Once food has been processed by the body, it reaches the final stage of the digestive tract, which is also known as the rectum. The anal canal occupies the area between the inside of the digestive tract and the outside world. Anal canal cancer occurs when cells in this region of the body multiply in an unregulated manner and may spread to other areas of the body.

The following may be indicative of anal canal cancer but may also be indicative of other illnesses:

• Anal discomfort, irritation, and/or pain
• Bleeding and/or discharge from the anus
• Blood and/or discharge in the stool
• Change in frequency of bowel movements
• Difficulty and/or pain while attempting to pass stool
• Enlargement of lymph nodes in the area surrounding the anus
• Narrowing of the stool
• Observation and/or sensation of a mass in the anal canal

It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.

Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner.

If anal canal cancer is suspected, a doctor will likely order imaging to help arrive at a diagnosis. Imaging might include a CT scan, PET scan, PET-CT scan, ultrasound, or MRI. A CT (computed tomography) scan uses X-rays to generate a three-dimensional picture of the body whereas a PET (positron emission tomography) scan uses a small amount of radioactive tracer to locate any cancer cells by how readily they take up the radiotracer. A PET-CT combines the features of a CT scan with those of a PET scan. An MRI (magnetic resonance imaging) uses magnetic fields to generate a detailed representation of the body. Lastly, an ultrasound sends sound waves through the body to generate images of the body’s organs and tissues.

Anal canal cancer develops as a result of changes to the genetic material within the cells of the anal canal. These changes result in the pattern of cell growth and division characteristic of anal canal cancer. Although the increased likelihood of developing anal canal cancer is associated with the following factors, according to the American Cancer Society, in most cases, physicians and scientists are still trying to determine what causes anal canal cancer to develop:

• Aging
• Family history of certain cancers
• Personal history of certain cancers
• Personal history of human papillomavirus
• Exposure to certain chemical substances
• Genetic mutations
• Immune system impairment
• Infection with human immunodeficiency virus
• Obesity
• Sexual activity

“Staging” occurs when a physician uses to test and scan results to determine which parts of the body are involved by cancer, in this case, anal canal cancer. Staging is important because different stages of anal canal cancer are better addressed with treatments that may differ in amount, combination, or type. According to the American Joint Committee on Cancer (AJCC), the stages for anal canal cancer are as follows:

Stage 0

This stage is the earliest stage of anal canal cancer development; cancer has not grown beyond the surface of the anal canal.

Stage I

This stage describes anal canal cancer that is no greater than 2 cm and isolated to the anal canal.

Stage II

Cancer has either grown larger than 2 cm but only involves the anal canal and has not spread to other parts of the body.

Stage III

Cancer may have grown into nearby organs or spread to include nearby lymph nodes.

Stage IV

In this stage, cancer has spread to parts of the body distant from where it began, such as different organ systems.

Treatment of anal canal cancer, depending on the stage and type, may include chemotherapy, radiation therapy, and/or surgery. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on an anal canal cancer treatment plan include

• Your age, health, and lifestyle.
• The stage of your cancer.
• Any other serious health conditions you have.
• Your feelings about the need to treat cancer right away.
• Your doctor’s opinion about if you need to treat cancer right away.
• The likelihood that treatment will help fight or cure your cancer.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.