Anal cancer is a rare cancer that starts in the tissues of the anus, the opening at the end of the large intestine, below the rectum through which stool leaves your body. Affecting approximately 7,000 people in the United States each year, anal cancer can cause rectal bleeding and anal pain.
Anal cancer is divided into cancers of the anal canal and cancers of the lower part of the anus known as the anal margin. The most common type of anal cancer is squamous cell carcinoma which begins in the cells that line the anal margin and most of the anal canal. Cloacogenic carcinomas (also called transitional cell carcinomas) account for the remainder of anal cancers. Other rare anal cancers are: adenocarcinoma of anal ducts, anal Paget’s, anal melanoma, small cell carcinoma, sarcoma (Kaposi’s) and lymphoma.
Surgeons specializing in colon and rectal surgery at Brigham and Women’s Hospital (BWH) are the surgical team for the Gastrointestinal Cancer Treatment Center at Dana-Farber/Brigham and Women’s Cancer Center, a unique center uniting the world’s best gastrointestinal cancer experts. Our board certified surgeons are leaders in advanced laparoscopic and minimally invasive surgical techniques such as sphincter sparing surgery and abdominoperineal resection.
Factors that contribute to an increased risk for anal cancer include:
The most common symptoms of anal cancer are often connected with other less serious medical problems. People experiencing the following symptoms should always see a doctor:
If you are having symptoms of anal cancer, your surgeon will ask you about your health history, your family’s history of cancer and risk factors (above). Additional diagnostic tests include:
The American Cancer Society suggests that people over the age of 50 have a digital rectal exam (DRE) every year.
Staging tests will determine to what degree your anal cancer has spread. Your surgeon may schedule one or more of the following tests to help determine the stage of anal cancer:
With the results of these studies, your doctor will assign your cancer a stage.
The TNM system, developed by the American Joint Committee on Cancer and the International Union Against Cancer, is a standard system used to stage anal cancer. TNM represents:
Patients have different options when it comes to anal cancer treatment. Often they receive a combination of surgical and medical treatments:
Colon and rectal surgeons at BWH are internationally recognized surgical specialists who are faculty at Harvard Medical School and have years of experience in anal cancer surgery. They have perfected progressive surgical procedures including:
You will receive a thorough diagnostic examination to evaluate if you have anal cancer and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced colon and rectal surgeon are important to the successful outcome for patients with anal cancer.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.
The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with anal cancer. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced medical and nursing staff.
The Gastrointestinal Cancer Treatment Center at Dana-Farber/Brigham and Women’s Cancer Center provides the world’s most advanced and innovative multidisciplinary care for patients with gastrointestinal diseases, such as anal cancer. Our treatment team includes colon and rectal surgeons, medical and radiation oncologists, nutritionists, pathologists, anesthesiologists and gastroenterologists. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.
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