The gastrointestinal system starts with the mouth and ends with the anus. It is located below the rectum; the stool leaves the body through the anus. Anal cancer is now amongst the most common type of cancers. Older adults are more susceptible to anal cancer, compared to people younger than 35 years. Anal cancer approximately affects 1 in every 500 individuals, women are most commonly affected with anal cancer than men.
Human papillomavirus (HPV) is the most common cause of anal cancer. When there is low immunity in the body, the capacity of the body to fight against the infections is reduced. This is the time when the HPV strikes.
There are many risk factors for developing anal cancer, which includes:
• Multiple sexual partners
• Older age greater than 50 years
• Anal sex
• Human papillomavirus infection
• Anal sores
• Anal inflammation
The common symptoms of anal cancer include the following, these can also be the symptoms of other conditions, so further tests may be needed:
• Anal bleeding
• Pain in the anus
• Anal discharge
• Anal itching
• Lump near the anus
• Change in bowel movements
The following tests and procedures are carried out to diagnose anal cancer.
Physical Examination: A physical examination is carried out to check for any unusual lumps. The patient’s medical history is taken to understand the health habits, past medical issues, and ongoing treatments.
Digital Rectal Exam (DRE): The doctor or nurse performs DRE by inserting the gloved finger into the rectum to feel the presence of any unusual masses and also check the prostate to feel any abnormalities.
Anoscopy uses a short, lighted tube called anoscope that helps in the examination of the anus and lower rectum.
Proctoscopy uses a short, lighted tube called proctoscope that helps in the examination of the anus.
Endorectal Ultrasound is a procedure performed by inserting a probe into the anus or rectum. It helps to takes pictures of body tissues called sonogram.
A Biopsy is the removal of cells to study under the microscope to check for the signs of cancer. A biopsy is performed during anoscopy if there is any abnormal growth. If any cancerous tissue is detected during a biopsy test then the following tests are recommended:
CT Scan is performed to create 3-dimensional images of the target site.
Magnetic Resonance Imaging (MRI) is performed by using magnetic and radio waves to produce 2-dimensional and 3-dimensional images of the target area.
An Ultrasound Scan uses sound waves to create the image of the target site. For this, the instrument must be inserted into the anus.
The choice of the treatment depends on the type, location and the stage of cancer. The treatment options for anal cancer include
• Radiation therapy
Surgery is performed based on the size and position of the tumor. If the cancer is small and near the anal margin, and has not spread to surrounding organs, then a local resection is done to remove the tumor. This procedure allows the patient to have normal bowel movements after the surgery. In abdominoperineal resection, the anus and rectum are removed. The patient’s ability to pass stools in a normal way is affected. Thus, the patient requires a colostomy in which the end of the bowel is open on to the abdominal surface from where the stool is collected into a bag. Patients who undergo abdominoperineal resection can lead the lives in a normal way.
Chemotherapy uses cytotoxic drugs to destroy the cancer cells whereas radiotherapy uses high-energy radiations to destroy the cancer cells. Radiotherapy along with chemotherapy is called chemoradiation and is commonly used to destroy the anal cancer cells. Chemoradiation has higher survival rates.
Coping and Support
Anal cancer can be a challenge for you. But yes, the challenges can always be accepted moving forward with a positive spirit. Support from family and friends can help in tiding over the difficult times. New technologies have emerged bringing new ways of treatment. So, early detection and best treatment approaches will benefit the life.