Anal cancer

• The standard treatment for stages 1-3 anal cancer is chemoradiation - 
  radiotherapy and chemotherapy given at the same time. 
• Very occasionally stage 1 cancer is treated with surgery alone.
• Stage 4 cancer may be treated with either chemotherapy or radiotherapy or both. This treatment usually aims to control symptoms rather than cure the cancer.

Chemoradiation for anal cancer aims to cure the cancer and is known as definitive chemoradiation. 

Having chemoradiation for anal cancer

You will have radiotherapy every weekday for 5.5 weeks along with chemotherapy drugs. The chemotherapy is usually given during the first and last week of radiotherapy. The chemotherapy drugs help the radiotherapy to work better. 

You may have to go to different departments for your chemotherapy and radiotherapy. Your medical team will organise this for you and tell you where you need to go.

Find out more:

• Chemotherapy
• Radiotherapy

Possible side-effects of chemoradiation

With chemoradiation you can get both radiotherapy and chemotherapy side-effects. For example, skin soreness in the area, fatigue and diarrhoea. Having both treatments together can make any side-effects worse. Most side-effects get better in the weeks and months after treatment. 

Read more about possible side effects:

• Chemotherapy side-effects 
• Radiotherapy side-effects

Surgery before chemoradiation

Very occasionally, patients who find it difficult or painful to open their bowels at the time of their diagnosis will have a surgery called a defunctioning colostomy, which makes it easier and safer to deliver chemoradiation. 

The surgery involves bringing part of the bowel above the cancer on to the surface of the abdominal wall. Usually this colostomy will be permanent.

Surgery after chemoradiation

Approximately 12 weeks after finishing treatment for anal cancer, you will have scans and a follow-up physical exam including a digital rectal examination (where the doctor inserts a gloved finger into your back passage).

Types of surgery for anal cancer

There are 2 main types of surgery:

Local resection

This surgery is used for small tumours. It only removes the area where the cancer cells are found.

Abdominoperineal resection

This is where your anus and rectum are removed. Having this surgery means that you will have a permanent colostomy. 

A colostomy is an opening of the large bowel on the surface of your abdomen. Poo passes through this opening and is collected in a bag.