Anal Cancer: Treatment, Symptoms & More

Anal cancer is relatively rare. Because it isn’t common, you need to be sure you have an expert team who understands every aspect of the condition. The UCLA Gastrointestinal Oncology Program offers all types of treatment for anal cancer — and we’ll always treat you as an individual, not a number.

Our team specializes in GI cancer, including anal cancer. Together with you, your doctors will develop an individualized treatment plan. Whenever possible, your oncologist will treat anal cancer nonsurgically to help support your quality of life after treatment.

What Is Anal Cancer?

Anal cancer occurs when cancerous cells grow in the anus or anal canal. The anal canal is the last 1½ inches of the gastrointestinal tract. The anal sphincter muscles form a ring that lets the body hold or release waste (feces or stool).

Most types of anal cancer are anal squamous cell carcinoma. Less often, another kind of tumor called adenocarcinoma develops in the anal canal. Anal cancer is also called anal canal cancer. 

Although anal cancer is rare, it is becoming more common. Risk factors for anal cancer include:

• HIV-positive status
• Human papillomavirus (HPV) infection
• Sexual activity, such as multiple sexual partners and receptive anal sex
• Lowered immunity, such as after organ transplant

What Are the Symptoms of Anal Cancer?

Anal cancer may not cause any symptoms at all. For some, bleeding is the first sign of anal cancer. Many people mistake this initial symptom for a benign cause of anal bleeding, such as hemorrhoids (swollen veins around the anal opening).

You should see a doctor if bleeding or discomfort continues, or if you have any of these other symptoms:

• A lump near the anus
• Pain around the anus
• Itching and bleeding or other discharge from the rectum
• Lumps or sensitive, swollen lymph nodes in the groin or around the anus
• A feeling of fullness, narrower stools or other changes in bowel movements

How Is Anal Cancer Diagnosed?

Your team will carefully examine you to diagnose possible anal cancer. Thorough tests and study of lab results will help your doctor recommend your customized care plan. Diagnostics may include:

• Physical exam: In addition to a complete physical exam, your doctor may do a digital rectal exam (DRE). In a DRE, a doctor inserts a gloved finger into your anus to check for lumps or growths. Meet our doctors.
• Anoscopy: Using a probe in the anus, your doctor can closely view the inside of your anus and rectum. The doctor can also take biopsies of tissue for testing.
• Endo-anal ultrasound: Your doctor may get a better picture of the tissues in your anus or rectum with an ultrasound probe inserted into the anus. This test uses high-energy sound waves to form an image.
• Other imaging: Your doctor may order additional imaging, such as X-rays, CT scans, PET scans or MRI scans. These tests can show whether cancer has spread elsewhere in your body. Learn more about our imaging technology.

How Is Anal Cancer Treated?

Most people don’t need surgery for anal cancer, especially if it is detected early. But if you do need surgery, your surgeon will explain your options and what to expect. Surgical and nonsurgical treatments for anal cancer include:

Chemoradiation

For most people with anal squamous cell carcinoma, chemoradiation therapy — radiation and chemotherapy at the same time — is the primary treatment. Radiation uses strong X-rays to destroy cancer cells. Chemotherapy medications make cells more susceptible to destruction by radiation.

Local resection

This type of surgery removes only the tumor and a small area around the tumor. It leaves the anal canal and the anal sphincter intact. After you recover, you’ll usually be able to move your bowels as you did before treatment.

Radiation therapy

Some people need additional radiation therapy after surgery. Specialized GI radiation oncologists use the most advanced forms of radiation therapy to shape radiation beams to the tumor. This technique minimizes your exposure to the high-powered radiation beams. Read more about radiation oncology.

Abdominoperineal resection (APR)

This extensive surgery removes the anus and the rectum (the tube that collects waste before it leaves your body). Your surgeon may recommend this procedure if no other treatment is appropriate.

After APR surgery, you’ll have a colostomy (an opening and removable bag that collect stool). Our support team will help you through the recovery process.

Contact Us

To schedule an appointment with the UCLA Gastrointestinal Oncology Program, please call the UCLA Cancer Hotline at 888-ONC-UCLA (888-662-8252) Monday through Friday, 9am to 5pm, or our Physician Referral Service at 1-800-UCLA-MD1 (310-825-2631).