INFORMATION ON ANAL CANCER

Anus is the muscular area at the very end of the large intestine through which body waste passes. Muscle which opens and closes to control bowel movements is Sphincter, and is where the bowel opens to the outside of the body. Cancer in the outer part of the anus is more likely to occur in men; cancer of the inner part of the rectum (anal canal) is more likely to occur in women..

Squamous cell is the most common type of anal cancer. Other rarer types are basal cell, adenocarcinoma and melanoma.

CAUSES OF ANAL CANCER

It is slightly more common in women than in men. Just like most cancers the cause of anal cancer is unknown. It has been acknowledged that anal cancer is more common in gay men. It is also more likely to develop in people who have had a particular virus infection called the human papilloma virus (HPV). This risk of having HPV increases with the number of sexual partners you have. Anal cancer is also more common in people who have a lowered immunity due to medical conditions, such as HIV. Cigarette smoking may also increase a person's risk of developing anal cancer.

SYMPTOMS OF ANAL CANCER

Pain and bleeding from the rectum, is the most common symptoms of anal cancer. If your anus is often red, swollen, and sore, you have a chance of getting anal cancer. Tumors found in the area of skin with hair on it just outside the anus are skin tumors, not anal cancer Small firm lumps are developed within few people which may be confused with piles (haemorrhoids). Few others may have discomfort, itching and a discharge of mucous (a jelly-like substance) from the anus. Faecal incontinence (a reduced ability to control bowel function) may also occur. Anal cancer can also appear as an ulcerated area and may spread to the skin of the buttocks sometimes.

DIAGNOSIS OF ANAL CANCER

Your doctor will examine you and refer you to a specialist in bowel conditions (gastroenterologist). A number of tests will have to be done before the doctor can make a firm diagnosis of anal cancer. The doctor at the hospital takes your full medical history, and does a physical examination and takes blood samples to check your general health..

Few examinations of Anal Cancer:-

Rectal examination- which is also known as a PR examination is the kind of examination where the doctor examines your back passage with a gloved finger.

Ultrasound scan - This is a simple, painless scan in which sound waves are used to form a picture of the inside of the abdomen.

Biopsy -This is the microscopic examination where a small sample of cells is taken from the tumor and examined under a microscope. This is usually done with the help of a special biopsy device (known as a punch biopsy) or the doctor can cut a small piece away from the tumor (known as an incisional biopsy). This can be done under local or general anaesthetic.

X-rays- X-ray is usually taken to show if there has been any spread of the cancer.

CT (computerized tomography) scan - CT is a refined type of x-ray in which three-dimensional picture of the inside of the body is made. This type of scan is painless but takes longer than an x-ray (10-30 minutes). CT scan is used to identify the exact site of the tumor or to check for any spread of the cancer. Before CT scan is been done most people are given a drink or injection so that particular areas are visibly clear. Before having the injection or drink, it is important to tell the person doing this test if you are allergic to iodine or have asthma.

MRI (magnetic resonance imaging) scan is almost similar to CT scan; the difference is just that in MRI scan magnetic fields are being used instead of x-rays to form a series of cross-sectional pictures of inside the body. For scanning the person is asked to lie very still on the couch inside a metal cylinder. He would be given an injection to allow the pictures to be seen more clearly.

This test takes approximately 30 minutes and is totally painless, although the machine is quite deafening. If a person does not like enclosed spaces he may find the machine claustrophobic. He would be given earplugs or headphones and can usually take someone into the room to keep company. A two-way intercom enables to talk with the people controlling the scanner.

TREATMENT OF ANAL CANCER

CHEMOTHERAPY

In Chemotherapy anti-cancer (cytotoxic) drugs are being used to destroy cancer cells. These chemotherapy drugs are generally given by injection into a vein (intravenously). These drugs can for a moment reduce the number of normal cells in your blood. While the blood count is low one is more likely to get an infection and may tire very easily. While this treatment of chemotherapy is going on blood would be tested regularly and, if necessary, given antibiotics to treat any infection. If a person becomes anemic due to chemotherapy Blood transfusions may be given.

Feeling sick (nausea) and vomiting can be few other side effects caused during the treatment of anal cancer with the help of Chemotherapy. Some chemotherapy drugs can also make your mouth sore and cause small mouth ulcers. Regular mouthwashes are vital. You can supplement your diet with nutritious drinks or soups too if you don't feel like eating regular meals. A wide range of drinks are available which are quite easily available at most chemists. One should ask ones doctor to refer to a dietitian for advice about your diet.

RADIOTHERAPY

Radiotherapy is often given for a few minutes each weekday for several weeks. In Radiotherapy high-energy rays are used to destroy cancer cells, trying doing as little harm as possible to normal cells. During the treatment through Radiotherapy for Anal Cancer there can be changes in bowel function such as diarrhea, or passing wind: though these side effects can sometimes be reduced by avoiding particular foods. Towards the final treatment through Radiotherapy one can have blistering and soreness of the skin around the anal area, and possibly in the groin areas too. Common side effect of radiotherapy can be Extreme tiredness, or fatigue.

SURGERY

Surgery may be used:-
. When a person does not get rid of cancer even without initial treatment
. Or when there are signs that your cancer has returned.

Basically there are two main types of surgery: local resection and abdominoperineal resection.

Combination of radiotherapy and chemotherapy are the common treatment used for anal cancer, this can be given at the same time or following one another. Combination of this treatment is generally very successful. Though Surgery can also be used, but it is not often used as the first choice of treatment for anal cancer

Local resection Local resection possibly may be used for small tumours on the outside of the anus. In this operation only the area of the anus containing the cancer cells are removed. The anal sphincter is not usually affected, and so normal bowel function is maintained for most people.

ABDOMINOPERINEAL RESECTION-
Abdominoperineal resection is the kind of treatment in which anus and rectum are removed. This operation requires a permanent colostomy, which involves diverting the open end of the bowel on to the surface of the abdomen (tummy area), to allow faeces to be passed out of the body into a colostomy bag. Stoma is the opening on the abdominal wall.