Anal cancer treatment depends on what type of cancer it is and how far it’s spread. The most common treatments include surgery to remove early-stage anal cancer; a combination of chemotherapy and radiation therapy (chemoradiation) for most stage two or stage three anal cancers; abdominoperineal resection (a surgical procedure performed when cancer hasn’t responded to other treatments) or chemotherapy and/or immunotherapy for those with stage four anal cancer.
Early-stage cancer that hasn’t entered your anal wall can be treated by removing the affected skin entirely. Even some smaller tumors (under one-half inch in size) that have grown into the anal wall can be removed surgically. These smaller tumors usually don’t require further treatment with radiation or chemotherapy. This surgery is called local excision.
Chemotherapy uses drugs to kill cancer cells. Some chemotherapy can be taken by mouth, while other drugs must be given through your vein or as a shot into your muscle.
Radiation therapy uses equipment that focuses high-energy X-rays or particle streams at cancer cells in your body.
Chemotherapy and radiation therapy work together for optimal effectiveness. (This approach is called chemoradiation.) Your healthcare provider will tailor your treatment plan according to your specific needs.
There’s a surgical treatment called abdominoperineal resection (APR). APR removes cancer cells in your anus, rectum and large intestine by cutting into your abdomen. APR might also remove lymph nodes that have become cancerous. APR is used when the cancer doesn’t respond to other methods or if the cancer comes back. If you have APR, you’ll need to have a permanent colostomy. In this case, part of your colon is taken out and the remaining part opens into the stoma on your abdomen. The stoma is covered by a pouch so stool (poop) can exit your body.
Your healthcare provider may recommend immunotherapy with or without chemotherapy to ease symptoms in those with stage four anal cancer. Immunotherapy uses medications to boost your own immune system so it can fight cancer cells more effectively.