Anal Cancer

THE TERMANAL cancer refers to any form of cancer associated with the anus. According to the National Cancer Institute, anal cancer is estimated to have affected 4,660 people in the United States in 2006, and is expected to result in 660 deaths. There are many types of malignant and benign cancers, as well as precancerous conditions, which can be found in the anal canal (a canal approximately an inch and a half long, which is connected to the rectum). There are many treatment options for anal cancer, ranging from surgery to radiation therapy and chemotherapy.

Some of the earliest signs of anal cancer include bleeding from the anus or rectum, pain around the anus, itching or discharge from the anus, and a lump near the rectum. Tests that may indicate the presence of anal cancer include a physical examination, a digital rectal examination, an anoscopy or proctoscopy, an ultrasound procedure in the anus or rectum, and a biopsy.

Many benign tumors occur in the anus. Some of these include polyps, warts, fibroid tumors (leiomyomas), granular cell myoblastoma (large cells filled with fine granules), hemangiomas (extra blood vessels in the skin that look like strawberry-colored birthmarks), lipomas (growths of fat under the skin) and schwannomas (tumors originating in the peripheral nerve fibers). Sometimes, benign tumors in the anus can turn malignant. These tumors are known as precancerous conditions, and those associated with anal cancer are specifically called anal intraepithelial neoplasia. Some anal warts are an example of an anal intraepithelial neoplasia.

In terms of malignant (or cancerous) tumors, the most common type of anal cancer is squamous cell carcinomas, which can be found in the tissues that line the anal canal and the anal margin. When these carcinomas have not spread from the original cancerous site, they are called carcinoma in situ. Another type of cancer occurs in the cloaca, which is located between the rectum and the anal canal. A specific type of scaly, cancerous tumors can occur there, which are known as cloacogenic carcinomas. Adenocarcinomas are another form of anal cancer, involving tumors that grow in the glands under the anal epithelium and discharge cancerous secretions into the anal canal. Those forms of cancer that form under the rectum are called rectal carcinomas. Basal cell carcinomas are another form of cancer that can develop in the skin outside the anus.

Anal cancer is usually curable. Treatment options for people with anal cancer include surgery (which may completely remove the cancerous site), radiation therapy, chemotherapy, or a combination of all of those treatments.

Some of the risk factors for anal cancer include age (it is more prevalent among people over 50), smoking (smokers have a higher rate of anal cancer), having many sexual partners, and having receptive anal sex. Anal cancer affects men and women differently. Men tend to get anal cancer outside the anus, whereas women tend to get anal cancer inside the anus. Although most forms of anal cancer can be cured, women experience a mortality rate from anal cancer that is approximately twice the rate experienced by men. One recent study suggests that black men have a higher rate of anal cancer and lower survival rates than other race-specific and gender-specific groups.

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