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Anal cancer is a malignant tumor of the end opening of the gastrointestinal tract. People with a history of this type of cancer in their family are most at risk of developing it. People who engage in unprotected anal sex are also at risk. What are the causes and other risk factors for anal cancer? How do I recognize my symptoms? How is the treatment going? What's the prognosis?

Anal canceris a malignant tumor of the terminal openingof the large intestinethat may be located at the edges of the anus or in the anal canal. In Poland, anal cancer ranks 7th among women and 6th among men in terms of cancer incidence. It most often affects people aged 50-60.

The literature describes the division of anal neoplasms into anal canal cancer and anal marginal cancer that develops within the skin. The most common type of cancer in this area is squamous cell cancer (rectal marginal cancer), but adenocarcinoma (anal canal cancer) is also seen.

It should be noted that rectal cancer is not the same asrectal cancerbecause the anus and the rectum are two different sections of the gastrointestinal tract (the rectum is the final segment of the large intestine, ). As such, they are two different conditions.

Anal cancer - causes and risk factors

The causes of anal cancer are unknown, but risk factors are known. Among them, genetic determinants (family history of the disease) play a major role.

Also some genetic and inflammatory diseases play an important role in the formation of this cancer. These are familial polyposis, Lynch syndrome, Gardner's syndrome, Turcot's syndrome, ulcerative colitis, and Crohn's disease.

Most people diagnosed with anal cancer have also been found to be infected with the human papillomavirus, or HPV (Human Papillomavirus), mainly types 16 and 18. Infection with this pathogen can occur sexually in sexually active people. The risk factors for the development of the neoplastic process within the anus also include anal fistulas and fissures, as well as genital warts.

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Other factors that can contribute to the development of anal cancer include: poor diet (too much alcohol, fat, red meat, low amounts of vegetables and fruits), obesity, smoking.

Anal cancer - symptoms

The disease may be asymptomatic for many years. Only at an advanced stage of development, they may appear:

  • blood in stool
  • rectal bleeding
  • diarrhea and / or constipation
  • feeling of incomplete bowel movement
  • intestinal colic that causes the need to have a bowel movement
  • abdominal and / or perineal pain
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Anal cancer and hemorrhoids (anal varices)

Blood in your stools, rectal bleeding, and a feeling of incomplete bowel movements do not always indicate anal cancer. These types of symptoms are also typical of troublesome, but not life-threatening hemorrhoids (haemorrhoids). However, if additional symptoms appear, such as the changing nature of bowel movements (once diarrhea, once constipated) and abdominal pain, there is cause for concern. It should be remembered that anal cancer and hemorrhoids may coexist, therefore in the event of the appearance of any of the above-mentioned. symptoms, see a doctor as soon as possible.

Anal cancer - diagnosis

The diagnosis of anal cancer involves a doctor examining the area of ​​the anus and a proctological examination -per rectum(i.e. finger examination of the anus). If the doctor finds disturbing lumps, he or she will refer the patient for additional tests, such as rectoscopy and / or colonoscopy with a biopsy sample for histopathological evaluation. However, the most accurate is the pelvic MRI, especially in patients with advanced disease.

Anal cancer - metastases

  • lymphatic vessels

The first symptom of the disease may be a palpable tumor in the inguinal area, which indicates regional lymph node metastases. As a rule, it is a painless lesion, it is shifting in relation to the tissues and skin, and the skin over the enlarged lymph node or the node bundle should not be pathologically changed or excessively warmed. Anal cancer can metastasize through the lymph nodes not only to the inguinal nodes, but also to the pelvis and mesenteric nodes. They are visible during imaging diagnostics using computed tomography methods after prior intravenous administration of a contrast agent and magnetic resonance imaging.

  • blood vessels

Cancer cells enter distant organs through blood vessels. Rectal neoplasms are the most commoncause the formation of new disease outbreaks in the liver, kidneys and bones.

  • adjacent organs

Anal cancer at an advanced stage spreads and affects the local organs, perineal muscles, vagina, urinary bladder and prostate gland.

Anal cancer - treatment

Rectal cancer treatment involves rectal excision. Currently, there are three methods of performing the operation: local excision, anterior resection with sphincters and an abdominocerebral excision with the formation of an artificial anus, i.e. a colostomy - it is a stoma made on the large intestine. During the operation, the doctor guides the large intestine to the surface of the abdomen and places an ostomy pouch on it to allow the contents of the intestine to be excreted. The choice of method depends, among others on the size of the tumor, the distance of the tumor from the edge of the anus and the depth of invasion.

In patients with advanced stages of cancer development, irradiation is usually performed before surgery to destroy the micrometastases and microfocuses of cancer in the lymph nodes. After the surgery, the treatment is supplemented with chemotherapy.

Anal cancer - prognosis

5-year survival in anal cancer patients is around 54%

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Category:

Oncology