There are several treatments for anal cancer. Your doctor will recommend specific therapies based on:
The stage and location of the anal tumor
Whether the patient has HIV
Whether the anal cancer has been previously treated
The standard treatments are radiation, chemotherapy, and surgery, often in combination.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells and shrink tumors. The radiation can be delivered from a machine outside the body. Or it can come from a radioactive substance placed in or near the cancer cells.
Chemotherapy uses drugs to kill cancer cells or stop them from dividing. Chemotherapy taken by mouth or injected into a vein or muscle travels through the bloodstream and body. This is called systemic chemotherapy. When placed into the spinal column, organ, or a body cavity such as the abdomen, chemotherapy affects mainly those areas. This is called regional chemotherapy.
Surgery. Sometimes anal cancer is treated with surgery. The type of surgery depends on the size of the tumor and how far it has spread.
Local resection: This procedure involves removing the tumor from the anus. Some surrounding healthy tissue is removed as well. This procedure may be used if the cancer is small and has not spread. This surgery can save the muscles that control bowel movements.
Abdominoperineal resection: This procedure removes the anus, rectum, and part of the colon. Cancerous lymph nodes may be removed as well. The surgeon sews the end of the intestine to an opening made in the abdomen. This allows waste to empty into a bag (colostomy bag) outside the body.
The most effective therapies now include a both chemotherapy and radiation therapy. Avoiding surgery that causes the loss of the anal sphincter is better in terms of quality of life. Surgery can be avoided and hence quality of life issues in terms of avoiding the loss of the anal sphincter can be achieved.
Patients with anal cancer and HIV disease already have weakened immune systems, so they may receive less intensive chemotherapy and radiation.
When you talk to your doctor about the treatment options, ask him or her about the expected benefits and risks. How will this treatment affect your prognosis? What will your quality of life be during and after treatment?
Follow-up tests during treatment will show how well the therapy is working. You should continue to have regular follow-up tests after your treatment is over to show if your condition has changed.