How Is Anal Cancer Treated?
There are treatments for all patients with anal cancer. Three kinds of treatment are used: surgery (taking out the cancer in an operation) radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells) chemotherapy (using drugs to kill cancer cells).
Surgery is a common way to diagnose and treat anal cancer. Your doctor may take out the cancer using one of the following methods:
Local resection is an operation that takes out only the cancer. Often the ring of muscle around the anus that opens and closes it (the sphincter muscle) can be saved during surgery so that you will be able to pass your body wastes as before.
Abdominoperineal resection is an operation in which the doctor removes the anus and the lower part of the rectum by cutting into the abdomen and the perineum, which is the space between the anus and the scrotum (in men) or the anus and the vulva (in women). Your doctor will then make an opening (stoma) on the outside of the body for waste to pass out of the body. This opening is called a colostomy. Although this operation was once commonly used for anal cancer, it is not used as much today because radiation therapy with or without chemotherapy is an equally effective treatment option but does not require a colostomy. If you have a colostomy, you will need to wear a special bag to collect body wastes. This bag, which sticks to the skin around the stoma with a special glue, can be thrown away after it is used. This bag does not show under clothing, and most people take care of these bags themselves. Lymph nodes may also be taken out at the same time or in a separate operation (lymph node dissection).
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Radiation can be used alone or in addition to other treatments.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body. Some chemotherapy drugs can also make cancer cells more sensitive to radiation therapy. Radiation therapy and chemotherapy can be used together to shrink tumors and make an abdominoperineal resection unnecessary. When only limited surgery is required, the sphincter muscle can often be saved.
