Anal Cancer: Symptoms, Diagnosis and Treatment

The anal canal is a little tube at the end of your rectum that bordered by muscle. The rectum is the colon’s lower part (large intestine). When you have a bowel movement, stool exits your body through the anal canal from the rectum. Cancer develops when some of the body’s cells divide uncontrollably. As cancer progresses, it may remain contained within local tissues or move to other parts of the body, a process known as metastasis. Anal cancer begins in the cells around or immediately next to the anal orifice. A person’s anal region may diagnose with precancerous cells. With time, these cells may have a high risk of cancer.

STATISTICAL INFORMATION AND FACTS

In 2016, around 8,000 adults in the United States will be diagnose with anal cancer, estimated 1,080 deaths.

  • Women account for around two-thirds of anal malignancies.
  • Mccounts for around 1-2 percent of all gastrointestinal cancers.
  • Most frequent diagnoses in adults between the ages of 55 and 64.

It is far less prevalent than colorectal cancer, affecting approximately one in 500 persons over their lifetime, compared to one in 22 people. For years, the number of cases of anal cancer has been continuously increasing.

Although anal tumors seldom spread, when they do, the condition is tough to treat. Anal cancer most frequently spreads to the liver and lungs.

FACTORS OF RISK

A risk factor raises the likelihood of contracting a disease. Infection with the human papillomavirus is the most prevalent risk factor for anal cancer (HPV). HPV is a sexually transmitted virus that can also produce warts in and around the anus or genitals in both men and women, but anal cancer can occur without warts. Additional risk factors include the following:

  • Affluence (55 and older)
  • Sexual anal sex
  • Sexually transmissible infections
  • Numerous sexual partners
  • Smoking
  • HPV-related malignancies, particularly cervical
  • Immune system impairment caused by HIV, chemotherapy, or organ transplantation
  • Chronically inflamed sites that generate chronic redness or discomfort, such as anal fistulas or open anal wounds.
  • Previously treated with pelvic radiation for rectal, prostate, bladder, or cervical cancer.

PREVENTION

Although few malignancies are completely avoidable, it is critical to eliminate risk factors and have frequent exams. Condom use may help reduce, but not eliminate the risk of HPV infection. HPV vaccines (for individuals between the ages of 9 and 26) reduce the chance of HPV infection and anal cancer in men and women. Your physician will swab the anal lining and examine the cells under a microscope for anything unexpected. Other screening methods include examining the area closely after surgery or in the office using a special scope to examine the anal canal. Early detection and treatment of precancerous lesions may help avoid the development of anal cancer.

SYMPTOMS

Up to 20% of people with anal cancer may have no symptoms. However, if you observe any of these symptoms, contact your physician immediately.

  • Bleeding from the rectum or anus.
  • Anal region pain.
  • A growth or bulk in the anal orifice.
  • Anal itching that persists.
  • Changes in bowel habits, such as increased or decreased frequency of stool movements or increased straining during a bowel movement.
  • Stools become narrower.
  • Anus discharge, mucus, or pus.
  • Lymph glands swollen in the anal or groin area.

DIAGNOSIS

Many anal malignancies detects early because they are in a visible and reachable region. When individuals exhibiting any of the symptoms as mentioned above undergo an anal exam, a diagnosis made. Additionally, anal cancer may be discovered inadvertently during routine annual physical examinations that involve a digital rectal exam. Rectal examinations use to examine the rectum, prostate, and other pelvic structures. Anal malignancies can potentially be detected through routine colorectal screening (such as a colonoscopy).

DIAGNOSTIC METHODS

A digital rectal exam in which your physician uses a gloved, lubricated finger to feel for lumps or other abnormalities in the anus and rectum.

The anal canal examines using a small, illuminated scope (anoscopy) to identify any abnormal regions.

Biopsy, in which tissue is plucked from the affected area and analyzed to obtain a precise diagnosis.

After a confirmed cancer diagnosis, anal ultrasound, MRI, or other imaging studies are used to identify cancer’s extent.

TREATMENT

When treated early, the majority of instances of anal cancer have a high cure rate. Treatment classifies into three broad categories:

  • Surgery – a procedure to remove the malignancy
  • Radiation therapy — the use of extremely high-dose X-rays to eliminate cancer cells
  • Chemotherapy – the use of chemicals to eradicate cancer cells

For most anal malignancies, a combination of radiation and chemotherapy is considered the gold standard of treatment. Occasionally, very small or early-stage tumors can be surgically removed without additional treatment. If cancer has progressed, extensive surgery may be necessary to remove the tumors.

COLOSTOMY SURGERY – WHAT IS IT?

This is a frequent enquire. A colostomy is a procedure that involves bringing the end of the colon (large intestine) through a hole (stoma) in the abdominal wall. To collect bowel motions, a bag affix to the outside of the patient’s belly.

A colostomy is rarely necessary, as many malignancies can be treated with chemotherapy and radiation alone. A colostomy may be necessary if the tumor does not respond to treatment or recurs following treatment. The surgeon may need to remove the rectum and anus and create a permanent colostomy if the anal cancer is advanced or atypical. Occasionally, this is the only approach to eradicate all cancer cells.

PROGNOSIS AFTER TREATMENT

The majority of anal malignancies are curable by combined therapy. Many malignancies that recur after nonsurgical treatment treated with surgery if discovered early. While combining radiation and chemotherapy has a higher risk of adverse effects, it also results in the highest long-term survival rates. At five years after completing this treatment, up to 70%-90 percent of patients are still living and cancer-free.

Regular follow-up with your colon and rectal surgeon is critical. During the appointment, he or she will evaluate the patient’s response to treatment and look for any new signs of anal cancer. Additional research may requires in some circumstances.

A COLON AND RECTAL SURGEON IS WHAT?

Colon and rectal surgeons are specialists in the surgical and non-surgical treatment of colon, rectum, and anus illnesses. They have received specialized surgical training in the treatment of various disorders in addition to completing a comprehensive general surgical training program. It passed rigorous tests administered by the American Board of Surgery and the American Colon and Rectal Surgery, respectively. The knowledgeable about the treatment of benign and malignant disorders of the colon, rectum, and anus. They are capable of performing routine screening examinations and surgically treating conditions when necessary.

DISCLAIMER

The American Society of Colon and Rectal Surgeons commits to advancing the study, prevention, and management of colon, rectum, and anus problems and diseases. These pamphlets intended to be inclusive rather than prescriptive.

Their objective is to educate the public about diseases and processes rather than prescribe a particular course of therapy. They design for use by all practitioners, health care professionals, and patients seeking knowledge on how to manage the conditions discussed. It is important to understand that these pamphlets are not exhaustive of all appropriate treatment techniques or exclusive of methods of care appropriately directed to achieve the same outcomes. The physician must ultimately determine the propriety of any particular procedure in light of all the facts surrounding the individual patient.

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