ANAL CANCER

Symptoms of Anal Cancer

About 20% of patients of anal cancer do not report any symptoms. A wrong diagnosis is also possible because of similar symptoms with other conditions. Symptoms of anal cancer often reflect a case of haemorrhoids. However, if anyone notices a series of these symptoms, then visit the physician. 

• Bleeding from the anus or rectum is one of the most common symptoms.
• The feeling of pain or discomfort in the anal region 
• Presence of a mass or a growth present in the anal opening 
• There is a change in bowel movement. Such as having too frequent bowel movements or less than normal. The patients also have to strain more to pass stool. 
• Narrow or loose stools. 
• Discharge from the anus. It may be either mucous or pus. 
• Lymph glands of the anal or groin region are swollen. 

Causes of Anal Cancer

The HPV virus is one of the biggest risk factors of getting anal cancer, followed by lifestyle and age. Although having HPV doesn’t necessarily mean one will get anal cancer

Human Papillomavirus (HPV) 

HPV is an extremely common virus that is gotten through sexual contact and there is an increased risk in people who have anal sex. There are about 150 different strains of HPV, and the most common one in anal cancer is type 16.

Most people will develop HPV at some time in their lives but some people do not get any symptoms and it goes away on its own.

You can limit your chances of getting HPV by using condoms every time you have sex and limiting your sexual partners. 

Smoking

Studies have shown that people that smoke have an increased risk of developing anal cancer.

HIV infection

People infected with HIV have a risk of developing anal cancer.

Diagnosis

Doctors usually diagnose anal cancer when a patient complains of symptoms relating to it. A physician can use the following to make a diagnosis:

Physical examination

A rectal exam occurs by insertion of fingers in the anus. It helps the doctor to feel any presence of lumps or other abnormalities. If any unusual lumps are felt, this would warrant further investigation.

Anoscopy and Biopsy

A small scope helps to examine the anal canal. The light in the scope helps the doctor to get a clear view of the area.

If the doctor find something suspicious, he takes a sample of tissue from the anus. Microscopy analysis of the tissue helps to observe the mutation in cells. 

Diagnostic Imaging Tests

Anal ultrasound and  MRI helps to find out the staging of cancer. These diagnostic imaging tests usually happen after the doctor makes a confirmed diagnosis of cancer and how far it has spread.

Staging

Diagnostic imaging tests help the doctor in finding out the stage of anal cancer. It helps in deciding a treatment plan for the patient. The stages of anal cancer usually start from stage 0, which is the beginning of the disease. Stage 4 is the highest stage of the disease. 

Stage 0

This stage means that anal cancer is only present in the uppermost layer of the anal tissue. The other name for this cancer is carcinoma in situ. Some doctors may also refer to it as Bowen’s disease. 

Stage 1

At this stage, cancer has penetrated the topmost tissue layer of the anus and hasn’t spread to nearby lymph nodes and organs. Stage 1 means the tumor is  less than 2cm.

Stage 2

At this stage, the tumor has grown to 2cm in size but has not spread to the lymph nodes or the nearby organs. 

Stage 3

It is usually classified into stages 3A or 3B. Further classification of stages of anal cancer depends on the extent that the tumor has spread to. These distant regions include lymph nodes, vagina, groin, and rectum. 

Stage 4

Stage 4 is the most advanced stage of anal cancer. At this stage, cancer may be of any size. However, it may have spread to the lymph nodes and distant organs like the lungs, liver or bones.

Treatment

The approach to anal cancer can involve standard treatments. Other treatments also include clinical trials. Doctors treat anal cancer following a standard protocol. This is as follows. 

Surgery

The surgical approach is the most common treatment. A surgeon cuts off the affected tissue of the anus—however, this approach best suits those whose cancer has not spread. Early surgeries help to save the sphincter muscles of the anus so the patient can control the bowel movements. 

Other surgeries include removal of the anus, rectum and the colon. The doctor then attaches an artificial abdomen called a stoma. The doctor may also remove lymph nodes affected by cancer. Anal cancer tends to recur even after successful treatment. 

Radiation Therapy

Radiation stops the cancer cells from growing. These are high energy x-rays. The selection of internal and external radiation therapy depends on the stage of cancer. 

Chemotherapy

The doctor administers strong chemotherapeutic drugs, sometimes in combination with radiation to stop the mutation of the cancerous cells. The administration of these drugs can be intravenous or oral. 

REFERENCES 

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616949/ 
• https://www.ncbi.nlm.nih.gov/books/NBK441891/ 

• https://www.ncbi.nlm.nih.gov/books/NBK65778/ 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639160/ 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472492/#:~:text=A%20systematic%20review%20found%20that,compared%20to%20the%20general%20population.&text=Sub%2DSaharan%20Africa%20has%20the,and%20over%2050%25%20are%20women. 
• https://www.cancernetwork.com/view/effect-of-lifestyle-factors-and-garlic-supplementation-on-gastric-cancer-incidence