoms that may signal anal cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family history.
One or more of the following tests may be used to find out if you have anal cancer and if it has spread. These tests also may be used to find out if treatment is working.
Imaging tests, which may include :
- ♦ Anoscopy : A short tube with a camera is inserted into the anus and lower rectum. The doctor examines the anus and can biopsy tissue.
- ♦ Proctoscopy: A short tube with a camera is inserted into the anus to the rectum. The doctor examines the anus and can biopsy tissue.
- ♦ Double contrast barium enema (DCBE): Barium is a chemical that allows the bowel lining to show up on an X-ray. You will be given an enema with a barium solution, and then X-rays will be taken.
- ♦ Colonoscopy
- ♦ Virtual colonoscopy or CT (computed tomography) colonoscopy
- ♦ CT or CAT (computed tomography) scans
- ♦ MRI (magnetic resonance imaging) scans
- ♦ PET/CT (positron emission tomography) scans
- ♦ Endo-anal or endorectal ultrasound: An endoscope is inserted into the anus. A probe at the end of the endoscope bounces high-energy sound waves (ultrasound) off organs to make an image (sonogram). Also called endosonography.
- ♦ Chest X-Ray
Fine-needle aspiration (FNA) biopsy : Anal cancer may spread through the lymph system, and sometimes it is found in lymph nodes. A tiny needle is placed into a lymph node, and cells are removed and looked at with a microscope. A positive lymph node biopsy may help the doctor decide what areas to treat with radiation therapy.
Anal Cancer Staging
If you are diagnosed with anal caner, your doctor will determine the stage of the disease. Staging is a way of talking about how much disease is in the body and where it has spread. This information helps the doctor treat the cancer. Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
Anal Cancer Stages :
- ♦ Stage I : Cancer has formed. The tumor is 2 centimeters or smaller
- ♦ Stage II : Tumor is larger than 2 centimeters but not greater than or equal to 5 centimeters
- ♦ Stage IIIA : Tumor is 5 centimeters or greater and/or has spread to either :
- Lymph nodes near the rectum
- Nearby organs, such as the vagina, urethra or bladder
- ♦ Stage IIIB : Tumor is 5 centimeters or greater and/or may be any size and has spread to :
- Nearby organs and lymph nodes near the rectum
- Lymph nodes on one side of the pelvis and/or groin and may have spread to nearby organs
- Lymph nodes near the rectum and in the groin and/or lymph nodes on both sides of the pelvis and/or groin and may have spread to nearby organs
- ♦ Stage IV : Tumor may be any size and may have spread to lymph nodes or nearby organs and has spread to distant parts of the body
Anal Cancer Facts
According to the American Cancer Society, more than 5,000 people are diagnosed with anal cancer in the United States each year. Unfortunately, this figure is increasing. The average age of people diagnosed with anal cancer is the early 60s. It occurs slightly more often in women than men because more women have human papilloma virus (HPV), which is a risk factor for anal cancer. Anal cancer often can be treated successfully if it is found early.
The anus, which is about 1-1/2 inches long, connects the rectum (lower part of the large intestine) to the outside of the body. It allows solid waste (also called stool or feces) to pass from the body. The sphincter is two muscles that open and close the anus to let waste pass. The anus is lined with squamous cells, which also are found in the bladder, cervix, vagina, urethra and other places in the body.
Anal Cancer Types
Several types of tumors may be found in the anus. While some of them are malignant (cancer), others are benign (not cancer) or precancerous (may develop into cancer). The main types of anal cancer are :
Carcinoma in situ is early cancer or precancerous cells. They are only on the surface cells of the anal canal. This also may be called Bowen’s disease.
Squamous cell cancer (carcinoma) forms in the cells that line the anus. This is the most common type of anal cancer.
Adenocarcinomas develop in the glands around the anus.
Skin cancers, including basal cell and melanoma, often are found when they are in advanced stages.
Our Approach :
This depth of experience and expertise sets us apart, enabling us to offer you the most accurate diagnosis methods and the very latest treatments for anal cancer.
Your care plan is customized by a team of renowned anal cancer specialists. They work together to ensure the most-advanced therapies with the fewest possible side effects. During treatment and beyond, they are supported by specially trained nurses, social workers, nutritionists and others.
Our high level of experience in minimally invasive and sphincter-sparing surgeries and other innovative techniques can help many people with anal cancer. We offer the most advanced therapies for every type of anal cancer, including in people with HIV and AIDS. Because we know quality of life is important, we make every effort to preserve the sphincter, without affecting control of bowel movements.
Anal Cancer Screening
Cancer screening exams are important medical tests done when you’re healthy and don’t have symptoms. They help find cancer at its earliest stage, when the chances for treating it are best.
The chances for successful treatment are much higher when anal cancer is found early. While anal cancer often does not have symptoms, a digital rectal exam (DRE) can diagnose some cases early.
Men over 50 years old should have annual rectal exams. Once they are sexually active, women should have annual pelvic exams that include rectal exams.
If you have risk factors for anal cancer, talk to your doctor about other tests, including an anal Pap test. In this test, much like the Pap test for cervical cancer, cells from the anus are removed and looked at under a microscope.
Anal Cancer Risk Factors
Anything that increases your chance of getting anal cancer is a risk factor. These include :
- ♦ Age: Squamous cell carcinoma of the anus most often is found in people older than 50
- ♦ Human papillomavirus (HPV) infection
- ♦ Human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)
- ♦ Having more than 10 sexual partners
- ♦ Anal intercourse
- ♦ Frequent anal redness, swelling and soreness
- ♦ Tobacco use
- ♦ Immunosuppression, including taking immune-suppressing drugs after an organ transplant
Not everyone with risk factors gets anal cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.
Anal Cancer Prevention :
Certain lifestyle choices can help prevent anal cancer. One of the most important is to avoid HPV infection. Some ways you can lower your chances of getting HPV include :
- ♦ Wait until you are older to have sex and limit your number of sexual partners
- ♦ Use condoms during sex
- ♦ Don’t smoke or use other types of tobacco
- ♦ Avoid sex with people with sexually transmitted diseases (STD) or who have had multiple sexual partners
- ♦ Get an HPV vaccine. Gardasil® and Cervarix® help protect against certain types of HPV. But if you have HPV, they do not cure it.
Anal cancer often does not have symptoms. When it does have symptoms, they vary from person to person. If you have anal cancer symptoms, they may include :
- ♦ Anal or rectal bleeding
- ♦ Pain or pressure around the anus
- ♦ Change in bowel habits
- ♦ Narrower stool than usual
- ♦ A lump close to the anus
- ♦ Swollen lymph nodes in the anal or groin area
- ♦ Anal discharge
These symptoms do not always mean you have anal cancer. However, it is important to discuss any symptoms that last more than two weeks with your doctor, since they may signal other health problems.
Our Treatment Approach
As one of the nation's largest cancer centers, we care for more patients with anal cancer than most other hospitals. A team of experts personalizes your comprehensive care plan to be sure you receive the most effective treatment with the fewest possible side effects.
A team of anal cancer specialists, including oncologists, radiation oncologists, surgeons and others as needed, focus on your treatment. They are supported by a group of specially trained nurses, nutritionists and social workers.
Most Advanced Therapies
We make every effort to preserve the sphincter without affecting control of bowel movements, and we use all means possible to decrease the risk of a colostomy. However, if a colostomy is needed, highly qualified nurses help you make the transition and maintain your quality of life.
If you have anal cancer that has spread (metastasized) and/or have HIV or AIDS, we offer the most advanced treatments for them.