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Anal Cancer

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Anal cancer is a rare type of cancer caused by the abnormal growth of cells in the anal region. Symptoms include rectal bleeding, pain, and itching around the anus. Anal cancer can arise from various cell types in the anus, including the mucosal lining, external skin cells, muscles, blood vessels, or lymphatic cells. The most common types originate from the mucosal lining and epithelial cells.

Symptoms of Anal Cancer
  • Rectal bleeding or mucus mixed in stool.
  • A lump near the anus that may protrude or be palpable during bowel movements.
  • Pain or itching in the anal area.
  • Changes in bowel habits or stool shape.
  • Chronic discharge from the anus.
  • Enlarged lymph nodes in the groin, detectable by touch, potentially on one or both sides (indicating advanced cancer).
Although the exact cause is unclear, certain factors have been linked to anal cancer:
  • Human Papillomavirus (HPV): Particularly strains HPV-16 and HPV-18.
  • Age over 50 years.
  • Smoking.
  • History of cervical, vaginal, or vulvar cancer.
  • Weakened immune system: From HIV infection, organ transplants, or immunosuppressant medications.
  • High-risk sexual behaviors: Multiple sexual partners, anal intercourse, or unprotected sex.
  • Chronic anal inflammation or hemorrhoid-like tumors.
  • Genetic abnormalities affecting cell division and apoptosis, though these are typically non-hereditary.
  • General Examination:  
    • Visual and digital rectal exams to detect lumps or abnormalities, aiding in determining further treatment.
    • Stool tests for abnormalities.
  • Anoscopy:
    • After initial examination, a lubricated anoscope is inserted into the rectum to inspect for tumors or other irregularities.
  • Biopsy:
    • A sample of abnormal tissue is removed using needles, scissors, or forceps for microscopic examination to confirm cancer. This may include fine-needle aspiration or sentinel lymph node biopsy.
  • PET/CT Scan:
    • Evaluates the stage of anal cancer and determines whether it has spread to lymph nodes or distant organs.
  • Stage 1: Tumor size is less than 2 cm.
  • Stage 2: Tumor size exceeds 2 cm but is still localized.
  • Stage 3: Cancer has spread to surrounding tissues and nearby organs.
  • Stage 4: Cancer has metastasized to distant organs, such as the lungs or liver, via blood vessels or lymph nodes.

 
Treatment is determined based on factors such as cancer stage, severity, and the patient’s overall health. Main treatment options include:
  1. Surgery:
    • Involves removing the cancerous tissue, often along with some healthy tissue nearby. This is typically used for small, localized tumors in the early stages. For advanced cancer, surgery may not be possible, requiring alternative treatments.
  2. Chemotherapy (Chemo):
    • Administered orally or intravenously to destroy cancer cells. While effective, it can harm healthy cells, causing side effects such as nausea, vomiting, and hair loss.
  3. Radiation Therapy:
    • High-energy radiation targets cancer cells to kill them. Often combined with chemotherapy for better results. Side effects may include damage to nearby tissues, skin irritation, or redness.
  4. Combined Modality Therapy:
    • For stages 2 and 3, a combination of chemotherapy and radiation is often recommended before surgery to shrink the tumor. Additional chemotherapy may be given after surgery to reduce recurrence.
Last modify: December 09, 2024

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