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The main types of treatment used for anal cancer are a combination of radiotherapy and chemotherapy, which may be given at the same time or following one another. This combination of treatment is usually very successful. Surgery is not often used as the first choice of treatment for anal cancer. Radiotherapy
High-energy rays are used to destroy cancer cells, while doing as little harm as possible to normal cells. The treatment is often given for a few minutes each weekday for several weeks. During the treatment period you may have changes in your bowel function such as diarrhoea, or passing wind: these side effects can sometimes be reduced by avoiding particular foods. CancerBACUP's section on diet and the cancer patient contains more information about this. Towards the end of the treatment period you may have blistering and soreness of the skin around the anal area, and possibly in the groin areas too. Extreme tiredness, or fatigue, is a common side effect of radiotherapy too. These side effects usually decrease gradually once the treatment has ended, but it may take some months for skin changes to go back to normal. A small proportion of people find that their bowel function is permanently altered, and it is important to discuss this with your doctor as it is often possible to find ways of reducing any problems. Your doctor or a dietitian at the hospital can give you advice. Other potential side effects that can occur after radiotherapy for anal cancer include narrowing of the vagina (vaginal stenosis), and dryness. To help prevent this, women will be asked to use a vaginal dilator with a lubricating jelly to keep the vaginal walls open and supple. Some women may also need to use lubricating jelly during sexual intercourse. Infertility can also be a side effect of radiotherapy. If you are concerned about your risks of being infertile following treatment, it is a good idea to discuss this issue with your specialist before starting.
Chemotherapy
This is the use of anti-cancer drugs to destroy cancer cells. The chemotherapy drugs are usually given by injection into a vein (intravenously). They can temporarily reduce the number of normal cells in your blood. When your blood count is low you are more likely to get an infection and you may tire very easily. During chemotherapy your blood will be tested regularly and, if necessary, you may be given antibiotics to treat any infection. Blood transfusions may be given if you become anaemic due to chemotherapy. Other side effects may include feeling sick (nausea) and vomiting. If you do feel sick you might find our section on controlling nausea and vomiting helpful. Some chemotherapy drugs can also make your mouth sore and cause small mouth ulcers. Regular mouthwashes are important and your nurse will show you how to use these properly. If you don't feel like eating meals, you can supplement your diet with nutritious drinks or soups. A wide range of drinks is available and you can buy them at most chemists. You can ask your doctor to refer you to a dietitian for advice about your diet. Surgery
Surgery may be used if initial treatment does not completely get rid of the cancer, or if there are signs that your cancer has returned. There are two main types of surgery: local resection and abdominoperineal resection. Local resection
This may be used for small tumours on the outside of the anus. This operation only removes the area of the anus containing the cancer cells. The muscle that opens and closes the anus to allow the faeces to be passed normally is not usually affected, and so normal bowel function is maintained for most people. Abdominoperineal resection
This is the removal of the anus and rectum. This operation requires a permanent colostomy, which involves diverting the open end of the bowel on to the surface of the abdomen (tummy area), to allow faeces to be passed out of the body into a colostomy bag. The opening on the abdominal wall is known as a stoma. |
