Understanding Anal Cancer: Types, Risk Factors, and Symptoms 

Anal cancer is a relatively uncommon form of cancer that affects the tissues of the anus, which is the opening at the end of the digestive tract through which stool exits the body. In the realm of cancer awareness, certain types tend to garner more attention than others. Anal cancer is one such often overlooked entity, but its prevalence and impact on individuals’ lives should not be underestimated. In this article, we delve into the various facets of anal cancer, exploring its types, risk factors, and symptoms.

Types of Anal Cancer

Anal cancer primarily manifests in two main types: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma arises from the cells lining the anus and is the most common type, accounting for approximately 80% of cases. Adenocarcinoma, on the other hand, originates in the glandular cells and comprises the remaining 20%. Though less frequent, adenocarcinoma tends to be more aggressive.

The risk factors for squamous cell carcinoma include persistent infection with certain strains of human papillomavirus (HPV) is a major risk factor for squamous cell carcinoma. Other risk factors include engaging in receptive anal intercourse, a weakened immune system, smoking, and a history of certain sexually transmitted infections.

The risk factors for adenocarcinoma include a history of anal fistulas or fissures, inflammatory bowel disease, and conditions that affect the glands in the anal region.

Risk Factors 

Understanding the key risk factors associated with anal cancer is important for early detection and prevention. Key risk factors include:

HPV Infection: Persistent infection with certain high-risk strains of HPV is a primary risk factor for anal cancer.

Sexual Practices: Engaging in receptive anal intercourse increases the risk of anal cancer.

Weakened Immune System: Individuals with a weakened immune system, such as those with HIV/AIDS, have an elevated risk.

Smoking: Smokers are at a higher risk of developing anal cancer compared to non-smokers.

History of STIs: A history of sexually transmitted infections, especially those affecting the anal region, can contribute to the development of anal cancer.

Symptoms of Anal Cancer

Recognizing the symptoms of anal cancer is necessary for early diagnosis and improved treatment outcomes. Common signs include:

Rectal Bleeding: One of the earliest signs is often bleeding from the rectum, which may be visible in the stool or on toilet paper. While bleeding can result from various conditions, persistent or unexplained bleeding demands medical attention.

Changes in Bowel Habits: Individuals may experience changes in bowel habits, such as persistent diarrhea or constipation. These changes may be accompanied by discomfort during bowel movements.

Anal Pain or Discomfort: Pain or a feeling of fullness in the anal region can be indicative of anal cancer. This discomfort may intensify during bowel movements or while sitting.

Lumps or Masses: A palpable lump or mass near the anus may signal the presence of a tumor. Any unusual growth should be promptly evaluated by a healthcare professional.

The treatment for anal cancer typically involves a combination of therapies and is tailored to the specific characteristics of the cancer, such as its type, stage, and location. The primary treatment modalities for anal cancer include surgery, radiation therapy, and chemotherapy. The choice of treatment depends on factors like the size of the tumor, its extent of spread, and the overall health of the patient.

In conclusion, though often overshadowed by more prevalent cancers, anal cancer demands attention due to its impact on affected individuals. Understanding the types, risk factors, and symptoms is crucial for early detection and successful management. Regular screenings, vaccination against HPV, and lifestyle modifications, such as smoking cessation, play key roles in preventing anal cancer. By ensuring all the necessary steps are followed, we can strive towards a future where anal cancer is not only treatable but preventable.

DR K P RANGANATH, CONSULTANT – RADIATION ONCOLOGIST, HCG CANCER CENTRE, VIJAYAWADA