Overview
Anal cancer is a rare type of cancer that affects the anus.
The anus is where your bowel connects to the outside of your body (the bottom).
Anal cancer can start in any part of the anus.
How serious anal cancer is depends on where it starts, how big it is, if it spreads and your general health.
Get your symptoms checked
It's important to get any symptoms of anal cancer checked as soon as possible. Finding it early can make it more treatable.
Symptoms
Symptoms of anal cancer can include:
- bleeding from the bottom
- itching and pain around the anus
- small lumps around and inside the bottom
- a discharge of mucus from the bottom
- having problems controlling when you poo (bowel incontinence)
- needing to poo often with looser, runnier poos
Anal cancer may have no symptoms at all, or they might be hard to spot.
Anal cancer symptoms are often similar to piles (haemorrhoids) and anal fissures, which are common and less serious conditions.
See a GP if you:
- have symptoms of anal cancer
- notice a change around your anus that is not normal for you
Important
Having these symptoms does not definitely mean you have anal cancer. But it's important to get them checked by a GP.
This is because if they're caused by cancer, finding it early makes it more treatable.
What happens at the GP appointment
The GP will ask you some questions about your health and your symptoms.
They may feel your tummy and insert a gloved finger into your bottom to feel for lumps or anything wrong.
After the GP examines you, they may refer you to see a specialist in hospital if they think more tests are needed.
You'll receive an appointment, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.
Find out more
Cancer Research UK: seeing a GP about symptoms of anal cancer.
Who can get it
Most anal cancers are caused by an infection called human papillomavirus (HPV).
You can get HPV from:
- any skin-to-skin contact of the genital area
- vaginal, anal or oral sex
- sharing sex toys
Anal cancer is rare. Most people affected by HPV will not develop cancer.
You may be more likely to get anal cancer if you:
- have anal sex
- are over the age of 75
- smoke
- have had cervical or vaginal cancer
- have a weakened immune system, such as from HIV or an organ transplant
How to reduce your risk of getting anal cancer
You cannot always prevent anal cancer. HPV vaccination is one of the best ways to protect against anal cancer.
All children aged 12 to 13 are offered the HPV vaccine. It helps protect against cancers caused by HPV, as well as genital warts.
There are also healthy changes you can make to lower your chances of getting anal cancer.
Do
- use a condom when having sex to lower your chances of getting HPV
- keep sex toys clean and do not share them
- try to quit smoking
Get your symptoms checked
It's important to get any symptoms of anal cancer checked by a GP.
Anyone can get anal cancer, even if you do not think you have a higher chance of getting it.
Find out more
Cancer Research UK: seeing a GP for symptoms that could be caused by anal cancer
Tests and next steps
You might have some tests and scans to check for anal cancer if a GP refers you to a specialist.
The tests you have will depend on your symptoms.
The tests may include:
- putting a thin tube with a camera and light into your bottom to check for any changes
- taking a small sample from your anus (biopsy) so it can be looked at in a laboratory under a microscope
- blood tests
Read more about tests to diagnose anal cancer on Cancer Research UK.
Getting your results
You should get the results of your tests within a few weeks
Try not to worry if your results are taking longer than you expected. You can call the hospital or GP if you're worried. They should be able to update you.
A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.
Get support when testing for cancer
You may be feeling anxious about what your results may be.
If you're concerned or need support before and after your test, you may find it useful to talk to:
You can also read more information and advice on coping with anal cancer on Cancer Research UK.
If you're told you have anal cancer
Being told you have anal cancer can feel overwhelming. You may be feeling anxious about what will happen next.
It can help to bring someone with you to any appointments you have.
A group of specialists will look after you throughout your diagnosis, during and after treatment.
Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.
You can ask them any questions you have.
Important
Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.
They're there to listen if you have anything you want to talk about.
Call: 0808 808 00 00
Next steps
If you've been told you have anal cancer, you may need some scans.
These, along with the tests you've already had, will help the specialists find out the size of the cancer and how far it has spread (called the stage).
Cancer Research UK has more information about?what cancer stages and grades mean.
The specialists will use the results of these tests and work with you to decide on the best treatment plan for you.
Find out more
Macmillan Cancer Support: information and support if you've just been diagnosed with cancer
Treatment
Anal cancer is often treatable when found early.
The treatment you have for anal cancer will depend on:
- the size of the cancer
- where it is
- if it has spread
- your general health
The main treatment for anal cancer is a combination of radiotherapy and chemotherapy, called chemoradiation (or chemoradiotherapy).
Other treatments include chemotherapy or radiotherapy on their own, and surgery.
The specialist care team looking after you will:
- explain the treatments, benefits and side effects
- work with you to create a treatment plan that is best for you
- help you manage any side effects, including any changes to your diet
You'll have regular check-ups during and after any treatments. You may also have tests and scans.
If you have any symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your next check-up.
Chemotherapy and radiotherapy
To treat anal cancer, chemotherapy and radiotherapy are often used together. This is often called chemoradiation.
Radiotherapy uses high-energy radiation to kill cancer cells.
Chemotherapy is medicine taken to kill cancer cells.
Chemoradiation is usually given if anal cancer has not spread. It means most people with anal cancer do not need to have surgery.
Find out more
Macmillan Cancer Support: chemoradiation for anal cancer
Surgery
Surgery is sometimes used to treat anal cancer.
You may have surgery if:
- the cancer is small and has not spread
- chemoradiation does not get rid of all the cancer, or it comes back
- you are not able to have radiotherapy, for example if you've had radiotherapy in the pelvic area before
Surgery for anal cancer usually involved removing just the part of the anus that is affected.
If the cancer has spread or come back, surgery may involve removing all of the anus, the rectum (which joins the anus to the bowel) and part of the bowel.
This means you'll need to have a pouch (stoma bag) fitted to the outside of your body to collect poo. This is called a colostomy.
If you need a colostomy, you'll be looked after by a specialist stoma nurse. They'll be able to offer you support.
Find out more
Care after your treatment
The clinical nurse specialist, or another member of your specialist team will be able to give you information on follow-up care after treatment.
It may also help to get support from family, friends or a support organisation, if you get anxious before or between appointments.
Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.
They're there to listen if you have anything you want to talk about.
Call: 0808 808 00 00
You can also read more about living with anal cancer on the Cancer Research UK website
Getting help
You and your loved ones will be supported throughout your treatment by a group of specialists.
The clinical nurse specialist, or another member of your specialist team will be able to give you information on local support services that you may find helpful.
There are also national cancer charities that offer support and information about anal cancer.
Macmillan Cancer Support
Information and support for anyone affected by cancer.
Cancer Research UK
Information and support for anyone affected by cancer.
Anal Cancer Foundation
Information and support for anyone affected by anal cancer.
The information on this page has been adapted by NHS Wales from original content supplied by 
NHS website nhs.uk
Last Updated:
18/11/2022 10:56:18