Anal cancer can be effectively treated with surgery or a combination of chemotherapy and radiotherapy. When diagnosed early, the cancer can be completely cured. However, all forms of treatment are subject of inconvenient. Surgery always consists of removing the anal sphincter; chemotherapy and radiation treatments can lead to complete healing without the removal of thesphincter; however, they always cause side effects, which may last a lifetime.
Anal cancer can be effectively treated with chemotherapy drugs: mitomycin and fluorouracil for instance. These medications are most often taken intravenously to kill or slow down the proliferation of cancer cells. Since cancer is characterized by uncontrolled cell division, these drugs work by acting on DNA, on RNA or the proteins of cells to block certain stages of their division. However, all chemotherapy drugs always attack health cells that multiply rapidly which lead to side effects in most patients:
- mouth sores
- weight loss
- decreased appetite
- bladder inflammation
- dry mouth
- hair loss
- Lung problems (rare).
Radiation therapy involves exposing the anus to electromagnetic waves to destroy or slow down the multiplication of cancer cells. Radiotherapy can treat and even eliminate the cancer without surgery. Exposure of ionizing radiation on large tumor is not only reducing symptoms but also allowing the preservation of the anal sphincter, unlike surgical treatment. In most cases, the radiation lasts about 4 weeks, 4 or 5 times per week, Monday through Friday.
Your oncologist can recommend external beam radiotherapy or internal radiotherapy (brachytherapy). Depending on your condition, both methods can be used.
However, like chemotherapy, radiation therapy kills both cancer cells and normal cells surrounding the tumor, which can lead to:
- anal bleeding
- burn in the anal area
- hardening of certain tissue of the anus
- anal incontinence (involuntary loss of gas or/and fecl matter)
- Significant narrowing of the anus (rare).
Surgery is reserved for advanced anal cancers or in cases of failure of radio-chemotherapy treatments. Like cancer treatments, surgical therapy has its inconvenient, the healing of the perineum (the area of the body located between the anus and the scrotum in men and between the anus and the vulva in women) is always long and arduous.
In early stage of the cancer, your surgeon can decide to remove the cancerous tissue without removing or damaging the anal sphincter. In this case, the surgery aims at stopping the progression of the tumor, and increases the effectiveness of the chemotherapy and radiation therapy.
Abdominoperineal resection(or abdominoperineal excision) – in very advanced form of anal cancer or in case of failure of radiotherapy and chemotherapy, removal of the anus, the rectum and part of the sigmoid colon will be the only option to get rid of the cancer. However, this surgery has many inconvenient, and is rarely performed.