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Anal cancer is rare, much more so than bowel and rectal cancers. 90% originate from the lining of the anal canal comprised of cells more like the skin surrounding the anal canal than those that line the rectum and the rest of the bowel.
10% of anal cancers are of a similar cell type to those of cancers of the rectum and are treated similarly with surgery and or radiotherapy. Very rarely malignant melanoma is found in the anal canal. It is found equally in men and women most commonly in the fifth and sixth decades.
The causes of anal cancer are largely unknown but there are strong associations with the presence of Human Papilloma Viruses (which cause genital warts and cervical cancer) and the HIV virus.
Symptoms of Anal Cancer
- Mucous Discharge
Once the diagnosis is made (by determining the type of abnormal cell involved) usually by biopsy under general anaesthetic, anal cancer is treated for cure with a combination of chemotherapy and radiotherapy. Rarely very small anal cancers that can be completely removed with surgery without injuring the anal sphincter do not need such treatment.
Usually surgery is reserved for tumours that do not fully respond to this chemo/ radiotherapy treatment or those that return after initial success. Surgery is with Abdomino-perineal Resection of the rectum.
Over 90% patients completely respond to treatment without surgery. Overall 5 year survival is of the order of 60%.