Anal Cancer

Why choose Henry Ford for anal cancer care?

People throughout Michigan and the Midwest turn to us for anal cancer care because we offer:

• Extensive experience: Anal cancer isn’t common, so other centers may not see many cases of this disease. But as a regional referral center for rare and hard-to-treat cancers, we routinely evaluate, diagnose and treat anal cancer. Our depth and breadth of expertise is hard to find elsewhere.
• Focus on prevention: HPV is the biggest risk factor for anal cancer. At Henry Ford, we’re committed to educating our patients about HPV vaccination and screening to help reduce the rates of anal cancer and other diseases.
• Anal cancer clinical trials: We participate in clinical trials to study new anal cancer treatments, such as combinations of chemotherapy and radiation therapy (chemoradiation) or immunotherapy. Clinical trials give you access to treatments that may not be widely available.

What is anal cancer?

Anal cancer starts in your anus, the opening at the end of your digestive tract that lets stool leave your body. It’s connected to your rectum and part of your large intestine.
Sometimes people use the term “colorectal cancer” to talk about colon cancer, rectal cancer and anal cancer. These organs are close together in your body, and symptoms of these cancers can be similar. But anal cancer is a distinct cancer with different risk factors. We also treat anal cancer differently than colon or rectal cancer.

What are the symptoms of anal cancer?

Anal cancer may not cause symptoms in its early stages. By the time symptoms develop, anal cancer has often spread beyond the anus to nearby organs and tissues. That’s why it’s so important to talk to your doctor if you’re at an increased risk for anal cancer.

Anal cancer signs may include:

• A lump or swelling in your anal opening
• Blood or discharge from your anus
• Itching in your rectum or around your anus
• Narrow stools or loss of bowel control
• Pain in your rectum or around your anus
• Swollen lymph nodes in your groin

What are the risk factors for anal cancer?

HPV is the most common risk factor for anal cancer and other cancers such as cervical cancer. HPV is a sexually transmitted infection. You can protect yourself or your child against HPV by getting vaccinated. If you’re sexually active, use condoms every time you have sex. Learn more about the cancer risks of HPV.

In addition to HPV, other risk factors for anal cancer include:

• Anal warts: Some strains of HPV cause anal warts, so people with anal warts are often at an increased risk for anal cancer.
• HIV: People living with HIV, the virus that causes AIDS, have compromised immune systems and widespread inflammation that may increase the risk of certain cancers.
• Other cancers: Cervical, vaginal or vulvar cancer may increase some women’s chances of anal cancer. These cancers are often a result of HPV.
• Race and ethnicity: For unknown reasons, anal cancer is more common in Black men and white women.
• Sexual activity: People who have multiple sexual partners, unprotected sex or men who have sex with men are at an increased risk for anal cancer.
• Smoking: Smoking increases your risk for anal cancer and many other cancers.

How is anal cancer detected?

There is no standard screening test for anal cancer like there is for colon and rectal cancers. And routine colonoscopies do not usually catch anal cancer. The best way to find anal cancer early is to talk to your doctor about your risk level and find out if you need periodic testing.

Tests for high-risk individuals may include:

• Digital rectal exam: Your healthcare provider inserts a gloved, lubricated finger into your anus to feel for abnormal lumps.
• Anal Pap test: We take a swab of cells from your anus, and a pathologist examines the sample for signs of disease.
• Anoscopy: Your doctor inserts a tube with a light into your anus and lower rectum to look for unusual growths.

How is anal cancer treated?

Anal cancer treatment depends on the exact location of the cancer and whether it has spread (metastasized). We also consider your age, health, lifestyle and goals for treatment. A team of medical oncologists, radiation oncologists, surgeons, pathologists and other anal cancer experts work together to build your care plan.

Anal cancer treatment may include:

• Chemoradiation: We typically treat anal cancer with a combination of chemotherapy and radiation therapy (chemoradiation). We carefully plan radiation therapy to minimize side effects to the sensitive anal area, such as skin irritation, bowel dysfunction or sexual problems.
• Local resection: We may do colorectal surgery to remove small anal tumors that haven’t spread. Our expertise in minimally invasive techniques means we spare the sphincter muscles and nerves, so you can still go to the bathroom normally.
• Abdominoperineal resection (APR): If anal cancer returns after treatment, we may do a more involved surgery. During APR, we remove your anus, rectum and part of your colon. People who have APR need a colostomy. A colostomy means we redirect the remaining part of your colon to a surgically created opening in your abdomen where stool leaves your body.
• Immunotherapy: This treatment can benefit people with anal cancer that has spread beyond the anus to organs such as the liver or lungs. Immunotherapy helps your body’s immune system fight cancer. It does not cure advanced anal cancer, but it can help some people live longer.