Cancer occurs when cells in our body multiply out of control, producing lots of abnormal cells. These abnormal cells don't function like the cell should and can invade tissues or organs and can sometimes spread to other parts of the body. Anal cancer is cancer that is in the anus, which is the last few centimetres of the bowel and connects the bowel to the outside of the body (the last part your stool passes through the anus when you go for a poo). It is not a common cancer, however HPV (human papillomavirus) infection increases your risk of developing anal cancer. HPV is a virus passed on through sexual intercourse. Most people will be infected with HPV infection in their lifetime and the majority will not develop anal cancer. Both HPV infection and anal cancer are more common in people who have anal sex with a lot of different partners, those who smoke, those with a lowered immune system, or those who have had cervical or vaginal cancer. The most common symptoms of anal cancer are bleeding, pain, itching, discharge and faecal incontinence (losing the ability to control when you poo). There are many more common causes of bleeding, pain and itching symptoms that are not anal cancer, so please don’t be worried if you have symptoms. We should be clear, that anal cancer is rare. More subtle signs of cancer can be unexplained tiredness or loss of weight, night sweats or pain in your bones.
There are 4 different stages that cancers are usually defined by, depending on the size of the mass, and whether it has spread from where it originally started, and if so how far it has spread. These are used to guide what treatment would be best. Stage 1 is when the cancer is small and has not spread anywhere. Stage 2 is when the cancer is larger but hasn't spread. At Stage 3 the cancer is larger and has spread to areas close by. Stage 4 is when the cancer has spread to other parts of the body and is known as metastatic cancer. There are many ways of treating cancer and what is chosen will depend on the area it is in, the stage of the cancer and the patient’s choice and wishes. The options range from surgery (where all or part of the cancer is removed via a surgeon cutting it out), chemotherapy (which is strong medication aimed to kill cancer cells and stop them multiplying) and radiotherapy (which uses radiation targeted at the cancer cells in order to kill them). Treatment could be one or a combination of these and the aim may be to cure the cancer or to improve quality of life by shrinking the cancer to improve symptoms.
You should see your doctor if you have new symptoms around the anus, or if you have unexplained general symptoms of tiredness or significant unexplained weight loss. You should book to see your doctor straight away if you notice blood in your poo, discharge or pain from your anus, you have severe pain or you develop faecal incontinence.
The doctor will ask about your symptoms and how long you have been experiencing them, your medical history and your family's medical history. With your permission, they will examine your abdomen and your anus. They may need to put their gloved finger into your anus to feel for any lumps. They may also do blood tests and refer you for further scans or tests.
The ability to work will depend on your symptoms: your doctor will help to decide whether you are fit for work, or if there are any modifications that would benefit you.