An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat anal cancer.
Navigating a cancer diagnosis and treatment options can be difficult. Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing anal cancer.
How is anal cancer diagnosed?
You’ll first meet with a gastroenterologist who’ll ask you about your symptoms and perform an exam. They’ll ask about your health, including past illnesses, treatments, and lifestyle habits. Since anal cancer is often linked to the human papillomavirus (HPV), they might also ask if you’ve gotten the HPV vaccine or been exposed to HPV.
Next, your doctor will do a physical exam to check the lymph nodes in your groin for swelling. They’ll also conduct a digital rectal exam. This means they’ll gently insert a lubricated, gloved finger into your rectum to feel for any lumps or other problems. If you are a woman, or assigned female at birth, your doctor may also do a pelvic exam. If any abnormalities are found, they might take a small sample of tissue or fluid (a needle biopsy).
To get a closer look inside your anal canal, your doctor might also do a test called an anoscopy. During the procedure, a thin, lighted tube called an anoscope is gently inserted a few inches into your anus. If the doctor sees anything unusual, they can take a tiny sample of cells using a swab. This sample is then examined under a microscope by a pathologist to see if there are any abnormal cells.
Staging anal cancer after the diagnosis
If tests show you have anal cancer, your doctor may run more tests to see how big the cancer is and if it has spread anywhere else. This is called staging. Staging helps doctors figure out the best anal cancer treatment plan for you. Knowing the stage of your cancer helps you make decisions about what treatment is right for you.
The stages of anal cancer include:
- Stage 0: Also known as carcinoma in situ, abnormal cells are found only in the innermost layer of the anus. These abnormal cells aren’t cancerous but may become cancerous.
- Stage I: Cancer cells have formed a tumor that measures 2 centimeters or less. It has not spread to nearby lymph nodes or to other parts of the body.
- Stage IIA: The cancer is between 2 and 5 centimeters across. It has not spread to nearby lymph nodes or to other parts of the body.
- Stage IIB: The cancer is no more than 5 centimeters across. It has spread to lymph nodes near the rectum but not to other parts of the body.
- Stage IIIA: The cancer is 5 centimeters or smaller and has spread to lymph nodes in the anus and groin.
- Stage IIIB: The cancer is any size and has spread to nearby organs and lymph nodes near the rectum. It has not spread to nearby lymph nodes or to other parts of the body.
- Stage IIIC: The cancer is any size and is growing into nearby organs. It has spread to lymph nodes near the rectum but not to other parts of the body.
- Stage IV: The cancer has spread (metastasized) from where it started to the lymph nodes, nearby organs, and distant parts of the body.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.