Anal Cancer: What to Ask Your Doctor


If are experiencing symptoms that make you believe you may have anal cancer, it is critical that you schedule an appointment with your doctor as soon as you can.  You are probably feeling worried and extremely scared if this is the case. Your primary doctor may have disclosed that anal cancer is a possibility. They may have even referred you to a specialist or a surgeon that treats these types of diseases.  This specialist is called a gastroenterologist. Once you have been diagnosed with anal cancer, you will typically be referred to an Oncologist. This type of specialist works with cancer patients. Appointments sometimes do not provide a lot of time to go over everything that needs to be discussed.  For this reason, you want to make sure that you are prepared when you go for your appointment. Here are some things that you can do to prepare.

What to do


The first thing you want to do is make sure you know of any restrictions before you go to the appointment. This means that when you call and schedule, you should make sure to ask about any paperwork or any steps that you need to take prior to the appointment.  For example, ask if there is anything you need to change your diet. Covering this ground before you go for your appointment can minimize the amount of time spent on the topic during the appointment and free up time to cover other necessary topics.  

Make sure that you make a list of all your symptoms, even ones you think may be unrelated to cancer.  That way, when the doctor asks, you have the symptoms at the ready. This helps ensure nothing is missed and saves time.  Make sure that you write down personal information that is typically asked during a medical history. Include things that increase your stress level and any changes that have taken place in your life (such as income change, getting married, or having a child.)  You should also write down all the medications (over-the-counter and prescribed) that you are currently taking. Ask someone to go to the appointment with you so that you have an extra pair of ears at the appointment. These appointments can be overwhelming. Having an extra person at the appointment can help ensure that more details are remembered. 

You also want to make sure that you write up a list of questions to ask the doctor when you go for the appointment.  You are not going to have a lot of time with your doctor. Therefore, you want to list the questions from the most to the least important so that you can ask the ones that matter most before your time is up.  

What should you ask?


The hardest part of making any list is figuring out what to put on it.  Some people are just natural list makers. We all know someone that make lists of their lists and can follow them with expertise.  However, there are much more than stare at a blank piece of paper having a hard time figuring out what to put on it. Here are some basic things you should go over with your doctor to get you started.  Remember, however, to order the questions based on what you feel is the most important. Everyone is different and everyone has different priorities. With that said, here are some things you might want to ask.

When speaking with your doctor about anal cancer, one of the most important things you are going to want to ask is what stage of cancer do you have.  This affects your overall prognosis and is important to talk about at some point during the visit. You should inquire about any further testing that is needed so that you are prepared for what you are facing.  Make sure that you ask about the different options available for treatment. This is important because what works for one doesn’t work for all. You want to ask about the doctor’s professional opinion of what treatment is best for the stage of cancer that you are facing and what research is available to back up that approach.  Evidence-based practice is normally the safest bet when it’s available. However, clinical trials have been known to work as well. Weigh the risks and benefits before you decide. This means that you need to know if you qualify for any clinical trials and make sure that you inquire about any side effects to each treatment option discussed.  Ask if the professional can recommend any one for a second opinion if you feel a second opinion is warranted. Finally, inquire about what factors determine if you need to follow-up.  





How is Anal Cancer Diagnosed?

There are cases of anal cancer where people that are at a high risk of the disease are diagnosed through screening tests.  There are other times that a doctor may find cancer during a routine checkup or when a minor procedure is performed. Typically, when cancer is identified this way, it is effective because the tumors are identified early on.  Anal cancer is typically diagnosed, however, because an individual is having symptoms consistent with the disease. When an individual is suspected of having anal cancer, there are exams and tests that are performed to confirm the diagnosis.  When cancer is identified, then more tests are conducted so that the stage of cancer can be identified. Here are some of the exams used to identify anal cancer.


When you are experiencing symptoms that coincide with anal cancer, a doctor will typically inquire about your medical history.   This is done to determine what risk factors you have. Further, your doctor is going to conduct an examination. This examination is done with the purpose identifying physical signs that anal cancer exists.  This typically includes a rectal exam. When the results are abnormal, the doctor may decide further testing is needed to identify the exact issue. This means that you may be referred to a specialist that specializes in diseases of the anus, colon, or rectum to have more tests conducted and to set up treatment options.  



Another examination you may be required to undergo is known as an endoscopy.  These exams are when a tub containing a small lens on the end of it is used to examine the inside of the body.  There are different types of endoscopy that can be utilized to find what is causing your symptoms. These tubes can even be used to get a biopsy from the anal canal.  When you have an endoscopy done, you are typically lying on a table on your side with your knees to your chest or bent over a table.



Anoscopy is like an endoscopy.  With these exams, a short hollow tube is used.  The tube is about three to four inches in length and around one inch around.  There are times that it will have a light on the end of it. The tube is lubricated and entered the anus and rectum.  When the light is shined into the tube, it provides the doctor of a clear view of the anus and the lining of the lower part of the rectum.  This exam isn’t exceptionally painful overall.


Another exam that you may have completed is the rigid Proctosigmoidoscopy.  The tube is like the one used for an Anoscopy. The main difference is that the tube is longer to allow the doctor to see both the rectum and the lower portion of your sigmoid colon.  You may find that you need to take laxatives or even have an enema before the test is completed so that you know that your bowels are empty.


There are times that the procedures will reveal suspicious growth.  When that happens, your doctor will need to take some of the tissue to sample it and find out whether it is cancer.  This is known as a biopsy. When the growth occurs inside the anal canal, the doctor can typically pull this sample using the scope during the examination.  There are times that anesthetic is given to numb the area before a biopsy is taken. Once this is completed, the doctor cuts a small amount of tissue and sends it to the lab for testing.  If the tumor is small, there are times that the doctor will remove the entire thing and send it to the lab for testing. There are different types of biopsy’s that can be completed, and you may want to ask your doctor about the procedure that is being conducted.

Other tests


There are other tests that you may also have to undergo for anal cancer to be properly diagnosed.  You may undergo Imaging tests that could help identify cancer, an ultrasound, a CT scan, an MRI, a chest X-ray, or a PET scan.  The type of testing that will be done depends on the symptoms you are experiencing, what the doctor finds, and what you and the doctor decide should be done.  



Know the Signs and Symptoms of Anal Cancer


You may be experiencing signs and symptoms that have you wondering if you could have anal cancer.  It is important for you to understand that anal cancer is not the same as bowel cancer. In fact, very few individuals are aware of what anal cancer is.  Most individuals that have it don’t want to have to talk about it. They don’t want to tell their family or friends. Anal cancer, if not caught in the early stages, can be deadly.  

Many experts have said that as many as one in every five-people affected by anal cancer never have any symptoms.  This can make cancer deadlier. This is because, without the signs and symptoms, individuals do not know what it is. Overall, the disease is more likely to affect women than it is to affect men.  However, in recent years, the number of individuals affected with anal cancer has increased. Research shows that the occurrence of anal cancer has gone up over one hundred percent since the end of the 1970s.   

Anal cancer is rare.  However, there are studies that indicate the rates are rising.  There are many that say the rise in cases of anal cancer can be attributed to HPV.   Anal cancer affects the anus. This is the part of your bowl that opens outside of your body away from the rectum.  The anus is about three centimeters.  

Nine out of ten cases of anal cancer are related to HPV.  This is the same virus that is responsible for many cancers in the cervix, vagina, oropharynx, vulva, and penis.  There are different types of HPV. Each one is separated into either high or low-risk category. They are separated into these categories based on the symptoms that each one causes.  HPV is contracted through skin-to-skin contact. Individuals can also contract HPV by engaging in oral, anal, or vaginal intercourse with an individual that is infected.    

Symptoms of anal cancer can be easy to miss because they sometimes mirror other health problems.  Here are some common signs and symptoms of anal cancer.


The most common symptom of anal cancer is blood in the feces.  Approximately half of all individuals struggling with anal cancer have experienced blood in their feces.


If you notice that you have unusual lumps around your anus, you might want to talk to your doctor.  Lumps located around the anus could be easily confused with hemorrhoids. When individuals have small lumps located around their groin area, this could be an indication of anal cancer.  



Around thirty percent of individuals diagnosed with anal cancer experience pain around their anus. There have been suggestions made that if you experience swelling and redness or soreness around your anus that will not go away, this could be a symptom of anal cancer.  If these symptoms combine with other symptoms or don’t seem to go away, make sure you call your doctor and schedule an appointment as soon as you can. 

Bowel Movements


Have you noticed that you have been having unusual bowel habits lately?  Has it been harder to pass a stool? Have you been experiencing bouts of extreme constipation?  Have you noticed that you continuously feel the urge to pass a stool, but you can’t seem to pass one?  These can be signs of anal cancer. Another sign that you may have anal cancer is difficulty controlling your bowel movements.  

Wrapping it Up

There is available research that shows around one in every three persons with anal cancer has a lump around their anus.  There are others that experience constant itching. Others have noted experiencing a discharge of mucus.  

No matter what symptoms lead you to believe something may be wrong, you should seek medical care immediately.  Your primary doctor should be able to refer you to a specialist if one is needed. There are many factors that can increase your risk for anal cancer and you should ensure that you go over these and your symptoms with your doctor as soon as possible.