Anal cancer (also known as carcinoma of the anal canal) is an uncommon type of cancer that develops in your anus’ tissues or the lining of your anal canal. Common symptoms are rectal bleeding or persistent anal itching. Often, healthcare providers can cure anal cancer that’s detected and treated early on.
Anal cancer (also known as carcinoma of the anal canal) develops in your anus’ tissues or the lining of your anal canal. Your anal canal connects your anus (the opening) to your rectum (the lower part of your digestive system). Your anus is where poop leaves your body. Healthcare providers can cure anal cancer if they detect and treat it early on.
There are two types of anal cancer — squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is the most common anal cancer type. Squamous cell carcinoma in anal cancer is different from skin cancer that starts in the top layer of your skin.
No, it’s not. The American Cancer Society estimates more than 9,000 people in the United States will receive an anal cancer diagnosis in 2023. (The ACS estimates include anal cancer, anorectal cancer and anal canal cancer.) In comparison, an estimated 153,000 people will learn they have colon cancer in 2023.
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Anal cancer symptoms may feel like common issues like a persistent itch in your anus. Other symptoms may include:
Many things can cause these symptoms. Having one or more doesn’t mean you have anal cancer. But you should talk to a healthcare provider if you have symptoms like these that get worse or don’t go away within a few days.
It’s normal to feel a little self-conscious, embarrassed or uncomfortable talking to your healthcare provider about some anal cancer symptoms, like having an itchy anus. Lots of things may cause anal cancer, so please know there’s nothing about having anal cancer symptoms that should make you feel ashamed. Your healthcare providers are here to help you with all your health concerns, including anal cancer symptoms.
The exact cause of anal cancer is unknown. However, there are certain risk factors associated with the disease. For example, most anal cancer cases are linked to certain types of human papilloma virus (HPV). But it’s important to note that the majority of people with HPV don’t get anal cancer.
In addition to HPV, there are other risk factors that could increase your chance of developing anal cancer, including:
Left untreated, anal cancer may spread (metastasize) to nearby tissues. Rarely, it can spread to your lungs or liver.
A healthcare provider will ask you about your symptoms, including how long you’ve had them. They’ll ask about your medical history, including conditions that affect your immune system. They may also ask about your sexual activity.
Your provider will do a digital rectal examination. They’ll do an anal Pap test or biopsy to obtain cells for a medical pathologist to examine under a microscope. (Women and people AFAB may have pelvic examinations.) Your provider will also do endoscopic tests and imaging tests.
Providers do endoscopic tests to look inside your rectum and anus. They do these tests using special instruments that are thin, flexible tubes that have a light, a lens and a video camera. They may take tissue samples (biopsy) for pathologists to examine. Endoscopic tests include:
Imaging tests help providers learn more about tumors, including tumor size and specific location. Imaging tests may include:
Healthcare providers use cancer staging systems to plan treatment and set prognoses, or what you can expect to happen after treatment. They consider factors like tumor size, if there’s cancer in your lymph nodes and whether the tumor has spread or metastasized. There are five stages of anal cancer:
There are abnormal cells in your anus’ mucosa, which is the innermost lining of your anus. The abnormal cells aren’t cancerous but may become cancerous. Stage 0 anal cancer is also called high-grade squamous intraepithelial lesion (HSIL).
Cancer cells have formed a tumor that measures 2 centimeters or less, or about the size of a peanut.
Stage II anal cancer is divided into two stages:
Stage III is divided into three stages:
Anal cancer treatment depends on the type and cancer stage, but may include:
Providers treat anal cancer with external beam radiation therapy (EBRT). Types of EBRT include:
Healthcare providers often combine chemotherapy and radiation therapy as initial anal cancer treatment. The combined treatments often eliminate anal cancer, so you don’t need surgery.
If you do need surgery, you may have chemotherapy beforehand to shrink the tumor (neoadjuvant chemotherapy) or after surgery to kill any remaining cancer cells (adjuvant chemotherapy).
Laparoscopic abdominoperineal resection is a minimally invasive surgery used to treat anal cancer that comes back (recurs) or didn’t respond to radiation therapy and/or chemotherapy. It involves removing your anus, rectum and colon.
If you have late-stage anal cancer, your provider may recommend immunotherapy to help you manage your symptoms. Immunotherapy helps your body fight cancer.
Most cancer treatments may cause side effects. For example, chemotherapy and radiation therapy side effects may include skin irritation, pain in your anal area, fatigue, chemotherapy brain fog, nausea and vomiting.
Healthcare providers may treat anal cancer with surgery. Surgery complications may include:
There’s no guaranteed way to prevent anal cancer, but you can reduce the chance of developing it by taking the following steps:
Anal cancer survival rates are estimates of the percentage of people with the condition who were alive five years after diagnosis. Rates vary depending on whether a provider diagnoses and treats the condition before it spreads. Overall, 70% of people with anal cancer were alive five years after diagnosis, according to the National Cancer Institute (U.S.). Survival rates by cancer location include:
|Cancer Stage||Survival Rate|
|Stages I and II||83%|
|Stages I and II|
It’s important to remember that survival rates are based on the experiences of large groups of people who may have different health issues. What’s true for them may not be true for you. If you have questions, ask your provider to explain what you can expect.
If you’re receiving treatment for anal cancer, you should follow the appointment schedule your healthcare provider set up and contact them as directed. For instance, your healthcare provider might tell you to call if you have pain or a fever.
Sometimes anal cancer treatment involves surgery to remove parts of your digestive system and to provide you with a permanent colostomy so your poop can leave your body. Living with a permanent colostomy can be challenging, but you won’t be alone. Your healthcare team will help you as you get used to managing how you poop and living a full and normal life after anal cancer surgery.
If you have anal cancer, you may want to ask your provider the following questions:
The difference is anal dysplasia isn’t cancer, but it may pave the way for anal cancer. In anal dysplasia, cells in your anus become abnormal. Over time, these abnormal cells could start multiplying, creating cancerous tumors.
Your anus, rectum and colon are all parts of your digestive system. But the cells that make up each parts’ tissue are very different, which means healthcare providers treat these cancers in different ways.
A note from Cleveland Clinic
Anal cancer is cancer in your anus — the part of your body that you wipe after you poop. The most common symptoms are bleeding from your anus or anal itching — things you may hesitate to discuss with a healthcare provider. But anal cancer is most easily treated when providers detect and treat it early, before it spreads. If you notice symptoms like an anal itch that won’t go away, talk to a provider. They’re ready to help.
Last reviewed by a Cleveland Clinic medical professional on 06/27/2023.
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