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Anal Cancer - Diagnosis and Treatment for Anal Cancer

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How to Diagnose Anal Cancer?

The diagnosis of any type of cancer starts with a series of tests conducted by the doctor. The same goes for an anal cancer diagnosis. These tests help the physician learn about the stage of cancer and the extent to which it has metastasized.

Also, these tests help a doctor determine the area where the cancer has started, which plays a major role in deciding the treatment line. Doctors perform various tests for the diagnosis of anal carcinoma.

The tests conducted for anal cancer diagnosis depend on some essential factors. These factors are the patient's symptoms, the patient's age and complete health overview, the kind of cancer suspected in a patient, and the results of some medical tests.

Here are some crucial tests healthcare providers conduct to check whether a patient is suffering from the said cancer and anal cancer types.

Medical history and physical exam

If the patient suffers from any of the symptoms of anal carcinoma, a quick assessment of the patient’s medical history and physical examination are recommended as part of the initial anal cancer diagnosis.

The medical history assessment involves looking for risk factors, hints about the patient's immune system, and signs of any other health problems.

After recording the medical history, the physicians move on to conducting a physical exam to check for any signs of cancer. These physical exams include a rectal exam, a pelvic exam, and a pap test (in women).

These tests indicate whether there are any lumps or lymph nodes in the body in addition to other symptoms. If these basic tests show some issues, the doctors then perform elaborate tests to confirm the anal cancer diagnosis and disease staging.

Here are some of the detailed tests conducted for anal cancer staging:

Anoscopy

Anoscopy refers to the examination of the anus and rectum with the help of an anoscope. An anoscope is a 3- to 4-inch-long tube that is 1-inch in diameter and is firm to touch. The anoscope gets coated with a gel, which the doctor gently pushes into the anus as well as the lower rectum.

An anoscopy enables the doctor to see the linings of the anus and rectal. If the doctor sees anything abnormal, he can take a sample for a biopsy during the anoscopy procedure only.

During the anoscopy, the patient is awake and is asked to lie on his side. Patients may find the procedure uncomfortable; however, it should not be painful. If the patient feels any pain during the procedure, they should be encouraged to inform their doctor.

Rigid proctosigmoidoscopy

Rigid protosigmoidoscopy is another technique used to localize anal tumors. It is similar to an anoscope but is longer than the former. With the help of rigid proctosigmoidoscopy, the doctor is able to look into the rectum, anus, and sigmoid colon's lower part.

Endoscopy

Endoscopy is another test conducted for anal cancer diagnosis, during which the physician inserts a thin and long tube inside the person's anus. The tube has a camera fixed at its end, which helps the physicians have a detailed look inside the anus.

Endoscopy is employed to collect tissue samples from inside the rectum and anal canal in the case of a biopsy. The test takes 15 minutes to 1 hour, and the patient is administered local anesthesia, which assists in making the patient comfortable. Again, if the patient feels any kind of pain during the test, they should inform the presiding doctor.

Biopsy

Another essential anal cancer test is a rectal biopsy, which the doctor uses to confirm the diagnosis of anal carcinoma. The test includes collecting a small swab of tissue from the rectum and anal canal, which a pathologist uses to make a proper diagnosis.

If the pathologist finds cancer in the tissues, he sends a report, including information on anal cancer staging, cell types, and other aspects of cancer. During the test, local anesthesia is administered, and if the cancer has spread to lymph nodes, they may remove a nearby lymph node and conduct a biopsy on it.

Blood Tests

When the question arises of how to detect anal cancer, blood tests do come up on the list. Blood tests are carried out to look for specific tumor markers.

Blood tests are also conducted to check for any kind of sexually transmitted disease, such as HIV. If the blood tests confirm HIV or any other disease, the patient is advised to go for its treatment first.

Imaging Test

Another effective test for anal cancer diagnosis is an imaging test. Imaging tests are also necessary for anal cancer staging. As the name suggests, these tests for imaging of anal cancer are used to get a clear picture of the internal organs of the human body. The imaging tests are helpful in learning about the extent of cancer spread, judging the efficiency of anus cancer treatment, and determining if there has been any recurrence of cancer of the anus even after the treatment.

Ultrasound

Ultrasound uses sound waves to create a proper image of the anus to help the doctor know the depth of cancer growth. The ultrasound of the anus is conducted to get a clear view of the squamous-cell cancer's penetration in the anal canal and rectum.

Computed tomography (CT) Scan

A computed tomography (CT) scan is an anal cancer test conducted to gauge the size of the tumor in the anus. The test uses X-rays and a computer screen to create 3-D images of the internal organs of the human body.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is another commonly recommended anal cancer test that uses radio waves and magnetic fields to create pictures of the insides of a human body from all angles. MRI is very helpful in getting a clear picture of the soft tissues and is thus often given preference for cancer staging. These images help the physician judge whether the cancer has spread to different body parts, such as the liver, kidney, spinal cord, etc.

Chest X-ray

Physicians often conduct a normal chest X-ray to check whether the cancer cells have spread to the lungs. However, if the CT scan of the chest has already been done, the doctors may surpass this test.

Positron emission tomography (PET) scan

A positron emission tomography (PET) scan is used for cancer detection and judging the efficiency of cancer treatment. The PET scan uses radioactive sugar, which accumulates in different quantities in various cells, defending against the cancer's spread.

A PET scan helps in anal cancer staging, planning treatment for anal cancer, and treatment monitoring.

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What are the Treatments for Anal Cancer?

Treatment for anal cancer depends upon the stage of the cancer, the patient's immune health, lifestyle changes, and the causes of anal cancer. Here are the most commonly recommended treatment options for anal cancer:

Surgery for early-stage cancer

Anal cancer surgery for early-stage cancer involves removing small anal tumors at an early stage. The doctor removes these tumors along with a small portion of healthy tissue surrounding them to stop the recurrence of the cancerous cells. This is often done during stage 1 anal cancer.

Depending on the extent of the spread, the physicians may suggest further treatments, such as chemotherapy, for the patients.

Surgery for cancer that hasn't responded to other treatments

If the cancerous cells are not getting damaged even after chemotherapy or radiation for anal cancer, the physician may recommend a more elaborate surgery known as abdominoperineal resection. During this extensive surgical oncology procedure, the doctor practically removes a significant part of the anal canal, a part of the colon, and the patient's rectum.

Abdominoperineal resection

Abdominal resection is a major surgical treatment for anal cancer that involves the removal of a major part of the patient's affected rectum, anal canal, and colon.

After the removal, the physician then attaches the left out part of the colon to the patient's stoma, an opening in the abdomen. Through the stoma, the human waste leaves the body and collects in a colostomy bag attached to the abdomen. This is an effective solution for recurrent cancer of the anus.

Chemotherapy and Radiation Therapy

In some cases, the doctor combines both radiation and chemotherapy treatments to destroy the cancerous cells. This combination is called chemoradiation. This line of treatment is adopted when the healthcare team finds that the anal tumor is located too near the anal sphincter and cannot be removed with the help of local resection.

Chemotherapy for anal cancer involves administering powerful drugs that destroy cancer cells throughout the body. Radiation for anal cancer, on the other hand, involves using high-intensity radiation beams to kill cancer cells.

Immunotherapy

Immunotherapy refers to using drugs to assist the patient's immune system in locating and killing cancerous cells. Physicians often recommend immune checkpoint inhibitors for treating carcinoma of the anus.

Most of the time, the patient's immune system does not fight the cancerous cells, as these cells produce a protein that makes them unrecognizable. Immunotherapy is a procedure to fight this very process of producing undetectable proteins.

Radiosensitizers

Radiosensitizers are a course adopted as a cure for anal cancer that makes the cancerous cells sensitive to radiation therapy. These sensitizers include signal transduction inhibitors, cell cycle modulators, and DNA-damaging agents.

Palliative Care

Palliative care refers to a professional team of medical experts who work together to offer pain relief and comfort from other symptoms to patients. This team consists of doctors, nurses, and trained professionals who focus on improving the patient's quality of life.

Treatment of Anal Cancer According to Stages

Here are the different treatments adopted as per the stages of cancer of the anus:

Stage 1 Anal Cancer Treatment

During Stage 1, the cancer has usually spread to the wall of the anal canal but has not spread to the other nearby organs. During this stage, the physicians recommend going for an early-stage surgery that involves removing the minor tumors, which are less than 2 centimeters in diameter. Often, surgery alone is considered a cure for anal cancer that is in its early stages.

Stage 2 Anal Cancer Treatment

Stage 2 treatment is similar to the former stage and involves local resection of the anal tumors, which are small in size. The doctor also recommends a combination of chemotherapy and radiation for this stage. The physician may recommend abdominoperineal resection in cases where the tumor is not responding to treatment and there are chances of recurrence.

Stage 3 Anal Cancer Treatment

During stage 3, the cancerous cells have invaded other nearby organs and lymph nodes, thus requiring more extensive treatments. The treatment for anal cancer at this stage includes radiation therapy, chemotherapy, and abdominoperitoneal resection.

Stage 4 Anal Cancer Treatment

Stage 4 implies that cancer has metastasized to other distant organs, usually the liver, lungs, lymph nodes, and bones. Thus, the treatment for anal cancer that is in stage 4 may involve immunotherapy, chemotherapy, radiation therapy, or palliative care.

Diet After Anal Cancer Treatment

The patients may have to change their eating habits after the treatment. Here are the dietary recommendations after the treatment.

Diet After Surgery

The diet depends on the line of treatment you have received for the cancer. If the patient has undergone surgery for the removal of the anal canal, rectum, and colon, he may not be allowed to eat immediately after the operation. The doctor would advise you to eat nothing of the sort that can upset your stomach, as it can affect your bowel movements.

Eat small meals often

Eating small meals in small portions would ensure that the body is getting enough vitamins, energy, and proteins and that bowel movements are not altered. Eating small portions also helps with after-surgery symptoms, such as nausea.

Eat more protein

Eating more proteins is recommended for patients after the treatment as it helps the body regain its energy levels.

Foods that can cause wind

Eat foods that are rich in fiber and fats, such as vegetables, fruits, cabbage, onions, etc., as this helps regulate your bowel movements after the surgery.

Seeing a dietitian

Seeing a dietitian is a must after cancer treatment so that you do not eat anything that can mess up the already fragile immune system of your body.

Diet After Radiotherapy

Eat more food items that have soluble fiber, such as oatmeal, bananas, pears, etc. Also, the patients are recommended to have more liquids and proteins to get the energy they need to fight against any side effects of radiation therapy.

Diet After Chemotherapy

Following chemotherapy for cancer of the anal canal, the patients are recommended to have a rich-fiber diet, which includes vegetables, fruits, and dried beans. Also, the patient is recommended to have 25 grams of dietary fiber per day, along with proteins.

How to Prepare for Anal Cancer Diagnosis?

The first line of preparation is making an appointment with your doctor in case of any symptoms. If the doctor finds the symptoms to be related to anal carcinoma, he would further recommend you see a specialist.

Be aware of any pre-appointment restrictions

Before going for the appointment, it is advised to talk to the doctor or his assistant to find out anything that you need to do before the appointment. This may include going through any dietary restrictions before the appointment.

Write down symptoms you're experiencing

It is always advisable to make a detailed list of the symptoms you are facing. This would help your physician get a clear picture of your health system.

Make a list of all medications

Getting information about what medications you are taking, such as vitamins or any other medicine, can help your physician understand what line of treatment to pick and what related illnesses to check for.

Write down questions to ask

To get the most out of your appointment and to ensure you don’t forget anything, it is always better to have a list of questions you want to ask him regarding your illness.


Why Choose HCG for Diagnosis and Treatment for Anal Cancer?

HCG has an assembly of specially trained professionals and doctors for diagnosing and training anal cancer. In addition, HCG's extensive experience in handling patients of all stages of anal tumors and cancer makes them stand apart from the crowd

Frequently Asked Questions

How long does it take to treat anal cancer?

The duration of treatment for anal cancer depends upon the extent of the cancer's spread in the patient's body. Depending on the severity of the disease, the doctor will devise a treatment plan, and the treatment may last for a few weeks or months.

It is possible to treat localized or stage 1 anal cancer successfully. Thus, it is advisable to see your physician as soon as you start getting symptoms.

Stage 4 cancer is uncurable if it has reached this stage, as it means that the cancerous cells have spread to major organs such as the liver, lungs, and lymph nodes. However, it is possible to manage stage 4 anal cancer with multimodal treatment approaches. These approaches help delay disease progression and prolong survival.

The risk of anal cancer returning or relapsing depends on various factors, which include the stage at which cancer was diagnosed and treated the first time, the treatment administered, and the patient’s health status.

During the first time, if the anal cancer was diagnosed and treated in the advanced stage, the risk of recurrence is higher.

In most cases, anal cancer recurs within the first two years after treatment; nonetheless, it can occur at any time.

In many cases, hemorrhoids and cancer present with symptoms, due to which the patients tend to ignore the symptoms. This may eventually lead to delayed diagnosis and poor clinical outcomes.

Rectal pain, itching, and bleeding are the early signs of anal cancer, and you should see a doctor if you are experiencing them.

In general, any abnormalities associated with your health should be brought to your doctor’s attention immediately, as this supports early detection and timely treatment.

TWhen anal cancer is left untreated, it starts spreading to nearby and distant organs. As the disease progresses, its treatment becomes more challenging, and the survival rates are also poor.

Early detection, therefore, plays a significant role in cancer management. It is important not to ignore any symptoms and to take appropriate action whenever necessary.

Side effects due to anal cancer treatment may vary from one patient to another. Some may experience very mild side effects, while others may experience moderate to severe side effects.

The potential side effects associated with anal cancer treatment include diarrhea, anal irritation and pain, hampered bowel movements, discomfort during bowel movements, tiredness, nausea, constipation, skin changes, low blood cell count, loss of appetite, hair loss, etc.