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In the early stages, anal carcinoma may not cause noticeable symptoms. As the cancer grows, however, symptoms can emerge. Common symptoms include:
Anal carcinoma is diagnosed through a combination of physical examination, imaging tests, and biopsy:
Physical Exam: A healthcare provider will conduct a digital rectal exam (DRE) to feel for lumps or abnormal growths in the anal area. A visual inspection of the anus may also reveal signs of a tumor.
Anoscopy or Proctoscopy: These procedures involve the insertion of a small tube with a camera (anoscope or proctoscope) into the anus to look for abnormal areas. A biopsy may be performed during this exam to collect tissue samples for further examination.
Biopsy: A biopsy is the most definitive test for diagnosing anal cancer. The tissue sample taken from the suspicious area is examined under a microscope to confirm the presence of cancer cells.
Imaging Tests: CT scans, MRI, and PET scans are used to assess the size of the tumor and determine whether the cancer has spread to other areas of the body, such as nearby lymph nodes or distant organs.
HPV Testing: In some cases, testing for high-risk HPV strains may be conducted to evaluate the potential link between HPV infection and the development of anal carcinoma.
Treatment for anal carcinoma typically involves a combination of radiation therapy and chemotherapy. Surgery is rarely necessary, as most anal tumors can be treated without removing the anus.
Chemoradiation (Chemotherapy and Radiation): Chemotherapy and radiation are often used together as the primary treatment for anal carcinoma. Chemotherapy drugs, such as fluorouracil (5-FU) and mitomycin C, are combined with radiation therapy to shrink the tumor and kill cancer cells. This treatment approach has shown high success rates in preserving the anus and function.
Surgery: In cases where the cancer does not respond to chemoradiation, or if there is significant tissue damage, surgery may be required. This may involve removing part or all of the anus (abdominoperineal resection), which can lead to the creation of a permanent colostomy.
Immunotherapy: For some patients, particularly those with advanced cancer, immunotherapy may be considered. This treatment boosts the body’s immune system to help fight cancer. Drugs like pembrolizumab have shown promise for patients with advanced anal cancer.
Targeted Therapy: Research is ongoing to identify specific molecular targets for treating anal carcinoma, though this approach is still in the experimental stages.
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