Anal Cancer

Overview

Anal cancer is a rare type of cancer that starts in the cells of the anus — the opening at the end of the digestive tract where stool leaves the body. It develops when cells grow out of control and form a tumor.

Anal cancer is uncommon compared to other cancers. In the UK, around 1,500 people are diagnosed each year.

It can affect anyone, but it is more common in adults over 50, and in people with certain risk factors such as HPV infection or a weakened immune system.

Symptoms

Common symptoms

• Rectal bleeding
• Pain or pressure in the anus
• Itching around the anus
• A lump or mass near the anus
• Changes in bowel habits, such as narrow stools
• Discharge from the anus
• Swollen lymph nodes in the groin

Symptoms in children

• Anal cancer is extremely rare in children. Symptoms like bleeding or a lump are more likely due to other causes, but any persistent concern should be evaluated by a doctor.

Symptoms in older adults

• Symptoms are similar to those in other adults, but they may be mistaken for hemorrhoids or other benign conditions. Persistent or worsening symptoms should always be checked.

Causes

Main causes

• Most anal cancers are linked to human papillomavirus (HPV) infection.
• Long-term smoking is a known cause.
• A weakened immune system, such as from HIV or after an organ transplant, increases risk.

Risk factors

• HPV infection
• Smoking
• Having a weakened immune system
• Being over age 50
• Having many sexual partners or receptive anal sex

When to see a doctor

See a doctor urgently if:

• If you have new rectal bleeding, persistent anal pain, or a lump near the anus, see a doctor within a few days.

Book a routine appointment if:

• If you have mild but persistent symptoms like itching, discharge, or changes in bowel habits lasting more than two to three weeks, make a routine appointment.

Diagnosis

A doctor will ask about your symptoms, examine the area, and may refer you to a specialist. A small tissue sample (biopsy) is usually needed to confirm whether cancer is present.

Tests that may be done

• Digital rectal exam
• Anoscopy or proctoscopy
• Biopsy
• MRI or CT scans to check for spread

What to expect at your appointment

The examination may feel uncomfortable but is quick. You will usually get results within a few weeks. If cancer is found, your care team will explain the next steps clearly.

Treatment

Treatment depends on the stage and type of anal cancer, as well as your overall health. The main treatments are radiotherapy, chemotherapy, and surgery.

Self-care at home

• Keep the anal area clean and dry.
• Use a cushion or ring pad to sit more comfortably.
• Talk to your doctor about managing pain or skin irritation.
• Avoid using over-the-counter creams without medical advice.

Medical treatments

Most anal cancers are treated with a combination of chemotherapy and radiation therapy to shrink or destroy the tumor. This approach often preserves the anus. If that does not work or the cancer is advanced, other therapies may be offered. Your team will explain the options and manage side effects.

When is surgery considered?

Surgery may be used if the cancer is very small or if other treatments have not worked. It usually involves removing the cancer and sometimes part of the anus or rectum.

Living with this condition

You will have regular follow-up appointments to monitor your recovery. It is normal to feel tired during treatment, so rest when you need to and ask your care team about managing side effects like skin irritation or bowel changes.

Lifestyle tips

• Avoid smoking and limit alcohol.
• Stay active as you feel able, but rest when needed.
• Keep a healthy routine to support your recovery.

Diet and exercise

Eat small, frequent meals if you have digestive symptoms. Include high-fiber foods if your doctor advises, and drink plenty of water. Gentle exercise like walking can help maintain energy and well-being.

Mental health and emotional wellbeing

A cancer diagnosis can be stressful and may affect your mood, body image, and relationships. Feeling anxious or low is normal. Talk to your care team about counseling or support groups.

Prevention

Not always, but you can reduce your risk by avoiding HPV infection, stopping smoking, and maintaining a healthy immune system.

Vaccines

HPV vaccination is available in many countries. Ask your healthcare provider if it is recommended for you or your children.

Screening programmes

There is no standard anal cancer screening for everyone, but people at high risk (such as those with HIV or prior HPV-related conditions) may be offered regular exams. Ask your doctor.

Complications

If left untreated

• The cancer can grow deeper into surrounding tissues.
• It can spread to lymph nodes or other organs.
• It can cause severe bleeding, bowel blockage, or infection.

Long-term outlook

Anal cancer is often treatable, especially when caught early. Many people are cured with treatment, and medical teams work hard to preserve quality of life. Your specific outlook depends on many factors, so ask your care team for honest and hopeful information about your situation.

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