Anal Cancer
Cancer of the anal canal, often associated with HPV infection.
Overview
Anal cancer (squamous cell carcinoma) is relatively rare but increasing in incidence. Unlike rectal cancer, the primary treatment is chemoradiation (Nigro protocol), not surgery. Surgery is reserved for residual/recurrent disease after definitive CRT.
Causes
- HPV infection (types 16, 18)
- Immunosuppression
- HIV infection
- Chronic anal inflammation
- Smoking
Risk Factors
- HPV infection
- HIV/AIDS
- Multiple sexual partners
- Receptive anal intercourse
- Smoking
- Immunosuppression
- History of cervical/vulvar cancer
Symptoms
Diagnosis
- Digital rectal examination
- Anoscopy with biopsy
- MRI pelvis (staging)
- CT chest/abdomen
- PET-CT
- Inguinal lymph node assessment
Treatment Options
Surgical Treatment
Surgery is NOT first-line for anal cancer. Definitive chemoradiation (5-FU + mitomycin C + radiation) cures 80%+ of cases. Surgery (APR with permanent colostomy) is reserved for persistent/recurrent disease after CRT — approximately 10-20% of patients.
Recovery
Chemoradiation: 5-6 weeks treatment. Side effects peak 2-3 weeks after completion and resolve over 4-6 weeks. Complete response assessed at 6 months. APR if needed: permanent stoma.
Prevention
- HPV vaccination (before sexual debut)
- Safe sexual practices
- Condom use
- Quit smoking
- Regular screening for high-risk groups
Frequently Asked Questions
Is anal cancer the same as rectal cancer?
Can anal cancer be prevented?
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