Anal Cancer – Types ,Stages and its Treatment
Anal cancer is more rare and uncommon type of cancer that effect your anus.
Cancer develops when there is abnormal cell growth in any parts of our body. Cancer can spread throughout your body after its initial stage.
To understand the anal cancer in better way we need to first known little bit about anus and how it function.
Anus is the opening at the end of our large intestine. When we eat food it fast goes to our stomach and then it will pass from stomach to small intestine where 90% of digestion and absorption process is performed.
Small intestine absorbs the vitamins ,minerals and the nutrients from the food that we eat. After this process is completed the remaining food will be then transferred to the Large intestine where another 10% of absorption is done.
After all this process is completed the waste matter that is left which is known as Stool will be stored at the end of the Large intestine which is known as Rectum. From there the waste matter will be excreted from our body through Anus.
So this was the small brief idea about anus and how it functions.
Where does Anal cancer growth begins?
Anal Cancer can start in any part of your anus depending upon which type of cell in your anus got effected by abnormal cell growth.
Anal cancer mainly fall in two Category:-
1.Anal canal Cancer – Anal canal is the end part of your Large intestine which is surrounded by two sphincter muscle that help your anus keep close and prevent the stool from leakage.
Anal canal cancer is more commonly seen in women.
2.Anal margin Cancer – The junction at the outside of your anus having hairy and non-hairy skin .The verge going outward for 2 to 3 inches which is known as perianal skin. This is referred as anal margin.
Anal margin cancer is more commonly observed in male
Different types of anal Cancer:-
1.Adenocarcinoma – It is very rare type of anal cancer that is usually developed around the glands in anus.
2.Bowen’s Disease – It is uncommon and slow growing skin cancer can be easily treated .It is the early form of skin cancer.
It is a anal diseases that can be easily identified by abnormal cell growth.The cause of Bowen’s Disease may be due to the presence of HPV(Human Papillomavirus).
3.Basal cell Carcinoma – This is the most common type of skin cancer and most frequently occurs.
This type of skin cancer affects the skin that is mostly exposed to the Sun. But it is rare that it affects your anus area. Basal cell carcinoma affects the perianal skin.
4.Squamous cell cancer – Squamous cells are the outermost part of the skin. This type of anal cancer is very common.
It spread to the other parts faster and should be treated as fast as possible.
As it spread faster it could affect other body parts and could be life threatening. This is the advanced type of skin cancer.
Stages of Anal cancer and TNM staging for cancer:-
There are 4 stage of cancer:-
1.Stage 0 – This stage means there is no cancer development ,only the changes in cells are abnormal.
2.Stage 1 – This stage means there is a small development of cancer but not spread to other parts.It’s still in the same area where it started.
3.Stage 2 – This stage indicated the cancer is still growing but not spread till now.
4.Stage 3 – This indicates the cancer is fully grown and has spread to nearby organs such as bladder, ureters and urethra or vagina.
5.Stage 4 – It is the advanced stage of Anal cancer that indicates the cancer is very much serious and that has spread to other body parts such as lungs, kidney and liver.
TNM staging of Cancer
To know the stage of your anal cancer doctor prescribe some test and diagnosis. After the correct test doctor will decide on further type treatments.
Doctors use TNM staging system to identify the anal cancer stage. TNM staging is widely used for various kinds of cancer to know their stage.
TNM staging are used to identify the following things:-
1.Type of cancer cell present.
2.Size of the main tumor.
3.To identify any abnormal changes in the cell
4.To identify which body parts the cancer is spread.
1.Tumor (to identify size of the tumor)
2.Node (To check the cancer is spread to nearby lymph or not)
3.Metastasize (to check the cancer is spread to other body parts or not)
Detailed Understanding of TNM staging
There is mainly 4 stage of tumor in TNM staging:-
T0 – It indicates there is no tumor but there is abnormal changes in skin cell in the anal area.
T1 – It indicates the size of the tumor is 1 to 2 cm.
T2 – It indicates the size of the cancer is 2 to 6 cm.
T3 – It indicates the size is bigger than 6 cm.
T4 – It indicates the cancer is spreading to the nearby organs.
There is 2 stage of node in TNM staging :-
N 0 – It indicates there is no presence of cancer cells in nearby lymph nodes .
N1 N2 N3 N4 N…. – It indicates the presence of cancer cell in nearby nodes.
The higher the number after N indicates presence of cancer cell is in higher number in nearby lymph nodes.
There is 2 stage of Metastasize:-
M0 – It indicates cancer is not spread to distant body parts.
M1 – It indicates the cancer is spread to distant part of the body
When the cancer stage is tested by using TNM staging
The result will somewhat look like this as mentioned below.
T2N4M0 – It clearly indicates the tumor is growing big ,4 nearby lymph is affected by cancer cells but the cancer is still now not spread to other body parts.
Symptoms of Anal cancer:-
2.Pain around the anus and sometimes it itches.
4.Mucus discharge from Anus.
Cause of Anal Cancer:-
The cause of anal cancer is still now not known exactly but several factors can contribute to the cause of Anal Cancer.
1.Having multiple sex partner.
2.Having anal sex with your partner regularly
3.Weak immune system
4.Effected by HPV or HIV due to sexual activities.
5.Old age also contribute to the cause of anal cancer.
6.Excessive smoking regularly.
Treatment and Diagnosis of Anal Cancer:-
For treatment of anal cancer you need some initial test and Diagnosis.
You should consult with your doctor about the signs and Symptoms that you observed.
If your doctor think you need some basic test he may recommend you the following tests to carryout the further treatment of anal cancer.
Following tests that can be recommended:-
1.Biopsy – It involves collecting a small amount of tissue samples to test under the microscope for detecting the presence of any cancer cell.
2.Anoscopy – This test involves entering a flexible tube consisting of light and a camera into your button to view inside of Sigmoid colon if there is any abnormal cell growth.
3.Proctoscopy – This test is done to view the inside of your rectum.
4.X-RAY – This is done to have a picture inside of your body .
Sometimes CT or MRI scan is recommended to have a detailed image inside of our body.
After all this recommended tests are done if your doctor thinks for further advanced treatment he can proceed.
In past the treatment for anal cancer was performing a surgery. But in this modern era surgery is not usually recommended for Anal cancer treatment.
Chemoradiation is usually preferred for Anal cancer treatment.
Chemoradiation is basically a combination of 2 things
1.Chemotherapy – This therapy uses several alkylating chemicals used to kill cancer cells.
2.Radiotherapy –This treatment uses a high dose of gamma radiation to kill the cancer cells.
But in some cases if chemoradiation fails to work then the doctor will go with Surgery process.
Side Effects of Chemoradiation Treatment:-
Short term effects:-
1.Hair loss (partially from scalp and Completely in pubic region)
4.Skin soreness in anus area
Long term effect:-
3.Itchy skin around anus
4.Bowel control problems
Prevention of Anal Cancer
1.Avoid anal sex and practice safe sex. HPV and HIV both are sexually transmitted diseases that can cause anal cancer.
2.Get HPV vaccination
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