Anal Cancer: Frequently Asked Questions

These are answers to some frequently asked questions about anal cancer:

What is anal cancer?

Anal cancer is cancer that starts in the anus. The anus is at the end of the rectum. Through it, bowel movements leave your body. Different types of tumors can form in the anus. Some of these tumors are not cancer. These are known as benign tumors. Some are cancer. These are called malignant tumors.

Who gets anal cancer?

Anal cancer is a rare cancer. Most people who get it are between ages 50 and 80. Slightly more women than men get anal cancer. But the rate is increasing in men, especially in those who have anal sex.

Who is at risk for anal cancer?

Certain things can make one person more likely to get anal cancer than another person. These are called risk factors. Here are some things that may increase your risk for anal cancer:

• Human papillomavirus (HPV) infection or genital warts

• Multiple sex partners

• Anal intercourse, especially if it’s unprotected

• A weakened immune system

• Smoking

• Older age

• Repeated inflammation in the anal region

What are the symptoms of anal cancer?

These are the most common symptoms of anal cancer:

• Bleeding from the rectum

• Pain or pressure in the anal area

• Discharge from the anus

• A lump from swollen lymph nodes in the anal or groin area

• Itching around the anus

• Change in bowel movements

Although these are symptoms of anal cancer, they may also be caused by other, less serious health issues. If you have these symptoms, talk with your healthcare provider.

How is anal cancer diagnosed?

Your healthcare provider asks questions about your health history and family history. He or she will also do a physical exam to check for signs of the cancer. He or she may also order these tests:

• Anoscopy or proctoscopy. These tests use a small instrument or tube to look at your anus.

• Biopsy

Should everyone get a second opinion for a diagnosis of anal cancer?

Many people with cancer get a second opinion from another healthcare provider. There are many reasons to get one. They include:

• Not feeling comfortable with the treatment decision

• Being diagnosed with a rare type of cancer

• Having several options for how to treat the cancer

• Not being able to see a cancer expert

Many people have a hard time deciding which anal cancer treatment to have. It may help to have a second healthcare provider look at the diagnosis and treatment options before starting treatment. It’s important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion. Many insurance companies will pay for a second opinion.

How can someone get a second opinion?

There are many ways to get a second opinion:

• Ask your primary care healthcare provider. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

• Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (or 800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

• Look for other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of healthcare providers who can give you a second opinion. Or ask other people who've had cancer for their recommendations.

How is anal cancer treated?

Anal cancer may be treated using radiation, chemotherapy (chemo), or surgery. The goal of radiation is to kill cancer cells by using X-rays. This is a common treatment for anal cancer. It can be used with or without chemo. Chemo is the use of medicines to shrink the tumor. In anal cancer, chemo combined with radiation can often cure the cancer without the need for surgery. The goal of surgery for anal cancer is to remove the tumor from the anus, while leaving as much of the anus as possible intact.

Healthcare providers are always finding new ways to treat anal cancer. These new methods are tested in clinical trials. Before starting treatment, you should ask your healthcare provider if there are any clinical trials to check on.

What's new in anal cancer research?

Cancer research should give you hope. Researchers around the world are learning more about what causes anal cancer and are looking for ways to prevent and treat it.

A vaccine for HPV is now available. It was developed to help prevent cervical cancer, but it may be able to prevent anal cancer as well. New medicine treatments for people with HIV will help delay a weakened immune system for several years. Experts are also studying new ways to test for anal cancer in its early stages before it has spread.

Researchers are also studying new treatments for anal cancer. Radiosensitizing agents may make radiation work better. They are being studied with chemo and radiation in clinical trials.

What should I know about clinical trials for anal cancer?

Clinical trials test new kinds of cancer treatments. You may also hear them called clinical studies. Healthcare providers use clinical trials to learn how well new treatments work and what their side effects are. Promising treatments are ones that work better or have fewer side effects than the current ones. People who join these trials get to use treatments before the FDA approves them for the public. People who join trials also help researchers learn more about cancer and help future people with cancer.