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Frequently Asked Questions About Anal Cancer

These are answers to some frequently asked questions about anal cancer:

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Q: What is anal cancer?

A: Anal cancer is cancer that starts in the anus. The anus is at the end of the rectum. Through it, bowel movements leave your body. The lower part of the anus is called the anal margin. Different types of tumors can form in the anus. Some of these tumors are not cancerous. These are known as benign tumors. Some are cancerous. These are called malignant tumors.

Q: Who gets anal cancer?

A: Anal cancer is a rare cancer. Most people who get it are between ages 50 and 80. Slightly more women than men get anal cancer. But the rate is increasing in men, especially in those who have anal sex.

Q: What are the risk factors for anal cancer?

A: Certain factors can make one person more likely to get anal cancer than another person. These are called risk factors. Here are some things that may increase your risk for anal cancer:

  • Human papillomavirus (HPV) infection or genital warts

  • Multiple sex partners

  • Anal intercourse, especially if it is unprotected

  • Having a weakened immune system

  • Smoking

  • Older age

  • Repeated inflammation in the anal region

Q: What are the symptoms of anal cancer?

A: These are the most common symptoms of anal cancer:

  • Bleeding from the rectum

  • Pain or pressure in the anal area

  • Discharge from the anus

  • A lump from swollen lymph nodes in the anal or groin area

  • Itching around the anus

  • Change in bowel movements

Although these are symptoms of anal cancer, they may also be caused by other, less serious medical problems. People with these symptoms should talk to a doctor.

Q: How is anal cancer diagnosed?

A: The doctor asks questions about a person's medical history and family history. The doctor will also do a physical exam to check for signs of the cancer. The doctor may order any of these tests to help make the diagnosis:

  • Anoscopy or proctoscopy, tests that use a small instrument or tube to look at the anus

  • Biopsy

  • Ultrasound

Q: Should everyone get a second opinion for a diagnosis of anal cancer?

A: Many people with cancer get a second opinion from another doctor. There are many reasons to get one. Here are some of those reasons:

  • Not feeling comfortable with the treatment decision

  • Being diagnosed with a rare type of cancer

  • Having several options for how to treat the cancer

  • Not being able to see a cancer expert

Many people have a hard time deciding which anal cancer treatment to have. It may help to have a second doctor review the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion, and many other companies will pay for a second opinion if asked.

Q: How can someone get a second opinion?

A: There are many ways to get a second opinion:

  • Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

  • Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (or 800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

  • Look for other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of doctors who can give you a second opinion. Or ask other people who've had cancer for their recommendations.

Q: How is anal cancer treated?

A: Anal cancer may be treated using radiation, chemotherapy, or surgery. The goal of radiation therapy is to kill cancer cells by using X-rays. This is a common treatment for anal cancer. It can be used with or without chemotherapy. Chemotherapy is the use of drugs to shrink the tumor. In anal cancer, chemotherapy combined with radiation therapy can often cure the cancer without the need for surgery. The goal of surgery for anal cancer is to remove the tumor from the anus, while leaving as much of the anus as possible intact.

Doctors are always finding new ways to treat anal cancer. These new methods are tested in clinical trials. Before beginning treatment, a person should ask his or her doctor if there are any clinical trials to check on.

Q: What's new in anal cancer research?

A: Cancer research should give you hope. Researchers around the world are learning more about what causes anal cancer and are looking for ways to prevent and treat it.

Vaccines for HPV are now available. While they were developed to help prevent cervical cancer, they might be able to prevent anal cancer as well. New drug treatments for people with HIV will help delay a weakened immune system for several years. Doctors are also studying new ways to test for anal cancer in its early stages before it has spread.

Researchers are also studying new treatments for anal cancer. Radiosensitizing agents may make radiation work better. They are being studied in combination with chemotherapy and radiation in clinical trials.

Q: What should I know about clinical trials for anal cancer?

A: Clinical trials test new kinds of cancer treatments. You may also hear them called clinical studies. Doctors use clinical trials to learn how well new treatments work and what their side effects are. Promising treatments are ones that work better or have fewer side effects than the current ones. People who join these trials get to use treatments before the FDA approves them for the public. People who join trials also help researchers learn more about cancer and help future people with cancer.