What is Anal Cancer?

If you or someone you love has recently been diagnosed with anal cancer, you are probably feeling extremely stressed out and confused.  Many individuals leave the initial doctor’s visit in a fog. They have no clue what their diagnosis means. If you or someone you love has recently been diagnosed with, you are afraid a diagnosis is a possibility, here is some critical to help you understand the diagnosis.

Is it Common?

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Many individuals are unaware of the fact that anal cancer is rare.  It begins in the anus. For those who are unaware, the anus is the medical term used for the opening that is found at the end of the rectum.  In 2014, it was predicted that little over seven thousand individuals would be diagnosed with anal cancer and it was predicted that nine-hundred and fifty of those would result in death.  Compare this to the predictions for colorectal cancer. In 2014, it was predicted that over one hundred and thirty-six thousand individuals would be diagnosed with anal cancer and over fifty thousand of those would result in death.

What are the odds?

About half of diagnosis of anal cancer occurs before cancer can spread.  Around thirteen to twenty-five percent of diagnosis has spread to the lymph nodes. Only ten percent of all cases are found after the cancer has spread throughout the organs or diagnosed after the cancer has metalized. The good news is that anal cancer is normally found in the early stages.  This means that the chances for successful treatment are very high. In fact, the survival rate for this type of cancer is around sixty percent for mean and approximately seventy-one percent for women.

When the cancer is found in the beginning, the survival rate is over eighty percent.  If the cancer is found after spreading to the lymph nodes, the survival rate is around sixty percent.  Once cancer reaches the organ, around one in every five patients live at least five years, if not longer.

Who is at Risk?

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You may be wondering if you or someone that you love could be at risk for anal cancer.  Around eighty percent of cases of anal cancer are diagnosed in individuals that are at least sixty-five years of age.  When anal cancer is diagnosed before the age of thirty-five, it is primarily found in men. When anal cancer is diagnosed after the age of fifty, it is more common in women.  

When you compare a number of single men with a number of men who are married that are diagnosed with anal cancer, it is found that single men are six times more likely to receive a diagnosis.  It has also been found that engaging in the receiving part of anal intercourse plays a part in the development of this type of cancer. HPV or human papillomavirus is a risk factor. Individuals with this virus have a higher chance of being diagnosed with anal cancer.  For those that may be unaware of what HPV is, it is a virus that results in genital warts.  

Individuals who have a diagnosis that means that their immune system has been compromised in some way, such as HIVs, are likely to end up with anal cancer.  The prognosis for this group is a lot more severe than individuals that have not had their immune system compromised in some way.

What to do?

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If you think that you or a loved one may have anal cancer, you need to make an appointment with your doctor immediately.  The sooner that you or your loved one are diagnosed and begin treatment, the better your chances will be to fight cancer. If you have a loved one that has been recently diagnosed with cancer, you want to make sure that you are patient with them and realize that they just got some scary news themselves.  Allow them some time to process the news before you begin asking them a bunch of questions. If you have recently been diagnosed, you should take a few days to process and then tell your friends and family. You do not want to wait to tell your friends and family because you are going to need them in the days to come.  

 

References

https://www.cancer.org/cancer/anal-cancer/about/what-is-anal-cancer.html

https://www.cancer.gov/types/anal/patient/anal-treatment-pdq

https://www.fascrs.org/patients/disease-condition/anal-cancer

 

How are the Stages of Anal Cancer Staged?

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Determining a stage for cancer is a process that doctors use to identify how extensive the spread of the cancer is.  Treatment options and the chances for survival depend on the stage of cancer that you are in. For this reason, it is important to know what stage of cancer you are facing.  Anytime that you are diagnosed with anal cancer, you want to ask about the stage you are in and have the treatment team that you can explain in a way that can be understood. Diagnosis of anal cancer comes from a variety of tests and examinations.  There are several different systems that can be used to determine the stage of anal cancer that you are facing. However, the system commonly used is known as the TNM system. This system is utilized for the tumors found in the anal canal only.

The System

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There are three vital pieces of information that are used in the TNM system for determining the stage of anal cancer that you are in.  The T describes the size of the tumor. The size of the tumor is measured using centimeters. The T is also used to describe if the cancer has hit the organs close to the tumor.  The N is used to describe the extent of the spread regarding lymph nodes nearby. The M indicates if the cancer is metastasized yet. Metastasized means that cancer has reached other organs.  More details about each factor are described by numbers that follow the letters. The numbers zero through four are used to describe the intensity of cancer. If you see the letter X, this means that it cannot be determined because there is no information available now.

T

TX means that the primary tumor is unable to be determined.  T0 means that there is no evidence present to suggest a primary tumor.  This means that the cancer is in the mucosa. The mucosa is the top layer of cells that line the inner anus.  This means that cancer has not spread to deeper layers. T1 means that the tumor that was found measures no more than 2cm across.  T2 means that the tumor measures between two and five centimeters across. T3 means that the tumor measures over five centimeters across. T4 can be related to any size tumor.  This means that the tumor has spread to nearby organs. This can be the urethra, the vagina, the bladder, or even the prostate gland.

N

NX means that the lymph nodes are not assessable now.  N0 means that cancer has not yet spread to the lymph nodes that are nearby.  N1 means that cancer has reached the lymph nodes located around the rectum. N2 means thatcancer has reached the lymph nodes located to one side of the pelvis/groin.  N3 means that cancer has reached the lymph nodes located near the rectum and to the lymph nodes located in the groin/pelvis area. It can also mean thatcancer has reached the lymph nodes on both sides of the groin/pelvis area. 

M

M0 indicates that cancer has not spread.  M1 indicates thatcancer has reached the lymph nodes of your abdomen or that it has reached your internal organs.

Grouping

After the separate categories are assigned, the information is combined to determine a stage of 0-IV.  Each stage coincides with a similar prognosis and is treated accordingly. Lower stages tend to have the best chances of survival than later stages.

STAGE 0

Stage 0 is typically Tis, N0, and M0.  This is an extremely early stage in cancer.  It is also commonly referred to as pre-cancer.  If you are in this stage of anal cancer, it means that the cancer is only located on the top layer of the anal tissue.

Stage 1

Stage 1 is T1, N0, M0.  This means that cancer has typically spread beyond the top tissue layer.  However, the tumor typically measures less than two centimeters across. However, cancer at this stage has not spread to lymph nodes or any distant location.

Stage 2

Stage 2 is typically T2 or T3, N0, and M0.  This is still a relatively early stage. However, cancer has reached nearby organs.  It has not yet reached the lymph nodes or any distant location.

Stage 3 

Stage three is typically broken into two different grouping.  Stage 3 A can be T1-T3, N1, M0 or T4, N0, M0. T1-T3, N1, M0 means that the tumor can be any size.  The tumor has not reached nearby organs but has reached the lymph nodes that are located around your rectum and has not spread to distant sites.  T4, N0, M0 means that cancer has grown into nearby organs but not the lymph nodes or distant sites.  

Stage 3 B is typically either T4, N1, M0 or Any T, N2-N3, M0.  With T4, N1, M0, cancer has grown in the nearby organs and the lymph nodes around your anus.  However, it hasn’t reached distant sites. With Any T, N2-N3, M0 cancer can be any size. It may or may not have grown in the organs nearby.  However, cancer in this group has spread to the lymph nodes in the pelvis, even if it hasn’t reached around the rectum. Cancer has not spread to distant sites at this point.

Stage 4

Stage four is the last stage.  This can be cancer of any size.  It doesn’t matter if it has grown in the nearby organs or nearby lymph nodes.  For it to be stage four cancer, it means that it has spread to distant organs or distant tissues.

Source: imgur.com

 

References:

https://www.cancer.org/cancer/anal-cancer/treating/by-stage.html

http://www.cancer.net/cancer-types/anal-cancer/stages-and-grades

http://www.cancercenter.com/anal-cancer/stages/

http://www.cancerresearchuk.org/about-cancer/anal-cancer/stages-types

http://analcancerinfo.ucsf.edu/staging-and-prognosis

Anal Cancer: What to Ask Your Doctor

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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

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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?

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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.  

 

References:

https://www.cancer.org/cancer/anal-cancer/detection-diagnosis-staging/talking-with-your-doctor.html

http://www.cancer.net/cancer-types/anal-cancer/questions-ask-doctor

https://www.analcancerfoundation.org/living-with-anal-cancer/questions-to-ask-your-doctor/

https://www.cancercare.org/publications/322-after_a_colorectal_cancer_diagnosis_questions_to_ask_your_doctor

 

 

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.

Medical/Physical

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.  

Endoscopy

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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

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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.

Proctosigmoidoscopy

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.

Biopsy

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

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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.  

 

References:

http://www.mayoclinic.org/diseases-conditions/anal-cancer/diagnosis-treatment/diagnosis/dxc-20233236

http://www.mayoclinic.org/diseases-conditions/anal-cancer/diagnosis-treatment/diagnosis/dxc-20233236

http://www.cancerresearchuk.org/about-cancer/anal-cancer/getting-diagnosed/tests-diagnose

https://www.mdanderson.org/cancer-types/anal-cancer.html

https://www.ucsfhealth.org/conditions/anal_cancer/diagnosis.html

Know the Signs and Symptoms of Anal Cancer

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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.

Blood

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.

Lumps

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.  

Pain

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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

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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.  

 

References

http://www.medicaldaily.com/anal-cancer-early-signs-and-symptoms-disease-no-one-talks-about-406240

http://www.cancerresearchuk.org/about-cancer/anal-cancer/symptoms

http://www.macmillan.org.uk/information-and-support/anal-cancer/understanding-cancer/signs-and-symptoms.html

https://www.cancer.org/cancer/anal-cancer/detection-diagnosis-staging/signs-and-symptoms.html

http://www.cancer.net/cancer-types/anal-cancer/symptoms-and-signs

http://www.cancercenter.com/anal-cancer/symptoms/

http://www.medicalnewstoday.com/articles/156549.php

https://thetruthaboutcancer.com/anal-cancer-symptoms-signs/