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Patient Information

Anal cancer is cancer that starts in the tissues of the anus.

WakeMed’s gastroenterology team helps anal cancer patients lead longer and healthier lives through early detection, a range of treatment options, and individualized and collaborative care. When surgery is warranted, our colorectal surgeons provide expert surgical care.

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What Are the Symptoms and Risk Factors of Anal Cancer?

Symptoms of anal cancer can include:

  • Bleeding from the anus or rectum
  • Lump near the anus
  • Itching, discharge, pain, or pressure in the anal region

There is a higher risk of anal cancer in people who have been infected with the human papillomavirus (HPV). Other risk factors include:

  • Multiple sexual partners
  • Anal intercourse
  • Being older than 50
  • Smoking
  • Anal fistulas, or openings

How Is Anal Cancer Diagnosed?

To diagnose anal cancer, a doctor will first perform a physical exam and get a detailed health history. A digital rectal examination will also be performed, in which the doctor inserts a lubricated, gloved finger into the rectum to feel for any abnormalities. If something is found, additional tests might include:

  • Proctoscopy, which uses a thin tube to look at the inside of the anus and rectum. Sometimes, it can also be used to remove tissue samples.
  • Biopsy, in which tissue is removed to be checked for signs of cancer
  • Ultrasound, in which sounds waves are used to take detailed pictures of the anus and rectum
  • Magnetic resonance imaging (MRI) scan of the rectum

How Is Anal Cancer Treated?

At WakeMed, we work collaboratively to create a customized treatment plan for each patient. Depending on the stage of the cancer, or how far it’s spread, treatment can include:

  • Chemoradiation, radiation therapy (which uses radiation to destroy cancer cells) together with chemotherapy (which uses drugs to destroy cancer cells)
  • Surgery to remove the part of the anus that has the cancer is an option if chemoradiation fails

What Does Surgical Treatment Involve? 

Thanks to minimally invasive laparoscopy, our colorectal surgeons can often perform surgery for anal cancer without making large incisions.

For small tumors that have not spread, a local resection can be performed. In this situation, the tumor as well as some of the healthy tissue around it is removed. In a local resection the sphincter muscles are preserved, so patients can maintain control of their bowel movements.

Sometimes, when chemoradiation fails or is ineffective, in order to effectively treat anal cancer, the anus, rectum, and part of the colon need to be removed. In this case, an opening, called a stoma, is created in the abdomen so that body waste can be collected in a disposal bag. This is called a colostomy.

Learn more about what to expect from colorectal surgery.