How is Anal Cancer Diagnosed?
Several types of tests and procedures are used to diagnose anal cancer. It is important to see your healthcare provider if you have any signs of anal cancer or a history of HPV to receive a thorough evaluation and diagnosis.
- Physical examination, including a visual inspection of the anal canal and rectum
- Digital rectum examination using an anoscope, a special tool with a light at the end that is inserted into the rectum to view lumps or infected areas
- Anal pap smear where samples of cells from the lining of the anal canal are collected for evaluation
- Imaging, such as ultrasounds, CT scans, and X-rays to view the anal canal in greater detail to spot new growths or changes
- Sigmoidoscopy is a tube-like instrument with an attached camera that provides a video image of the anus and rectum
- Biopsy, or sample tissue testing, may be collected during certain tests to determine if any cells are cancerous
A doctor may order additional tests after diagnosis. These are important in staging anal cancer to determine whether the cancer has spread to other parts of your body. Tests may include imaging, including computed tomography (CT), MRI, and Positron emission tomography (PET) scan. The doctor will use this information to assign your anal cancer a stage and determine the correct course of treatment.
How is Anal Cancer Treated?
While initial treatment of anal cancer is non-surgical, surgical removal of anal cancer may be necessary to treat the cancer and stop it from spreading.
For early-stage anal cancer, your doctor may recommend surgery to remove the tumor and the areas directly surrounding the mass. This type of surgery is called local resection and is used when the tumor is small and the cancer has not spread into tissues or lymph nodes.
Chemo, radiation, and targeted therapies
Radiation therapy and chemotherapy may be the recommended course of anal cancer treatment if the cancer has been found in more than one area. For more targeted treatment options, your NewYork-Presbyterian doctor may offer immunotherapy. Cancer treatment side effects may also be treated with other specialty care services while at NewYork-Presbyterian.
Minimally invasive procedures
For invasive anal cancers where more extensive surgery is required, our surgeons use minimally invasive techniques, laparoscopic surgery, and advanced robotic technology.
Immunotherapy may be used to treat invasive anal cancer and ease symptoms of stage four anal cancer. It may also be paired with chemotherapy to increase the body's response to the treatment. Immunotherapy is medication that triggers your immune system's response against cancer cells. Immune checkpoint inhibitors, such as Nivolumab and pembrolizumab, are certain types of immunotherapies that may be used to treat severe anal cancer.
Chemotherapy is an anticancer medication that travels through the blood stream and is used to reduce and kill cancer cells. Chemotherapy for anal cancer may be given to you before surgery, after surgery, if your cancer returns, or if anal cancer metastasized or spreads.
In most situations, anal cancer is treated with chemotherapy and radiation therapy to remove the tumor while avoiding surgery altogether. Your doctors will let you know if your anal cancer requires treatment with anticancer drugs. Treatment will be carefully coordinated with all members of the multidisciplinary team to ensure the best possible outcomes. In some cases, only chemotherapy is needed. You may be eligible for cutting-edge new therapies as well.
If your anal cancer is treatable with radiation, NewYork-Presbyterian provides advanced radiation oncology techniques and evidence-based treatments. Our radiation oncologists offer a comprehensive care plan to treat anal cancer based on the unique genetics of your tumor and surrounding tissues. The goal of radiation therapy is to treat the cancer safely in as few sessions as possible.
We use 3D imaging to shape and target high doses of radiation directly to your tumor, killing cancer cells while sparing nearby healthy tissue. You can receive radiation therapy in our state-of-the-art radiation oncology units.
Abdominoperineal resection (APR)
Another procedure called an abdominoperineal resection or APR may be recommended when other therapies and treatments are ineffective. To remove cancerous cells and affected areas, your surgeon will remove the anus, rectum, and the lower part of the colon. Once these are removed, a permanent colostomy will be created to drain stool from the colon. This type of invasive surgery for anal cancer is used less frequently.
Our researchers are directing clinical trials evaluating novel treatment approaches for advanced anal cancer. Your treatment team will inform you if you can receive an innovative investigational treatment by participating in a clinical trial.
The most common way to get anal cancer is by having a long-term infection of HPV, or human papillomavirus. HPV is a sexually transmitted disease that causes about 90 percent of all anal cancer cases. If abnormal cells form within anal warts and are left untreated, they may develop into anal cancer. A family history of cancer, sexual activity, and certain medical conditions may increase your risk. Learn more about the risk factors of anal cancer.
Anal cancer is considered a rare form of cancer. According to the American Cancer Society, the lifetime risk of getting anal cancer is 1 in 500. An estimated 8,000 people in the U.S. receive a diagnosis of anal cancer each year
Anal cancer signs and symptoms may include itchiness in the anal area and bleeding or discharge from the anus. You may also feel a fullness or discomfort in the region due to anal warts or growths.
Some people with anal cancer experience little to no symptoms. If left untreated, anal warts or masses may multiply, which may increase your discomfort. See your doctor for early diagnosis and treatment if you experience these signs or symptoms.
The only way to know if you have anal cancer is to make an appointment with your physician for a physical evaluation and diagnostic testing. A series of tests and different procedures will help your doctor determine if you have anal cancer, including the tumor size, location, and stage of your cancer.
According to the American Society of Colon and Rectal Surgeons, a combinatioen therapy of chemo and radiation is considered the most effective course of treatment. After receiving these therapies, around 70 to 90 percent of anal cancer patients are alive and still cancer free at five years. If the cancer returns, surgery is often the next recommended treatment.
Trust NewYork-Presbyterian for Anal Cancer Treatment
NewYork-Presbyterian's colorectal surgeons and other cancer experts have the experience and compassion to treat people with anal cancer, using therapies based on the latest scientific advances, and minimally invasive therapies. We offer the full spectrum of anal cancer care, from diagnosis through treatment and survival. We have an international reputation for superior care, with thousands of patients traveling to us from across the country and around the world to receive care from our renowned team of surgeons and oncologists.