Anal cancer

ANAL CANCER is a rare type of cancer that is localized in the anal canal, the distal part of the digestive tract, a tubular structure that starts from the dentate line and ends with the anal opening. 

WHAT ARE THE SYMPTOMS OF ANAL CANCER?

  • From a slight admixture of blood in the stool to heavy bleeding from the anus
  • Pain in the anus and rectum
  • Feeling of a foreign body in the anus
  • Anal itch 

IF THERE ARE ANY SIMILAR SIGNS, YOU SHOULD CONSULT A SPECIALIST!

WHAT ARE THE CAUSES OF ANAL CANCER?

Like any type of cancer, anal cancer develops in the presence of genetic mutations – normal healthy cells are transformed into "atypical" (cancer), which in turn multiply at a high rate, eventually this process gets out of control and forms a mass (tumor) of these pathological cells. Then the cancer cells separate from the tumor, and can spread to other organs by lymphogenic or hematogenic pathways (metastasis). The development of anal cancer has a close relationship with the human papillomavirus (HPV), this fact is confirmed by the fact that most patients with anal cancer are diagnosed with HPV. HPV is thought to be the most likely cause of anal cancer.  

WHAT ARE THE RISK FACTORS FOR ANAL CANCER?

Age. Most cases of anal cancer occur in people aged 50 and older. 

A large number of sexual partners. People who have many sexual partners during their lifetime have a greater risk of developing anal cancer.

Ano-receptive connections. People who have ano-receptive connections are at an increased risk of developing anal cancer. 

Smoking. Smoking increases the risk of anal cancer. 

A history of cancer. The presence of cancer of other localization (cancer of the cervix, vagina, prostate cancer) increases the risk of developing anal cancer. 

Human papillomavirus (HPV). The presence of HPV infection increases the risk of developing both anal cancer and cervical cancer. HPV is a sexually transmitted infection and is also the cause of genital herpes.  

Immunosuppression. People who take medications to suppress their immune system (immunosuppressants), for example, for Crohn's disease, or those who have had organ transplants, have an increased risk of developing anal cancer. Also in this group of factors can be attributed to HIV-the virus that causes AIDS-suppresses the immune system and increases the risk of anal cancer. 

WHERE DOES ANAL CANCER METASTASIZE?

Metastasis of anal cancer to distant organs is quite rare, but despite this, the presence of distant metastases in anal cancer has a very unfavorable prognosis. Most often, anal cancer metastasizes lymphogenically, that is, the regional lymphatic pathways of the pelvis and inguinal lymph nodes are affected. 

IS IT POSSIBLE TO PREVENT THE DEVELOPMENT OF ANAL CANCER?

It is impossible to completely prevent anal cancer. However, it is possible to reduce the likelihood of its development:

  • Protected sexual intercourse. The use of protective measures can reduce the chance of getting HPV and HIV. 
  • HPV vaccination. There is a vaccine that reduces the risk of HPV disease. Vaccination is recommended to be carried out in adolescence, both girls and boys, but in addition it can be used in adulthood. 
  • Smoking cessation. Smoking increases the risk of developing anal cancer. Don't start smoking! If you are currently smoking-give it up!

HOW IS ANAL CANCER DIAGNOSED?

  • Finger examination of the rectum and anal canal 
  • Visual inspection with an anoscope
  • Transrectal ultrasound examination (TRUZI)   
  • Tissue biopsy

After confirming the diagnosis, it is necessary to conduct a follow-up examination to determine the prevalence of the tumor process:

  • Computed tomography (CT) of the chest and abdomen with intravenous contrast
  • Magnetic resonance imaging (MRI) of the pelvis with intravenous contrast
  • Positron emission tomography (PET)

After further examination, the doctor determines the stage of cancer, which determines the tactics of further treatment. 

HOW IS ANAL CANCER TREATED?

Chemoradiotherapy. Anal cancer is well treated with a combination of chemotherapy and radiation therapy. Together, these two treatments enhance each other's effects and improve the outcome of treatment. Usually, radiation therapy lasts about 5-6 weeks, chemotherapy is usually performed during the first and last week. 
Surgical treatment. For small tumors, the tumor is removed without damaging the muscles of the anus. In the case of a large tumor and the absence of the effect of radiation and / or chemotherapy, an extensive operation is performed with the removal of the anal canal and rectum with the surrounding tissues (abdominal-perineal extirpation), a permanent stoma is formed on the abdomen (the remaining part of the colon is connected to the anterior abdominal wall).

In the Moscow Clinical Scientific and Practical Center named after A. S. Loginov, a multidisciplinary team consisting of doctors of diagnostic services, coloproctology surgeons and oncologists is engaged in the treatment of anal cancer.

Do not delay your visit to the specialists of our Center. This will help to diagnose the disease in a timely manner and choose the right treatment tactics. The doctors of the Coloproctology department of the MCSC are always ready to help you. 

GBUZ Moscow Clinical Scientific Center named after Loginov MHD