What is anal cancer?

a doctor holding HPV placard.

Anal cancer refers to cancer that develops in the tissues of the anus. The anus is present at the end of the large intestine, and that is where this cancer is located. While this cancer is rare, it can happen, and the cancer cells can also spread to other parts of the body. The symptoms of anal cancer may include anal bleeding, formation of an anal cancer lump at the anus, or even difficulty in performing bowel movements. Read on to know how this cancer can be diagnosed, risk factors as well as prevention and treatment of anal cancer.

What is anal cancer?

Anal cancer is not as commonly discussed as other types of cancers, but it is an important health issue. Anal cancer affects the very end of the large intestine—the anus. It is a type of cancer that forms in the tissues of the anal canal, the short tube at the end of your rectum through which stool leaves your body, explains oncologist Dr Ganesh Nagarajan.

What causes anal cancer?

Understanding the causes of anal cancer is the first step to prevent the condition.

1.Human Papillomavirus (HPV) infection:

Certain types of HPVs are linked to changes in the anal cells, which can become cancerous over time. It’s the reason why HPV vaccination is discussed widely nowadays. People who have sex without condoms, are at a high risk of catching HPV, and this can lead to anal cancer, states Cancer Research UK.

Also Read: Single dose of HPV vaccine might be enough to prevent the cancer-causing infection

2. Smoking

Most people think smoking only causes head and neck or lung cancers but, smoking can increase the risk of anal cancer, states this study, published in the World Journal of Clinical Oncology. Smokers also have a higher recurrence rate, the study points out.

3. Weak immunity

People with weak immune systems, sometimes because of HIV or medications taken after organ transplants, are also at a higher risk of developing anal cancers. These medications damp down immunity, and put you at a higher risk for anal cancer, points out this study published in Cancer Research UK.

4. Having cervical, vaginal, or vulval cancer

There is a higher risk of having anal cancer if you have a history of cervical, vaginal, or vulval cancer. The Journal of Lower Genital Tract Disease states that women with vulvar HSIL, abnormal cells due to HPV infection, have a higher risk of developing anal cancer.

Human Papillomavirus is a main cause behind anal cancer. Image courtesy: Adobe Stock

Symptoms of anal cancer

Most cases of anal cancer are diagnosed late because the majority of anal cancer symptoms may not be observable in its early stages. That’s why routine examinations and screening are essential. Following are a few symptoms that develop as the disease progresses:

  • Anal Bleeding: This is not something to ignore or be embarrassed about. If you notice blood after a bowel movement, it’s important to see an oncologist.
  • Pain or a Lump in the Anal Area: Any new discomfort or a noticeable lump needs to be examined by the colorectal oncologist, as it can be cancerous.
  • Changes in Bowel Habits: If you experience persistent changes in the usual pattern or the consistency of your stools, immediately visit your colorectal oncologist to learn more about the cause of the condition.

Risk factors in anal cancer

Risk factors don’t necessarily mean that someone will get anal cancer, but they increase the chances. “The risk of anal cancer increases with age, particularly after 50, and women are slightly more likely to develop this cancer than men,” says Dr Nagarajan. A study published in the British Journal of Cancer assessed 1.3 million women from 1996–2001 and checked for anal cancer. Out of these five hundred and seventeen of them were reported to have got anal cancer due to cervical intraepithelial neoplasia grade 3, a condition that can turn cancerous over time, smoking, and use of oral contraceptives.

“Individuals with multiple sexual partners or who engage in anal intercourse may have a higher risk, primarily due to increased chances of HPV infection,” says Dr Nagarajan. An undiagnosed or treated, long-standing anal irritation or inflammation can increase the risk of cancer.

Diagnosis of anal cancer

If the doctors suspect that you may have oral cancer, they will first conduct a Digital Rectal Exam (DRE) to feel the abnormalities around the area with a gloved finger. “This can be followed by a proctoscopy where with a tiny scope, the doctor may take a closer look inside your anus. If there’s anything unusual, a small piece of tissue will be taken for examination under a microscope,” says Dr Nagarajan. This is the definitive way to tell if cancer is present.

How to treat anal cancer?

Treatment of anal cancer depends on the stage of the cancer, the patient’s age and overall health. It can be subjective. “Squamous cancers of the anal canal are usually treated by chemoradiation. Most tumors respond well to this treatment,” says Dr Nagarajan, adding, “In case there is a residual tumor after the chemoradiation, the patient may need surgery.” After the treatment, regular check-ups are essential.

A man breaking cigarette
Smoking is one of the most common reasons for anal cancer. Image courtesy: Adobe Stock

How to prevent anal cancer?

Preventing the condition is always preferable to the psychological and physical burden of long complex treatments. Though anal cancer can’t be completely prevented, some simple lifestyle practices and alterations can substantially reduce the risk of anal cancer.

  • HPV Vaccination: This is an efficient way to protect against the types of HPV that most commonly cause anal cancer. Both boys and girls can avail of the vaccination.
  • Safe Sexual Practices: Using condoms can reduce the risk of HPV and other sexually transmitted infections. Have transparent conversations with your partner and be aware of safe sex practices.
  • Avoid Smoking: If you smoke, quit now. Use helplines, support groups, over-the-counter medications, and your friends and family to quit smoking and reduce your chances of developing any type of cancer.
  • Regular Screening: All high-risk individuals, like individuals with multiple sexual partners, a history of HPV infections, or immunosuppression have to undergo regular screenings to catch precancerous lesions. Even healthy individuals should undergo a regular screening once or twice a year after the age of 50, to be tested for anal cancer.

 

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