Cancer of the anus - is a malignant disease of the intestine , which is quite rare. The most common type of anal cancer by histological structure is squamous, rarely observed basal cell carcinoma, adenocarcinoma, and melanoma. This information is devoted to the squamous cell carcinoma.
The anus is an external opening of the rectum, the closed annular muscle. Zone connecting the anus to the rectum, called the anal canal, a length of about 3-4 cm.
Possible causes and risk factors for anal cancer
The disease is most often diagnosed in women. Certain factors may increase the risk of its development.
Human papillomavirus (HPV)
Anal cancer in most cases occurs in people, which is present in the body of this viral infection. The probability of contracting HPV increases with the number of sexual partners.
People who have anal sex, more likely to develop this type of cancer. This is probably associated with an increased risk of infection with human papillomavirus.
The immune system protects the body against infection and disease. Cancer of the anus is more common in people who have a reduced immune system, for example, those who take drugs to suppress the immune system after organ transplants or suffer from HIV.
This habit increases the risk of anal cancer.
Although these factors can increase the likelihood of the disease, but there are cases when those who are ill with anal cancer do not have a database of causes and risk factors.
Symptoms of anal cancer
The most common symptoms of the disease include:
- bleeding from the anus;
- pain, discomfort and itching around the anus;
- small swelling, which is sometimes confused with hemorrhoids;
- fecal incontinence;
- sores that may spread to the skin of the buttocks.
Diagnosis of anal cancer in the Assuta
First, the doctor will make inspection, will collect history. Then follows a number of other diagnostic procedures.
For suspected cancer of the anus is performed a digital rectal examination. Women can also assign inspection of the vagina, as its walls are adjacent to the anal canal.
During the procedure, the doctor uses a special proctoscopy endoscopic instrument by inserting it into the rectum to examine the anal canal and rectum. Tumor sample is extracted for further studies on the presence of abnormal cells. It can be used general or local anesthesia. Sometimes just biopsy without proctoscopy.
These tests show whether cancer of the anus is. Further studies will be needed to find out more about the location and spread of malignancy in the body.
Computed tomography using X-rays, creates detailed images of internal body cavities. Procedure for anal cancer is painless, lasts for ten to thirty minutes. The amount of radiation is very low, so it is unlikely that it will cause any harm. At least four hours prior to the test will need to refrain from the use of liquids and food.
Contrast agent can be used to better display, it is given as an injection or beverage. Advance physician reported information, if you are allergic to iodine or asthma, as there may be a serious reaction to the contrast.
This type of diagnosis is similar to CT, but uses a magnetic field instead of X-rays to build a detailed picture of areas of the body. Before the procedure, the patient presented with a list of questions to be answered and sign for safety MRI for a patient.
Before scanning removes any metal objects. Sometimes appointed contrast injection in arm, through which the image acquire greater clarity. Diagnosis of cancer of the anus extends for about thirty minutes.
This combination PET scan, which employs low doses of radiation for measuring activity of cells in different parts of the body, and computerized tomography. This method of diagnosis in anal cancer provides more information and is only required in some cases.
To create the image, this method uses sound waves. A small probe is introduced into the rectum. This test will show in anal cancer tumor size and the area of its distribution. It takes about thirty minutes.
anal cancer stage
The term "stage" describes the size of malignancy and proliferation process beyond the initial focus. This information is necessary for the development of optimal treatment for cancer of the anus.
Malignant cells spread through the body or through the blood or lymphatic system. The latter helps protect the body against infection and disease. Doctors Be sure to check with a tumor located near the lymph nodes.
Struck only the anus, there is no distribution on the sphincter muscle, the tumor size of less than 2 cm.
Malignant neoplasm for more than 2 cm, the nearby lymph nodes or other parts of the body affected by the pathological process.
Anal cancer has spread to lymph nodes near the rectum or to nearby areas organs such as the bladder or vagina.
The disease struck the lymph nodes in the groin and pelvis, around the anus and nearby organs.
Malignant cells infiltrated lymph node in the abdomen or other body parts, such as the liver.
Another TNM system is sometimes used for anal cancer, instead of the above.
- T - it indicates the size of the tumor and spread it to nearby organs.
- N - the penetration of malignant cells in the lymph nodes.
- M - the defeat of other parts of the body such as the liver (secondary or metastatic cancer).
This system is more complex and can give more accurate information about the stage of cancer of the anus.
Graduation for appearance of pathological cells in considering them under the microscope and gives an idea of how quickly disease can develop. low-risk tumor means that the abnormal cells are very similar to healthy. In general, they develop slowly and is less likely to spread. Cells in high-risk tumors appear abnormally, and, most likely, will be faster to develop and grow throughout the body.
anal cancer treatment at Assuta
For best results, treatment should be supervised by a team of specialists. highly professional services of doctors offering Assuta Hospital.
The main method of treatment of anal cancer - a combination of radiation and chemotherapy (chemoradiotherapy). Two procedures are usually given at the same time, but sometimes in one sequence after another. Combination therapy is usually very successful, but the side effects may be more severe.
Surgery is prescribed for smaller tumors and in combination with cytotoxic drugs or radiation treatment for advanced anal cancer.
Radiation therapy in the treatment of anal cancer
This type of therapy uses high energy rays to destroy abnormal cells, causing the least possible damage to healthy areas. Applied external radiation therapy for anal cancer. Held a short, daily routines every weekday, and their duration is a few minutes. The total course of treatment in Israel lasts about a month and a half.
Potential side effects during radiotherapy anal cancer
Diarrhea and flatulence
During therapy, undesirable changes in bowel habits. Sometimes it provides for exclusion of certain foods. A doctor or dietitian in a hospital Assuta will give advice on this matter.
Perhaps, in the treatment will be painful, blisters - around the anus, and probably in the scrotum in men and vulva - women. Symptom develops within 2-3 weeks after initiation of therapy of cancer of the anus. Are appointed painkillers to alleviate these symptoms.
Doctors give advice on skin care. It will be important to use the recommended products. In severe pain during urination the bladder catheter to drain urine. It is removed after the skin heals.
Often there is loss of hair in the pubic area. After completion of the irradiation of anal cancer they grow, but sometimes it does not.
Fatigue is noted quite often in patients. Vacation, a short walk brings some benefit.
In women during anal cancer irradiation sometimes observed dryness and narrowing of the vagina. Perhaps in the future we will have to use a lubricant during sex. It may be recommended the use of the vaginal extender with a lubricant in order to keep open the walls of the vagina. The doctor will give more information on this subject.
Once treatment of anal cancer is finished, the above side effects is gradually reduced. To disappeared skin reactions, it may take several months. For some people, change in bowel habits become long-term, but mostly they are not heavy. To cope, you may need the drug. It is important to discuss the existing problems with the doctor, as often there are ways to reduce them.
Potential side effects after exposure anus cancer
Irradiation can cause infertility. If it is important for the patient to talk with a specialist before starting treatment.
Radiation therapy is a cancer of the anus is able to trigger early menopause in women, causing hot flushes and sweating. The doctor will give advice on managing symptoms.
There is a possibility of impotence after irradiation with anal cancer. However, there are different ways of correcting this side effect, so it is important to inform the specialist.
Chemotherapy for anal cancer in Assuta
This method is used cytotoxic drugs in the fight with cancer, they are administered intravenously, usually. For the treatment of anal cancer is usually administered mitomycin and fluorouracil (5-Fu). Sometimes fluorouracil replace capecitabine.
Possible side effects of cytostatic treatment of anal cancer
If the reduced number of red blood cells in the blood, there is fatigue, malaise. You may need a blood transfusion. By reducing the number of platelets increases the chance of bleeding and hematoma.
Vomiting and nausea
This common adverse effects of treatment of anal cancer may prescribe drugs to reduce symptoms.
Taking certain cytostatics causes temporary hair loss. The doctor at the clinic Assuta describe in detail, whether prescribed medications lead to this phenomenon. It gives detailed information on how to cope with it.
Inflammation in the mouth
Chemotherapy drugs can provoke inflammation, ulcerations in the mouth. Medical personnel will train special care.
Loss of appetite, changes in taste
Sometimes there are changes in taste sensations and loss of appetite. It is important to supplement the diet of nutritious drinks or soups. Will benefit consulting a nutritionist, one of the specialists treating patients at the clinic Assuta team.
Surgical method for the treatment of anal cancer in Israel
Operation at low applied malignancies, in the palliative treatment or recurrence of disease, and also if there are contraindications for radiotherapy (previously carried out).
Performed with small tumors on the outside of the anus. During the operation, the affected area is removed. The sphincter is usually not affected, so the work of the intestine remains intact. Physicians in the clinic Assuta postoperative irradiation may sometimes recommend or chemoradiotherapy.
BPE in the treatment of anal cancer
Abdominoperineal extirpation of the rectum involves the removal of the anus and rectum. The operation requires the creation of a permanent stoma - artificial opening in the abdominal cavity, through which the waste will be excretion from the body.
Although the establishment of the stoma for cancer of the anus scares and upsets, but most patients adapt with time and return to normal life. Support, advice, guidance will provide the hospital.
Surgery to relieve symptoms
Sometimes you may need an operation to form a temporary stoma before chemoradiotherapy for anal cancer. It can help relieve symptoms if the disease was the cause of urinary incontinence, bowel obstruction or significant pain.
After completion of treatment of cancer of the anus will need constant supervision for 5-10 years.