Anal cancer forms from genetic mutations that cause normal cells in the anal canal to grow abnormally and potentially spread. It is staged based on tumor size and spread. Risk factors include older age, many sexual partners, anal sex, smoking, and HPV. Symptoms include bleeding, pain, masses, and itching in the anal area. Diagnosis involves exams, biopsies, and imaging tests. Treatment options include chemotherapy, radiation, and surgery depending on cancer stage.

2.  Anal cancer is an uncommon type of cancer that occurs
in the anal canal.

3.  Stage I. Anal cancer is 2 centimeters (about 3/4 inch) or
less — about the size of a peanut or smaller.
 Stage II. Anal cancer is larger than 2 centimeters (about 3/4
inch), but has not spread beyond the anal canal.
 Stage IIIA. Anal cancer is any size and has spread either to
lymph nodes near the rectum or to nearby areas, such as the
bladder, urethra or vagina.
 Stage IIIB. Anal cancer is any size and has spread to
nearby areas and lymph nodes, or it has spread to other
lymph nodes in the pelvis.
 Stage IV. Anal cancer has spread to parts of the body away
from the pelvis.

4.  Anal cancer forms when a genetic mutation turns
normal, healthy cells into abnormal cells. Healthy cells
grow and multiply at a set rate, eventually dying at a set
time. Abnormal cells grow and multiply out of control,
and they don't die. The accumulating abnormal cells
form a mass (tumor). Cancer cells invade nearby
tissues and can separate from an initial tumor to spread
elsewhere in the body (metastasize).

5.  Older age.
 Many sexual partners.
 Anal sex.
 Smoking.
 Human papillomavirus (HPV).
 Drugs or conditions that suppress the immune system.

6.  Anal cancer forms when a genetic mutation turns
normal, healthy cells into abnormal cells.
 Healthy cells grow and multiply at a set rate, eventually
dying at a set time.
 Abnormal cells grow and multiply out of control, and
they don't die.
 The accumulating abnormal cells form a mass (tumor).
 Cancer cells invade nearby tissues and can separate
from an initial tumor to spread elsewhere in the body
(metastasize).

7.  Bleeding from the anus or rectum
 Pain in the area of the anus
 A mass or growth in the anal canal
 Anal itching

8.  Examining the anal canal and rectum for
abnormalities. During a digital rectal exam, the doctor
inserts a gloved, lubricated finger into the rectum. The
doctor identifies anything unusual, such as growths.
 Anoscope To visually inspect the anal canal and rectum
using a short, lighted tube

9.  Taking sound wave pictures of anal canal. In order to
create a picture of the anal canal, the doctor inserts a
probe, into the anal canal and rectum. The probe emits
high-energy sound waves, called ultrasound waves,
which bounce off tissues and organs in the body to
create a picture. The doctor evaluates the picture to
look for anything abnormal.
 Biopsy To remove a sample of tissue for laboratory
testing.
 Computerized tomography (CT) scan
 Magnetic resonance imaging (MRI)
 Positron emission tomography (PET)

10.  Combined chemotherapy and radiation
 Chemotherapy. Chemotherapy drugs are injected into
a vein or taken as pills. The chemicals travel
throughout the body, killing rapidly growing cells, such
as cancer cells. Chemotherapy is typically administered
during the first week and the fifth week.
 Radiation therapy. Radiation therapy uses high-
powered beams, such as X-rays, to kill cancer cells.
Radiation therapy is given for five or six weeks.

11.  Surgery
 Surgery to remove early-stage anal cancers. Very small
anal cancers may be removed through surgery. During this
procedure, the surgeon removes the tumor and a small
amount of healthy tissue that surrounds it.
 Surgery for late-stage anal cancers or anal cancers that
haven't responded to other treatments. a more extensive
operation called abdominoperineal resection, which is
sometimes referred to as an AP resection is done. During
this procedure the surgeon removes the anal canal, rectum
and a portion of the colon. The surgeon then attaches the
remaining portion of the colon to an opening (stoma) in the
abdomen through which waste will leave the body and
collect in a colostomy bag.

12.  Practice safer sex.
 Get vaccinated against HPV.
 Stop smoking.

13.  Anal cancer rarely spreads (metastasizes) to distant
parts of the body. Anal cancer that metastasizes most
commonly spreads to the liver and the lungs.