The anus lies at the end of the GI or gastrointestinal tract while the anal canal is the interconnecting tube between the rectum and the outside part of the body. The anal canal is delimited by the sphincter – a muscle with its contraction and relaxation action is responsible for controlling bowel movements.
Anal cancer is a gastrointestinal cancer. It is not colon cancer or rectal cancer. The anus is the very end part of the rectum, where the waste leaves the body.
Anal Cancer is a rare condition caused due to malignant and anomalous cell proliferation that affects the rear end of the gastrointestinal tract – the anus. Consented to anal intercourse and among individuals with depleted immune systems. Experts have stated that anal cancer is closely related to few strains of HPV.
Less Likely to be seen in women more likely to occur in men, while cancer of the rectum’s inner portion of the rectum is very frequent in women. Cancer that is located in the outer region of the anus tends be found in men, whereas cancer that develops within the canal of anal is likely be seen in women. The tumors that are found in the area of the skin, with hair growing around it, just outside the anus are known as skin tumors and not cancer of the anal.
The squamous cells are flat and fish-scale-like in appearance, forming a lining inside the anal canal. Most of the anal cancer cases developing from these squamous cells are called squamous cell carcinomas.
The spot where the anal canal gives way to the rectum is known as the transitional zone. This zone is lined by squamous cells and glandular cells that produce mucus thus providing lubrication for easy passage of stool or feces. Adenocarcinoma – a cancerous form affecting the anus that could arise from the glandular cells, yet squamous cell carcinomas constitute most of the anal cancer cases.
What are the stages of cancers that affect your body?
Stage 1: tumor is located within the upper layer of anal tissues. At this point, treatment is likely to be straightforward surgical procedure to eliminate all the cancer.
Stage 2: The cancer has spread past the top layer of the anal tissue, is less than 2 centimeters (less than 1 inch) and is not extending to the muscles of the sphincter.
Stage 3: cancer has spread to lymph nodes in the rectum, or to other organs, such as the bladder or vagina.
Stage 3(B): If the tumor has spread to lymph nodes located in mid-section of abdomen, or in the groin. Or it has spread to the nearby organs and lymph nodes surrounding the rectum.
Stage 4: Cancer has expanded to distant lymph nodes in the abdomen, or to organs in different areas of the body.
Recurrent: Recurrent cancer refers to cancer that has returned (recurred) after it had been treated. It can occur in the anus or an area within the body.
What are the Types of Anal Cancer?
Anal cancer, which is rare cancer, is where cancerous cells grow within the anus. Cancer can grow inside the body, in those tissues that line the canal, or within the anal sphincter, or in the exterior area that surrounds the anus.
Squamous-cell carcinomas :
Different types of cancers can grow in various parts of the anus, a portion of which is within the body, while the other part that outside. Some abnormalities of the anus can be harmless at first, however, they could later progress into cancer. Certain anal warts, for instance, are cancerous areas that can grow into cancer. Around half of the cancers that occur in the anal area squamous-cell carcinomas that originate from the cells that line the anal margin as well as the anal canal. Anal margins are the area of the anus which is partially inside and partly outside the body.
And the canal that runs through it is that part of the anus which is within the body. The most common form of squamous cell cancer is called carcinoma in situ or Bowen’s disease. Around one-fourth or one-third of Anal tumors constitute cacogenic cancers. The tumors are found in the zone of transition, also known as the cloaca. It is a ring of tissues that lies between the canal of the anal as well as the rectum.
About 15% of all anal cancers are adenocarcinomas. They are a problem for glands that reside in the anal part of the body. A particular type of adenocarcinoma that is found in the anal region is known as Paget’s Disease, which may be a threat to the vulva, breasts, as well as other parts in the body.
A small proportion of cancers in the anal area are basal cell carcinomas or malignant melanomas. Both are kinds of skin cancers. Malignant melanomas that develop from skin cells that create melanin, a brown pigment are much more common in areas of the body exposed to the sun.
What are the Causes of Anal Cancer?
The true reasons behind the occurrence of anal cancer are still quite blurred, though the below-stated factors could possibly raise the risks.
- Aging – Aging is known to be directly proportional to the development of anal cancer that seems to rise as age increases.
- A diminished immune system – Those with lowered immunity like HIV or AIDS-infected persons, those having undergone transplants or are on the course of immunosuppressant medicines are noted to be at increased risk of developing anal cancer.
- Smoking – Those who smoke are more prone to contracting anal cancer than non-smokers. Factually, smoking has been noted to be the harbinger of a host of cancerous forms.
- Non-malignant anal abrasions – Inflammation arising from benign anal lacerations caused due to either irritable bowel disease or IBD, hemorrhoid, fistulae or cicatrices are known to raise the chances of developing anal cancers.
- Presence of HPV or Human Papilloma Virus – Some HPV forms have been strongly associated with anal cancer. Nearly, eighty percent of anal cancer cases arise due to HPV infection.
- Sexual Promiscuousness – has additionally been associated with HPV. The greater the shifting among sexual partners, the higher is the risk factor of contracting HPV that has strongly been related to anal cancer.
- Amenable anal intercourse – Both the sexes that opted for anal intercourse had an increased likelihood of developing anal cancer. A study has revealed that those HIV-infected men that had sexual contacts with the same sex were close to ninety times more prone to developing anal cancer as compared to the general populace.
- Other cancerous forms – Those women that had a past of vaginal or cervical cancer and men with a history of penile cancer are at a greater likelihood of contracting anal cancer. This has also been related to HPV infection.
What are the symptoms of anal cancer?
Many people with anal cancer have no noticeable symptoms. Since symptoms of anal cancer can be similar to symptoms of other, more benign conditions, such as hemorrhoids, unfortunately, some people do not seek medical attention until cancer has progressed. Around 25% of patients who have anal cancer don’t show symptoms. In these cases, the cancer is discovered only after a routine check-up.
- Bleeding from the anus or rectum
- Rectal itching
- Pain in the anal area
- Change in the diameter of the stool
- A discharge from the anus
- Swollen lymph nodes in the anal area or groin area
- Are you at risk for developing anal cancer? People between 50 to 80.
- Being diagnosed with Human papillomavirus (HPV) disease, also than venereal warts. HPV can be spread easily by sexual contact.
- If you have multiple sexual partners throughout your lives you are at greater risk of contracting anal cancer.
- Smokers of cigarettes tend to be eight times more likely than those who do not smoke to be diagnosed with anal cancer.
- Patients suffering from a condition known as an anal fistula. This can be described as a tear, or tunnel that is formed between the anal channel and the outside surface of the anus. The fistula may become inflamed or infected, which can increase the risk to develop anal cancer.
- Patients with a deficient immune system because of certain drugs and/or HIV are less likely to fight illness and thus more susceptible to developing anal cancer.
What is the process for diagnosing anal cancer?
The treatment for cancer of the gastrointestinal tract is based on three strategies, which can be used individually or in combination using radiation therapy, surgery and chemotherapy.
- Routine physicals Checkup: Anal cancer can be detected in routine physicals or even during minor procedures, like hemorrhoid elimination.
- Digital rectal exam: It can also be detected through a digital rectal exam (DRE) which is when doctors insert the finger of a gloved and lubricate it into the anus to look for abnormal growths. People over 50 who do not have any symptoms are advised to undergo an examination of the digital rectal (DRE) at least every 5 to 10 years based on American Cancer Society (ACS) guidelines for the early screening for colorectal cancer.
- A Biopsy: A biopsy is carried out on any suspicious growths. That is, a small piece from the tumor is scrutinized under a microscope to detect cancerous cells. The doctor may also carry out an operation known as the fine needle aspiration biopsy where a needle is used to draw lymph nodes close to the growth. This is done to ensure that there isn’t any cancer spreading to these lymph nodes.
- Surgery: Two kinds of surgeries can be carried out. A local resection procedure carried out in cases where cancer has not expanded removes cancer and the area surrounding the tumor. This procedure is often used to treat small tumors that are located on the exterior of the anus. This procedure is only removing the anus area that contains the cancerous cells.
The muscle which opens and closes the anus in order to allow stool to pass normally is not affected in the majority of cases, therefore the normal function of the bowel is preserved for the majority of people.
An abdominoperineal surgery is an even more complicated procedure that involves removing the anus and the lower rectum are eliminated, and an opening known as a colostomy is constructed to allow the body’s waste to be able to go out. This procedure is not very common nowadays, as chemotherapy and radiation are equally efficient.
This procedure involves a permanent colostomy that involves diverting the open portion of the bowel on the abdomen surface (tummy region) in order for the faces through the body and into the bag called a colostomy. The opening in the abdominal wall is called the tomar.
- Radiation therapy: Radiation therapy employs high-energy radiation to destroy cancerous cells. It is typically administered via an external device however it could be administered via implants surgically placed radioactive pellets. This is referred to as internal radiation or brachytherapy and also interstitial radiotherapy.
The side effects of radiation could include fatigue, skin damage similar to sunburn, as well as damage to the anal tissues. The effects of radiation usually diminish gradually after treatment is finished, but it could take a few months before skin changes be restored to normal. Some people experience that their bowel function has been permanently altered. It is essential to discuss this with your physician because it’s possible to identify ways to alleviate any issues. Your physician or dietitian at the hospital will give the advice you need.
Other possible adverse effects that could be experienced following radiation therapy for anal cancer are shrinking the vagina (vaginal stenosis) and dryness. To avoid this, women are asked to make use of a vaginal dilator using lubricating jelly in order in order to maintain the vaginal wall flexible and open.
Certain women might also need to use lubricating gel during sexual interactions. Infertility may also be one of the side effects of radiotherapy. If you’re concerned about the risk of becoming infertile after treatment, it’s an ideal idea to talk about this with your physician prior to starting.
- Chemotherapy: Chemotherapy is a treatment for cancer that uses medications, which can be administered through a needle or pill. Certain chemotherapy treatments eliminate cancer cells directly while others work indirectly by creating cancerous cells susceptible to radiation. The most commonly used drugs to treat cancer of the gastrointestinal tract is 5 fluorouracil (5-FU) along with mitomycin, or 5-FU and Cisplatin.
The side effects of chemotherapy, which harm healthy cells, in addition to cancer cells, can include vomiting and nausea hair loss and loss of appetite, mouth sores, diarrhea, fatigue, breathlessness, and a weakening of the immune system. The chemotherapy drugs are typically administered by injecting them into veins (intravenously). They can reduce temporarily the amount of normal cells present in your blood. If your blood count is low, there is a greater chance that you will develop an infection.
When you undergo chemotherapy, your blood count will be checked often and, if required you could be prescribed antibiotics to cure any disease. Transfusions of blood can be administered in the event that you develop anemia as a result of chemotherapy.
What can be done to reduce the risk of developing anal cancer?
- Stop smoking. Smoking increase the chances of cancer by many folds stop smoking immediately.
- Develop a healthy habit of eating vegetables and fruits, exercising, and using intimate products carefully.
- Always make sure to use condoms. While condoms can’t fully protect against HPV however, it is highly effective in fighting HIV, and being diagnosed with HIV increases the risk of being diagnosed with anal cancer.
- The reduction in the quantity of partner sexual could aid in reducing the risk of becoming HIV, HPV, and anal cancer
- Being vaccination-free against HPV can reduce the chance of getting anal cancer.
Do not be shy or unwilling to discuss any signs associated with anal cancer with your doctor.