Jane Doe
What is anal cancer?
The anus
The anus is the body's opening at the lower end of the intestines. The anal canal is the tube that connects the lower part of the large intestine (rectum) to the anus and the outside of the body. As food is digested, it passes from the stomach to the small intestine. It then travels from the small intestine into the large intestine (colon). The colon absorbs water and liquid from the digested food. The waste matter that is left after going through the colon is known as feces or stool. Feces are stored in the rectum, the final 6 inches of the digestive system. From there, they pass out of the body through the anus as a bowel movement.
Anal cancer is very rare. In the UK approximately 800 patients are diagnosed annually, out of a total population of 61 million (2009). According to the American Cancer Society, approximately 5,070 new cases of anal cancers were diagnosed in the USA in 2008, of which about 60% were women. Most anal cancer patients are diagnosed in their early 60s. Approximately 680 people died from anal cancer in the USA in 2008. The USA has a population of 300 million (2009). Anal cancer is more common among women, men who receive anal intercourse, and people with weakened immune systems. Experts say that anal cancer is closely associated with some HPV (human papilloma virus) strains.
Surgery
The type of surgery a patient will require depends on the size and position of the tumor.
Resection
This removes a small tumor and some surrounding tissue. This type of surgery can only be carried out if the anal sphincter is not sacrificed. Patients who undergo a resection do not have their ability to pass a bowel movement affected.
Abdominoperineal resection
The anus, rectum and a section of the bowel are surgically removed. The patient will need a colostomy - the end of the bowel is brought out onto the skin on the surface of the abdomen. A bag is placed over the stoma - the opening of the bowel - and collects the stools (feces) outside the patient's body. Although this sounds shocking, people with colostomies can lead normal lives, play sports and have active sex lives.
In most cases, the patient will probably have to undergo chemotherapy and/or radiotherapy.
Chemotherapy and radiotherapy
Radiotherapy combined with chemotherapy treatments (chemoradiation) are commonly used to destroy the anal cancer cells. Treatments are either given simultaneously or consecutively. This combined therapy approach has led to a much higher percentage of patients with an intact anal sphincter - survival and cure rates are good.
Radiotherapy uses high-energy rays that destroy the cancer cells. This can be given by an external beam or internally (brachytherapy).
Radiotherapy has side effects, as does chemotherapy. When the treatment is combined the side effects may be more acute. Side effects may include:
Prevention
Lifestyle changes after Anal Cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life -- making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it's really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. (For more information on dealing with fatigue, please see Fatigue in People With Cancer and Anemia in People With Cancer.)
Keep in mind exercise can improve your physical and emotional health.
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The anus
The anus is the body's opening at the lower end of the intestines. The anal canal is the tube that connects the lower part of the large intestine (rectum) to the anus and the outside of the body. As food is digested, it passes from the stomach to the small intestine. It then travels from the small intestine into the large intestine (colon). The colon absorbs water and liquid from the digested food. The waste matter that is left after going through the colon is known as feces or stool. Feces are stored in the rectum, the final 6 inches of the digestive system. From there, they pass out of the body through the anus as a bowel movement.
What are the symptoms of anal cancer?
- The patient may notice blood on feces or toilet paper.
- Pain in the anal area.
- Lumps around the anus. These are frequently mistaken for piles (hemorrhoids).
- Mucus discharge from the anus.
- Jelly-like discharge from the anus.
- Anal itching.
- Change in bowel movements. This may include diarrhea, constipation, or thinning of stools.
- Fecal incontinence (problems controlling bowel movements).
- Bloating.
- Women may experience lower back pain as the tumor exerts pressure on the vagina.
- Women may experience vaginal dryness.
What causes anal cancer?
Experts are not sure what causes anal cancer. However, the following are considered as possible risk factors:
HPV (human papilloma virus)
Some types of HPV are closely linked to anal cancer. Approximately 80% of patients with anal cancer are infected in the anal area with a HPV.
Sexual partner numbers
This is also linked to HPV. The more sexual partners somebody has (or has had) the higher are the chances of being infected with HPV, which is closely linked to anal cancer risk.
Receptive anal intercourse
Both men and women who receive anal intercourse have a higher risk of developing anal cancer. HIV-positive men who have sex with men are up to 90 times more likely than the general population to develop anal cancer, this study revealed.
Other cancers
Women who have had vaginal or cervical cancer, and men who have had penile cancer are at higher risk of developing anal cancer. This is also linked to HPV infection.
Age
The older somebody is the higher is his/her risk of developing anal cancer. In fact, this is the case with most cancers.
A weak immune system
People with a weakened immune system have a higher risk of developing anal cancer. This may include people with HIV/AIDS, patients who have had transplants and are taking immunosuppressant medications.
Smoking
Smokers are significantly more likely to develop anal cancer compared to non-smokers. In fact, smoking raises the risk of developing several cancers.
Benign anal lesions
IBD (irritable bowel disease), hemorrhoids, fistulae or cicatrices. Inflammation resulting from benign anal lesions may increase a person's risk of developing anal cancer.
HPV (human papilloma virus)
Some types of HPV are closely linked to anal cancer. Approximately 80% of patients with anal cancer are infected in the anal area with a HPV.
Sexual partner numbers
This is also linked to HPV. The more sexual partners somebody has (or has had) the higher are the chances of being infected with HPV, which is closely linked to anal cancer risk.
Receptive anal intercourse
Both men and women who receive anal intercourse have a higher risk of developing anal cancer. HIV-positive men who have sex with men are up to 90 times more likely than the general population to develop anal cancer, this study revealed.
Other cancers
Women who have had vaginal or cervical cancer, and men who have had penile cancer are at higher risk of developing anal cancer. This is also linked to HPV infection.
Age
The older somebody is the higher is his/her risk of developing anal cancer. In fact, this is the case with most cancers.
A weak immune system
People with a weakened immune system have a higher risk of developing anal cancer. This may include people with HIV/AIDS, patients who have had transplants and are taking immunosuppressant medications.
Smoking
Smokers are significantly more likely to develop anal cancer compared to non-smokers. In fact, smoking raises the risk of developing several cancers.
Benign anal lesions
IBD (irritable bowel disease), hemorrhoids, fistulae or cicatrices. Inflammation resulting from benign anal lesions may increase a person's risk of developing anal cancer.
Anal Cancer Treatment
Treatment for anal cancer will depend on various factors, including how big the tumor is, whether or not it has spread, where it is, and the general health of the patient. If the tumor is small it can be removed surgically, and that's it.Surgery
The type of surgery a patient will require depends on the size and position of the tumor.
Resection
This removes a small tumor and some surrounding tissue. This type of surgery can only be carried out if the anal sphincter is not sacrificed. Patients who undergo a resection do not have their ability to pass a bowel movement affected.
Abdominoperineal resection
The anus, rectum and a section of the bowel are surgically removed. The patient will need a colostomy - the end of the bowel is brought out onto the skin on the surface of the abdomen. A bag is placed over the stoma - the opening of the bowel - and collects the stools (feces) outside the patient's body. Although this sounds shocking, people with colostomies can lead normal lives, play sports and have active sex lives.
In most cases, the patient will probably have to undergo chemotherapy and/or radiotherapy.
Chemotherapy and radiotherapy
Radiotherapy combined with chemotherapy treatments (chemoradiation) are commonly used to destroy the anal cancer cells. Treatments are either given simultaneously or consecutively. This combined therapy approach has led to a much higher percentage of patients with an intact anal sphincter - survival and cure rates are good.
Radiotherapy uses high-energy rays that destroy the cancer cells. This can be given by an external beam or internally (brachytherapy).
Radiotherapy has side effects, as does chemotherapy. When the treatment is combined the side effects may be more acute. Side effects may include:
- Diarrhea
- Constipation
- Soreness and blistering around the target area (anus)
- A higher susceptibility to infections during treatment
- Low white blood cell count (which raises infection risk)
- Fatigue
- Loss of appetite
- Nausea or vomiting
- Mouth ulcers
- Sore mouth
- Loss of hair
- Narrowing and dryness of the vagina
- Anemia (low red blood cell count)
- Low platelet count which raises risk of bruising or bleeding
- Dry skin
- Rashes
- Muscle and nerve problems
- Excessive coughing, sometimes breathing difficulties
- Fertility problems
Prevention
- Reduce your chances of being infected with HPV
- Use condoms when having sex
- Limit the numbers of sexual partners
- Abstain from anal intercourse
- Quit smoking
Lifestyle changes after Anal Cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life -- making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it's really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. (For more information on dealing with fatigue, please see Fatigue in People With Cancer and Anemia in People With Cancer.)
Keep in mind exercise can improve your physical and emotional health.
- It improves your cardiovascular (heart and circulation) fitness.
- Along with a good diet, it will help you get to and stay at a healthy weight.
- It makes your muscles stronger.
- It reduces fatigue and helps you have more energy.
- It can help lower anxiety and depression.
- It can make you feel happier.
- It helps you feel better about yourself.