Treatment of Anal Cancer

What are the options for anal cancer treatment?

There are different types of anal cancer treatments available for patients. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Three types of standard treatment are used:

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the anal cancer. The way the radiation therapy is given depends on the stage of the cancer cells being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the anus, the drugs mainly affect cancer cells in those areas and is known as regional chemotherapy. The way the chemotherapy is given also depends on the type and stage of the cancer cells that are to be treated.

Surgery

  • Local resection: A surgical procedure in which the tumor is cut from the anus along with some of the healthy tissue around it. Local resection may be used if the cancer is small and has not spread. This procedure may save the sphincter muscles so the patient can still control bowel movements. Tumors that develop in the lower part of the anus can often be removed with local resection.
  • Abdominoperineal resection: A surgical procedure in which the anus, the rectum, and part of the sigmoid colon are removed through an incision made in the abdomen. The doctor sews the end of the intestine to an opening, called a stoma, made in the surface of the abdomen so body waste can be collected in a disposable bag outside of the body. This is called a colostomy. Lymph nodes that contain cancer may also be removed during this operation.

New types of Treatment

New types of treatment are being tested in clinical trials. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Patients can enter clinical trials before, during, or after starting their cancer treatment.

Treatment Options for Recurrent Anal Cancer

Treatment of recurrent anal cancer may include the following:
  • Radiation therapy and chemotherapy, for recurrence after surgery.
  • Surgery, for recurrence after radiation therapy and/or chemotherapy.
  • A clinical trial of radiation therapy with chemotherapy and/or radiosensitizers (Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy). Combining radiation therapy with radiosensitizers may kill more tumor cells.

Follow-up

Some of the tests that were done to diagnose anal cancer or to find out the stage of the cancer may be repeated after treatment as part of the follow up protocol. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred. These tests are sometimes called follow-up tests or check-ups. Contact us to request an appointment with one of the oncologists at Diablo Valley Oncology to discuss your treatment options or obtain a second opinion on your diagnosis.