The majority of patients who are diagnosed with anal cancer don't have a clearly defined risk factor. However, factors that increase the risk of developing anal cancer are associated with the risk of human papillomavirus (HPV) infection. This virus is the same kind that causes genital warts. Certain strains of the HPV virus are associated with a high risk of developing anal cancer as well as cervical cancer and some types of throat cancer. Activities that put people at risk for HPV, like receptive anal intercourse, also put them at risk of later developing anal cancer.
SIGNS & SYMPTOMS
Patients often present to their doctors with complaints of anal pain or bleeding. Many patients ignore or downplay the symptoms, often initially …show more content…
Early stage disease is limited to the anus, while advanced disease refers to cancers that have invaded nearby organs or lymph nodes in the pelvis or groins. Imaging studies should include CT scan of the abdomen and pelvis and a chest X-ray at minimum. Staging may also include a PET/CT scan. This imaging test allows the radiologist as well as the treating cancer specialists to see if the anal cancer has spread to involve lymph nodes in the groin or pelvis, or metastasized to other sites in the body such as the liver or …show more content…
Since most anal cancers invade the sphincter that controls defecation, surgery to remove such a cancer would require removal of the sphincter and creation of a colostomy. Therefore, surgery is generally avoided in favor of treatment that will keep the anal sphincter intact. An exception would be very early cancers of the anal margin, on the skin outside the anus.
Concurrent chemoRT is the standard treatment for the majority of patients with anal cancer, to obtain the best chance of cure with sphincter preservation. RT delivered over roughly 6 weeks with concurrent IV fluorouracil (5FU) and mitomycin-C (MMC) chemotherapy provides patients the best chance for cure. RT is delivered in daily fractions using either 3D conformal RT or IMRT. The latter technique may be used in order to minimize the amount of normal bowel and/or genitalia receiving full-dose RT (& therefore minimize side