Diagnosis of Anal Cancer

Diagnosis of Anal Cancer

The following tests and procedures may be used to diagnose anal cancer:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Digital rectal examination (DRE): An exam of the anus and rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.
  • Anoscopy: An exam of the anus and lower rectum using a short, lighted tube called an anoscope.
  • Proctoscopy: An exam of the rectum using a short, lighted tube called a proctoscope.
  • Endo-anal or endorectal ultrasound: A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If an abnormal area is seen during the anoscopy, a biopsy may be done at that time.

Prognosis

Certain factors affect the prognosis (chance of recovery) and treatment options of anal cancer such as:
  • The size of the tumor.
  • The stage of the cancer.
  • Where the tumor is in the anus.
  • Whether the cancer has spread to the lymph nodes.
  • Whether the patient has human immunodeficiency virus (HIV).
  • Whether cancer remains after initial treatment or has recurred.

Staging

After anal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the anus or to other parts of the body. This process is called staging. . The following tests may be used in the staging process:
  • CT scan
  • Chest x-ray
  • Endo-anal or endorectal ultrasound
The three ways that cancer spreads in the body are:
  • Through tissue: Cancer invades the surrounding normal tissue.
  • Through the lymph system: Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Through the blood: Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, secondary tumor may form. This process is called metastasis. The secondary or metastatic tumor is the same type of cancer as the primary tumor. The following are the stages of anal cancer: Stage 0 (Carcinoma in Situ): In stage 0, abnormal cells are found in the innermost lining of the anus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage I: In stage I, cancer has formed and the tumor is 2 centimeters or smaller. Stage II: In stage II, the tumor is larger than 2 centimeters. Stage IIIA: In stage IIIA, the tumor may be any size and has spread to either:
  • lymph nodes near the rectum; or
  • nearby organs, such as the vagina, urethra, and bladder.
Stage IIIB: In stage IIIB, the tumor may be any size and has spread:
  • to nearby organs and to lymph nodes near the rectum; or
  • to lymph nodes on one side of the pelvis and/or groin, and may have spread to nearby organs; or
  • to lymph nodes near the rectum and in the groin, and/or to lymph nodes on both sides of the pelvis and/or groin, and may have spread to nearby organs.
Stage IV: In stage IV, the tumor may be any size and cancer may have spread to lymph nodes or nearby organs and has spread to distant parts of the body.

Recurrent Anal Cancer

Recurrent anal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the anus or in other parts of the body. If you are experiencing the signs or symptoms of anal cancer, contact us to request an appointment with our bay area cancer specialists to begin diagnostic testing or to obtain a second opinion.