Anal Cancer: Symptoms, Causes, and Treatments

What is anal cancer?

Anal cancer is a type of tumor located in the anal canal and the outer edges of the anus. It is rare and accounts for about 1 to 2% of all large intestine (colon) tumors and 2 to 4% of cancers affecting the large intestine.

According to data from the Ministry of Health, 38,000 hospitalizations for anal cancer were recorded in the Brazilian Public Health System (SUS) over the past ten years.

Symptoms

The main symptoms of anal cancer include:

bleeding: during bowel movements
irregular bowel habits: may include increased or decreased frequency of bowel movements, as well as changes in stool consistency
itching, pain burning, discharge, and sores: in the anal region
fecal incontinence: difficulty controlling bowel movements

Risk Factors

Some factors may increase the risk of developing the disease, such as:

smoking: also linked to the development of other types of cancer
immunosuppression: in patients who have undergone transplants, especially kidney or heart
sexually transmitted infections (STIs): such as condylomatosis, gonorrhea, genital herpes, chlamydia, HPV, and HIV
poor hygiene: may cause chronic irritation of the anus
chronic anal fistula: an abnormal connection between the surface of the anal canal and the surrounding tissue, often with pus discharge

The symptoms mentioned are not exclusive to this disease, so it is necessary to seek a healthcare professional for a proper diagnosis.

Diagnosis

The main diagnostic methods for anal cancer include:

digital rectal exam: the healthcare professional examines the rectum (the final part of the large intestine, just before the anus) to detect changes such as masses or stiffness
anoscopy and proctoscopy: similar medical exams using a thin, rigid tube inserted into the anal canal. The main difference is depth—anoscopy is more superficial and examines the anus and the initial part of the anal canal, while proctoscopy allows observation of the rectum and part of the intestine
biopsy: a medical test involving the removal of a small tissue sample from the anus
magnetic resonance imaging (MRI): generates detailed images using radiofrequency pulses and helps determine tumor size and the best treatment approach

Treatment

Treatment varies depending on the tumor's stage, which must be assessed during diagnosis. Some options include:

combination of chemotherapy and radiotherapy
local surgery: mainly performed when the disease is detected early to remove the affected area

Einstein's Oncology and Hematology department offers comprehensive care from diagnosis to treatment. Learn more.