Anal cancer is a disease in which malignant cells form in the tissues of the anus.
The anus is the end of the large intestine, the lower part of the rectum through which stool exits the body. Two ring-like muscles called the sphincter open and close the anus, allowing stool to pass out of the body. The anal canal is the part of the anus between the rectum and the anus, within 1 inch in length.
The skin within the anus beyond is called the perianal region. Tumors in this area are skin tumors, not anal cancer.
People with HPV are at risk for developing anal cancer.
The reasons
The main causes of anal cancer are:
- Age over 50 years.
- Papillomavirus infection.
- Having multiple sexual partners.
- Anal sex.
- Frequent redness, swelling and soreness in the anus.
- Presence of an anal fistula.
- Smoking cigarettes.
Symptoms
The most common and earliest symptom of anal cancer is the presence of red blood in the stool. The second symptom is pain in the anus. At the beginning of the disease, pain appears during defecation. Gradually, they intensify, become permanent, sometimes radiating to the genitals, thighs, lower abdomen.
Constipation is not often noted. They are caused not so much by a violation of intestinal patency, but by “stool fear” due to pain in the anus, a restrictive diet, arbitrary stool retention.
Constipation is not often noted. They are caused not so much by a violation of intestinal patency, but by “stool fear” due to pain in the anus, a restrictive diet, arbitrary stool retention.
Diagnosis
Timely diagnosis of AK cancer is difficult due to the wide range of clinical manifestations and the absence of pathognomonic symptoms.
The main methods for diagnosing cancer:
- Physical examination: identifying symptoms of a disease, such as tumors or anything else that seems unusual. Examining habits and past illnesses and treatments.
- Rectal examination: examination of the anus, rectum. The doctor or nurse inserts a lubricated finger into the rectum to feel for tumors or other growths.
- Anoscopy: examination of the anus, the lower part of the rectum, using a short tube – an anoscope.
- Proctoscopy: An examination of the rectum using a short tube called a proctoscope.
- Endoanal or endorectal ultrasound: a procedure in which an ultrasound transducer is inserted into the anus, rectum, the resulting image is displayed on a monitor at the doctor.
- Biopsy: The removal of cells or tissue for examination under a microscope by a pathologist to look for cancer cells. If a pathologically altered area is found during anoscopy, then a biopsy may be performed.
Treatment
Currently, radiation therapy is preferred as the first line in the treatment of AK cancer. Concomitant chemotherapy, usually a combination of 5-fluorouracil and mitomycin C, is used in otherwise healthy patients with advanced disease. The observed 5-year survival rate for these AK cancer regimens ranges from 52% to 87%.
The surgical method remains an important component of the combined treatment of AK cancer. However, interventions are usually limited to colostomy formation and inguinal lymph node biopsies. Abdominal-perineal extirpation of the rectum is performed in case of relapses and in the event of purulent-necrotic complications of the disease.