Anal Cancer Overview
What is anal cancer?
Cancer is made of changed cells that grow out of control. The changed (abnormal) cells
often grow to form a lump or mass called a tumor. Cancer cells can also grow into
(invade) nearby areas. And they can spread to other parts of the body. This is called
The anus is the last part of the digestive tract. It's where stool comes out of the
body. It’s a short tube made of layers of tissue surrounded by a ring of muscles (sphincter
muscles). You control these muscles during a bowel movement so stool can pass through.
Most anal cancers start in the cells that make the inside lining of the anus. This
is called squamous cell carcinoma. From the lining it can move deeper into the other
layers of the anus and the sphincter muscles.
Who is at risk for anal cancer?
A risk factor is anything that may increase your chance of having a disease. The exact
cause of someone’s cancer may not be known. But risk factors can make it more likely
for a person to have cancer. Some risk factors may not be in your control. But others
may be things you can change.
The risk factors for anal cancer include:
HPV (human papilloma virus) infection
Many sex partners
A weakened immune system because of HIV or other causes
Frequent inflammation in the anal area
Having anal fistulas
Talk with your healthcare provider about your risk factors for anal cancer and what
you can do about them.
Can anal cancer be prevented?
There’s no sure way to prevent anal cancer. But there are some things that may help
lower your risk for it, such as:
Get the HPV vaccine before you start having sex
Don’t have anal sex
Use condoms every time you have any type of sex (vaginal, anal, or oral)
Are there screening tests for anal cancer?
There are currently no regular screening tests for anal cancer for people at average
risk. Screening tests are done to check for disease in people who don’t have symptoms.
Many people who get anal cancer (squamous cell carcinoma) first have patches of changed
cells in the lining of the anus. These are precancer cells that are called anal intraepithelial
neoplasia (AIN). Finding and treating AIN may keep it from becoming cancer. Tests
called anal cytology or an anal Pap test can help find AIN. Talk with your doctor
about testing for anal cancer if you’re at high risk because you have any of these:
Regular anal sex
A history of cervical, vaginal, or vulvar cancer
A history of organ transplant
A history of anal warts
What are the symptoms of anal cancer?
Sometimes anal cancer doesn’t cause symptoms until it grows or spreads. Common symptoms
of anal cancer are:
Bleeding from the anus
Pain or pressure in your anal area
Itching around your anus
Fluid leaking from your anus
Narrower stools or other changes in your bowel movements
A lump or swelling near your anus
Swollen lymph nodes in your anal or groin area
Many of these may be caused by other health problems. But it’s important to see a
healthcare provider if you have these symptoms. Only a healthcare provider can tell
if you have cancer.
How is anal cancer diagnosed?
Your healthcare provider will ask you about your health history, symptoms, risk factors,
and family history of disease. He or she will do a physical exam. This may include
a digital rectal exam (DRE). During a DRE, your provider puts a gloved, lubricated
finger into your rectum to check for hard or lumpy areas.
You may also have one or more of these tests:
After a diagnosis of anal cancer, you’ll likely need other tests. These help your
healthcare providers learn more about the cancer. They can help determine the stage
of the cancer. The stage is how much and how far the cancer has spread (metastasized)
in your body. It is one of the most important things to know when deciding how to
treat the cancer.
Once your cancer is staged, your healthcare provider will talk with you about what
the stage means for your treatment. Be sure to ask your healthcare provider to explain
the stage of your cancer to you in a way you can understand.
How is anal cancer treated?
Your treatment choices depend on the type of anal cancer you have, test results, and
the stage of the cancer. Other things to think about are if the cancer can be removed
with surgery and your overall health. The goal of treatment may be to cure you, control
the cancer, or help ease problems caused by the cancer. Talk with your healthcare
team about your treatment choices, and what the risks and side effects may be.
Types of treatment for cancer are either local or systemic. Local treatments remove,
destroy, or control cancer cells in one area. Surgery and radiation are local treatments.
Systemic treatment is used to destroy or control cancer cells that may have traveled
around your body. When taken by pill or injection, chemotherapy is a systemic treatment.
You may have just one treatment or a combination of treatments.
Anal cancer can be treated with:
Talk with your healthcare providers about your treatment options. Make a list of questions.
Think about the benefits and possible side effects of each option. Talk about your
concerns with your healthcare provider before making a decision.
What are treatment side effects?
Cancer treatment such as chemotherapy and radiation can damage normal cells. This
can cause side effects such as hair loss, mouth sores, and vomiting. Talk with your
healthcare provider about side effects you might have and ways to manage them. There
may be things you can do and medicines you can take to help prevent or control side
Depending on where the tumor is and how big it is, a lot of tissue may need to be
removed with surgery. If the anus and rectum are removed, you’ll no longer be able
to pass stool the same way. The surgeon will make an opening on your belly called
a colostomy. A plastic bag sticks to the skin around the colostomy to collect the
stool as it passes through the opening. If you need surgery for anal cancer, be sure
to talk with your doctor about what you can expect.
Coping with anal cancer
Many people feel worried, depressed, and stressed when dealing with cancer. Getting
treatment for cancer can be hard on your mind and body. Keep talking with your healthcare
team about any problems or concerns you may have. Work together to ease the effect
of cancer and its symptoms on your daily life.
Here are tips:
Talk with your family or friends.
Ask your healthcare team or social worker for help.
Speak with a counselor.
Talk with a spiritual advisor, such as a minister or rabbi.
Ask your healthcare team about medicines for depression or anxiety.
Keep socially active.
Join a cancer support group.
Cancer treatment is also hard on the body. To help yourself stay healthier, try to:
Eat a healthy diet, with a focus on high-protein foods.
Drink plenty of water, fruit juices, and other liquids.
Keep physically active.
Rest as much as needed.
Talk with your healthcare team about ways to manage treatment side effects.
Take your medicines as directed by your team.
When should I call my healthcare provider?
Your healthcare provider will talk with you about when to call. You may be told to
call if you have any of the below:
New symptoms or symptoms that get worse
Signs of an infection, such as a fever
Side effects of treatment that affect your daily function or don’t get better with
Ask your healthcare provider what signs to watch for, and when to call. Know how to
get help after office hours and on weekends and holidays.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your provider if you have questions.