Anal cancer is a squamous cancer, or a cancer of the skin-like cells of the anal canal or perianal skin. It occurs in the anus, the area at the end of the digestive tract below the rectum. The rectum is where the stool (feces) is stored, while the anus is the opening through which the stool leaves the body. Anal cancer happens when cells start to grow abnormally in the anus.

Anal cancer is rare, accounting for just one to two percent of gastrointestinal (GI) cancers. Many cases of anal cancer can be found early because the cancer forms in an area that physicians can see and reach easily.

Most cases of this cancer result from human papillomavirus (HPV), a common infection that spreads through sexual contact. Getting an HPV vaccine can lower your risk of developing anal cancer. It’s best to get the vaccine before you become sexually active, though you can get the vaccine later. Talk to your doctor about whether the vaccine makes sense for you.

Anal cancer is treated by gastroenterologists, medical oncologists, colorectal surgeons, and radiation oncologists. The GI cancer experts at Penn Medicine lead the nation in anal cancer treatment. Our team approach translates to exceptional care and dedication to finding the right treatments for you.

Symptoms of anal cancer

Anal cancer can be mistaken for hemorrhoids because some symptoms, like bleeding, are similar. Sometimes there are no symptoms at all.

Symptoms of anal cancer can include:

• A lump or mass at the anal opening
• Bleeding from the rectum or anus
• Change in bowel movements
• Straining during a bowel movement
• Itching in the anus or discharge
• Mucous or pus discharge from the anus
• Narrowing of the stools
• Pain or pressure around the anus
• Swollen lymph nodes in the groin or anus

Navigating a cancer diagnosis can be difficult. Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing anal cancer. Once you receive a precise diagnosis, your care team can create the best treatment plan for you.

Treating anal cancer

The main treatment for anal cancer is a combination of chemotherapy and radiation, but the treatment depends on the tumor’s location, type of tumor, and extent of spread (stage). Cancer that begins in the anal canal may require different treatments than cancer that begins in the perianal skin.

Reducing your risk for anal cancer

While cancer cannot be totally prevented, you can significantly reduce your risk for anal cancer with preventative measures like quitting smoking, avoiding unprotected anal intercourse, and using condoms to prevent HIV or HPV infection. If you feel you are at risk, you may benefit from consulting with a risk assessment specialist within Penn Medicine’s Gastrointestinal Cancer Risk Evaluation Program.

Why choose Penn Medicine?

Anal cancer is a rare disease that requires specialized expertise. When you choose Penn Medicine for anal cancer care, you can expect:

• Highly skilled experts: Our board-certified doctors and surgeons have subspecialty fellowship training in treating anal and similar cancers of the digestive tract. Our experts follow evolving cancer research and participate in a wide range of clinical trials, offering options for advanced disease.
• Precise diagnosis: Our doctors treat more anal cancer patients than many other centers, so we have a high level of expertise in diagnosing this rare disease. Our pathologists specialize in GI cancer, ensuring an accurate diagnosis that helps guide our team to the right treatments for you.
• Leading treatment options: We offer the latest anal cancer therapies, including cancer drug innovations such as targeted therapy, immunotherapy, and the latest radiation treatments.
• Team approach: Cancer affects everyone differently. At Penn Medicine, your treatment is coordinated by medical oncologists, colorectal surgeons, and radiation oncologists who collaborate on your treatment plan. A wealth of expertise goes into every recommendation we make.
• One-on-one support: Our GI oncology nurse navigators help you get seen by the appropriate specialists quickly, coordinate appointments, and guide you through the treatment process.
• Trusted care, close to home: You’ll receive expert anal cancer care at convenient locations in the southeastern Pennsylvania and New Jersey area.