Anal cancer is a rare cancer of the opening at the end of the intestines called the anus. The tube joining the end of the large intestine to the outside of the body and the anus is called the anal canal, according to the American Cancer Society. Anal cancer can originate here, as well. Although this cancer is not often diagnosed, various treatment methods are available. The specific treatment chosen will depend on the extent and location of the cancer, as well as the individual's general health.
Significance
Anal cancer is rarely diagnosed. In the United States, approximately 5,290 new diagnoses of anal cancer were made in 2009, according to the National Cancer Institute. Nearly 710 deaths were attributed to the disease that year. It is found more often in women, according to the American Cancer Society.
Surgery
According to the American Cancer Society, surgery is no longer the main type of treatment for anal cancer. When surgery is called for, various types of surgery are used, depending on the type of anal cancer and location of the tumor.
A local resection excises the tumor along with a surrounding area of normal, healthy tissue. This operation is typically done when the tumor has not invaded other tissues or lymph nodes, and if the tumor is fairly small. Tumors on the anal margin are taken addressed with this surgery.
Abdominoperineal resection, or APR, is more complicated than a local resection. In APR, incisions are made on the abdomen and anus, and the anus and rectum are removed, along with lymph nodes in some cases. An ostomy is made, where a a bag is attached to the end of the colon at the abdomen so waste can leave the body. This operation is typically done only if other treatments are not effective or if the cancer recurs despite treatments.
Radiation Therapy
Radiation therapy involves using high energy rays to kill cancer cells and keep them from multiplying. This therapy can be administered in two ways: externally and internally. External-beam radiation therapy is the most common kind of radiation. In this type of treatment, radiation is administered via a machine that aims rays toward the cancerous area. The treatment is typically given five days a week for about five weeks. Internal radiation, also called brachytherapy, involves placing pellets filled with a radioactive substance into the cancerous area.
Chemotherapy
Chemotherapy is the use of anti-cancer drugs to kill cancer cells. These drugs can be given intravenously, intramuscularly or orally as pills. Because these medications travel through the bloodstream, they are able to reach cancer cells throughout the body; therefore, this is called a systemic therapy. For anal cancer, chemotherapy is often given together with radiation therapy, since the treatments are more effective together. The main drugs used for anal cancer are 5-fluorouracil, or 5-FU, and cisplatin.
Effects
Treatment for anal cancer can cause side effects, depending on the treatment given. Radiation can cause skin changes in the radiation field, typical to that of a sunburn. It also can cause nausea, fatigue, diarrhea and temporary irritation in the anal area, according to the American Cancer Society. Rectal bleeding may also occur due to inflammation of the rectal lining. Chemotherapy may cause side effects like nausea, vomiting, lowered white and red blood cell counts that may lead to anemia or higher risk of infection, fatigue and shortness of breath. Not everyone will have all these side effects from treatment, which tend to be temporary and may resolve once treatment has ended.
Other Options
Clinical trials may be an option for some people. Clinical trials are closely monitored research studies that examine the effectiveness of potential treatments. These studies often have eligibility criteria, and patients can leave the studies at any time, with no impact on their health care. Patients who are interested in learning more or possibly participating in clinical trials should consult their physicians first.
