ANAL CANCER - Information and Treatment

GHS - Anal cancer is a dangerous disease (cancer) cells form in the tissues of the anus.

Anal cancer

The anus is the final part of the large intestine, below the rectum through which stool (solid waste) to exit from the body. The anus is formed partly from the outer layer of the skin of the body and partly from the intestine. Two ring-like muscles, called sphincter muscles, serves to open and close the anus, anal opening so that the dirt out of the body. anal canal, the part between the rectum and the anal opening about 1 ½ inches in length.

The outer skin around the anus is called the perianal area. Tumors in this area are skin tumors, not anal cancer.

Being infected with human papillomavirus (HPV) can affect the risk of developing anal cancer.

Risk factors include the:

• Age over 50 years.
• Being infected with human papillomavirus (HPV).
• Having multiple sex partners.
• Anal sexual intercourse.
• Anus often experience redness, swelling and pain.
• Suffering from anal fistulas (abnormal openings).
• Smoking.

Possible signs of anal cancer include bleeding from the anus or rectum or a lump near the anus.

These and other symptoms may be caused by anal cancer. Other conditions can cause similar symptoms. Should consult a doctor if there is a problem to the following:

• Bleeding from the anus or rectum.
• Pain or pressure in the rectal area.
• Itching or a lot of mucus from the anus.
• A lump near the anus.
• Changes in bowel habits.

Tests to check the anus are used to detect (input) and diagnose anal cancer.

The following tests and procedures may be used:

Physical examination and history: An examination of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A patient's health history and customs of the last illness and its treatment.

Digital rectal examination (DRE): An examination of the anus and rectum. The doctor or nurse inserting lubricants, gloved finger inserted into the rectum to feel for lumps or anything else that seems unusual.

• Anoscopy: A tool examination of the anus and lower rectum, lighted tube called an anoscope.
• Proctoscopy: A short inspection tools to examine the rectum, lighted tube called a proctoscope.
• Endo-anal or endorectal ultrasound: A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to emit high-energy sound waves (ultrasound) off internal organs and make echoes. The echoes form a picture of body tissues called a sonogram.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If this would be the abnormal area during anoscopy, ever done at that time.

Times (Chance of recovery) depends on the following:

• The size of tumors.
• Section where the tumor is located within the anus.
• Whether the cancer has spread to the lymph nodes.

Treatment depends on the following options:

• Stages of cancer.
• Where the tumor is in the anus.
• Does the patient has suffered Human Immunodeficiency Virus (HIV).
• Whether the cancer remains after treatment or recurrence.

After anal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the anus or to other parts of the body.

The process used to find out whether the cancer has spread within the anus or to other parts of the body is called staging. The information gathered from the staging process determines the stage of disease. It is important to know the stage to plan treatment. The following tests may be used in the staging process:

• CT scan: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. Images created by a computer linked to an x-ray machine. Dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. For anal cancer, which in the CT scan of the pelvis and abdomen may be done.
• Chest X-ray: An x-ray to the organs and bones inside the chest. An x-ray is a type of energy beam that can penetrate into the body and immortalized kebentuk film, making pictures of areas inside the body.
• Endo-anal or endorectal ultrasound: A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to emit high-energy sound waves (ultrasound) off internal organs and make echoes. The echoes form a picture of body tissues called a sonogram.

The stages are used for anal cancer:

Stage 0 (cancerous ulcers there)

In stage 0, cancer is found only in the layer farthest from the anus. Stage 0 cancer is also called there cancer ulcers.

Stage I

In stage I, the tumor is 2 centimeters or smaller.

Stage II

In stage II, the tumor is larger than 2 centimeters.

Stage IIIA

In stage IIIA, tumors can be any size and has spread to either:

• Lymph nodes near the rectum; or
• Close to organs, such as the vagina, urethra, and bladder.

Stage IIIB

In stage IIIB, whatever the size of a tumor and has spread:

• To places organs and to lymph nodes near the rectum; or
• To lymph nodes on one side of the pelvis and / or groin, and may have spread to nearby organs; or
• To lymph nodes near the rectum and in the groin, and / or to lymph nodes on both sides of the pelvis and / or groin, and may have spread to nearby organs.

Stage IV

In stage IV, which may be of any size of a tumor and the cancer may have spread to lymph nodes or nearby organs and has spread to distant parts of the body.

Anal cancer relapse

Recurrent anal cancer is cancer that has recurred (come back) after being treated. Cancer can come back in the anus or in other parts of the body.

Overview of the treatment of choice

There are different types of treatment for patients with anal cancer.

Different types of treatments available for patients with anal cancer. Some treatments are standard (the currently used), and several more are being investigated in clinical trials. Before treatment begins, a patient might be thinking about taking part in a clinical trial. Clinical treatment trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials in many states. Information about clinical trials is available on NCI Site. Choosing the appropriate cancer treatment ideally involves the decision of the patient, family and health care team.

Three types of standard treatment are used:

• Radiation therapy
  Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance die in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
  
• Chemotherapy
  Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping cell division. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
  
• Surgery
  
• Local resection: A surgical procedure Tumors were removed from the anus along with some of the healthy tissue around it. Local resection may be used if the cancer is small and has not spread. This procedure may save the sphincter muscles so the patient can still control bowel movements. Tumors that develop in the lower part of the anus can often be removed with local resection.
  
• Abdominoperineal resection: A surgical procedure anus, rectum, and part of the sigmoid colon removed through the incision made in the abdomen. Doctors cut ends of the intestine and connect the side of the abdomen, called a stoma, made in the body surface of the abdomen to facilitate the dirt out and collected in a bag outside the body. This is called a colostomy. Lymph nodes that contain cancer may also be removed during this operation.

Patients who suffer from the human immunodeficiency virus or HIV can affect treatment of anal cancer.

Cancer therapy can further damage or weaken the immune system of patients who have the human immunodeficiency virus (HIV). For this reason, patients suffering from anal cancer and HIV are usually treated by lowering the dose of anticancer drugs and radiation than patients who do not have HIV.

Other types of treatment are being tested in clinical trials, including the following:

Radiosensitizers

Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

This summary refers to specific treatments under study in clinical trials, but it may not mention every test of new treatments. Information about ongoing clinical trials is available on NCI's site.

Treatment options by stage:

Stage 0 anal cancer (cancer ulcers there)

Treatment of stage 0 anal anus is usually local resection.

Anal cancer Stage I

Treatment of anal cancer stage I can include:

• Local Resection.
• External beam radiation therapy with or without chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid a colostomy done.
• Abdominoperineal resection, if cancer remains or comes back after treatment with radiation therapy and chemotherapy.

Internal radiation therapy for cancer that remains after treatment with external-beam radiation therapy.

Patients who have treatment and successfully leaving the sphincter muscles may receive follow-up studies every 3 months for the first 2 years, including checking the rectum with endoscopy and biopsy, as needed.

Anal cancer stage II

Care stage II anal cancer may include:

• Local Resection.
• External beam radiation therapy with or without chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid a colostomy done.
• Internal radiation therapy.
• Abdominoperineal resection, if cancer remains or comes back after treatment with radiation therapy and chemotherapy.
• A new treatment clinical trials as an option.

Patients who have treatment and successfully leaving the sphincter muscles may receive follow-up studies every 3 months for the first 2 years, including checking the rectum with endoscopy and biopsy, as needed.

Anal cancer stage IIIA

Treatment stage IIIA anal cancer may include:

• External beam radiation therapy with or without chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid a colostomy done.
• Internal radiation
• Abdominoperineal resection, if cancer remains or comes back after treatment with radiation therapy and chemotherapy.
• A new treatment clinical trials as an option.

Anal cancer stage IIIB

Treatment stage IIIB anal cancer may include:

• External beam radiation therapy with chemotherapy.
• Local resection or abdominoperineal resection, if cancer remains or comes back after treatment with chemotherapy and radiation therapy. The lymph nodes may also be removed.
• A new treatment clinical trials as an option.

Anal cancer stage IV

Stage IV rectal cancer treatments may include:

• Surgery as palliative therapy to relieve symptoms and improve quality of life.
• Radiation therapy as palliative therapy.
• Chemotherapy with radiation therapy as palliative therapy.
• A new treatment clinical trials as an option.

Treatment options for recurrent rectal cancer

Treatment for recurrent anal cancer may include:

• Radiation therapy and chemotherapy, for recurrence after surgery.
• Surgery, for recurrence after radiation therapy and / or chemotherapy.
• A clinical trial of radiation therapy with chemotherapy and / or radiosensitizers.

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source: www.doktersehat.com

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written by Said Zulhelmi Arif on date Monday, 28 March 2016