Anal Cancer

What is anal cancer?

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body. The anus is formed partly from your outer layers of skin and partly from your intestine. Anal cancer is a type of cancer that forms in the tissues of your anus.

Who is more likely to develop anal cancer?

Anyone can get anal cancer, but you are more likely to develop it if you:

• You have an infection with high-risk HPV, especially if you have certain types. Most anal cancers are related to HPV infection.
• Have a weakened immune system, from conditions such as HIV or because of medicines you need to take after an organ transplant.
• Have had vulvar, vaginal, or cervical cancer.
• Have many sexual partners.
• Have anal sex.
• Smoke cigarettes.

What are the symptoms of anal cancer?

The signs and symptoms of anal cancer may include:

• Bleeding from the anus or rectum
• A lump near the anus
• Pain or pressure in the area around the anus
• Itching or discharge from the anus
• A change in bowel habits, such as narrower stools, having to go more often, or bowel incontinence

How is anal cancer diagnosed?

To find out if you have anal cancer, your provider:

• Will take your medical history, which includes asking about your symptoms.
• Will ask about your family health history.
• May do a digital rectal examination (DRE). A DRE is an exam of the anus and rectum. For the exam, your provider will insert a lubricated, gloved finger into the lower part of your rectum to feel for lumps or anything else that seems unusual.
• May order tests that examine the anus and rectum, such as:
  • An anoscopy, an exam of the anus and lower rectum using a short, lighted tube called an anoscope. There is also a type of anoscopy called a high-resolution anoscopy. It uses a special magnifying device called a colposcope along with the anoscope to view these areas.
  • A proctoscopy, a procedure to look inside the rectum and anus using a thin, tube-like instrument with a light and a lens.
  • An endo-anal or endorectal ultrasound, a procedure in which an ultrasound probe is inserted into the rectum.
• May do a biopsy during an anoscopy or proctoscopy.

What are the treatments for anal cancer?

The treatments for anal cancer include radiation therapy, chemotherapy, and surgery. Which treatment you get will depend on how advanced the cancer is, your overall health, and your preferences.

Can anal cancer be prevented?

You may be able to lower your risk of getting anal cancer by getting an HPV vaccine and not smoking. Contact your provider if you need help quitting smoking.

It is currently not known if using condoms can prevent anal HPV infections. But using latex condoms every time you have sex can help prevent HIV, a risk factor for anal cancer. And they also help prevent other sexually transmitted infections (STIs). If your or your partner is allergic to latex, you can use polyurethane condoms.

If you are an adult with HIV, it's important to get an anal cancer screening every year. The screening checks for anything that seems unusual, such as lumps, burning, and precancer cells (cells that could turn into cancer). The screening will include a digital rectal exam. If anything unusual is found, you will have an anoscopy or high resolution anoscopy.

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?