Anal Cancer Symptoms and Progression
Medically reviewed by Qin Rao, MDMedically reviewed by Qin Rao, MDAnal cancer can present with a variety of symptoms that can include itching, pain, or a feeling of fullness in or around the anus. Some people may also notice bleeding, unusual lumps, or a change in their bowel habits.As symptoms progress, more serious complications can occur, including difficulty controlling bowel movements and possibly spreading the cancer to nearby organs.
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Common Symptoms Anal cancer symptoms may initially be mistaken for being caused by a less serious condition, such as hemorrhoids (swollen anal or rectal veins). Common symptoms of anal cancer are:Change in bowel habits, which can include straining to have a bowel movement, loose stools, constipation, narrow stools, or increased frequency in bowel movementsFeeling of pressure or fullness at the anusLump or swelling near the anus, which can cause a sensation of fullness or pressure Mucus or other drainage from the anusPain during bowel movements Persistent itching or discomfort in and around the anus Rectal bleeding, which may appear as bright red blood on toilet paper or in the stoolIt’s important not to dismiss or ignore these symptoms, especially if they persist or get worse over time. The earlier anal cancer can be caught, the better treatment outcomes can be. It’s important to contact a healthcare provider if experiencing any of these symptoms.Symptom OnsetThe first symptoms of anal cancer can be mild and develop slowly, which often leads people to believe they are due to a minor problem such as a fissure or hemorrhoids. As anal cancer progresses, the symptoms progress as well, and become more severe and more difficult to ignore.What Happens as Symptoms ProgressIn the early stages, mild discomfort or occasional bleeding may be seen, but as the tumor grows larger, the bleeding can become heavier and more frequent and the pain more severe.For example, the pain may initially only occur while having a bowel movement but can progress to the point where it is constant and interferes with activities such as sitting or moving around. Pain is typically due to the tumor putting pressure on surrounding nerves or tissues in the anal region.Other symptoms often get worse as anal cancer spreads. Lumps in the anal area may grow in size. Some people may also lose control of their bowels or notice more discharge when not having a bowel movement.When anal cancer spreads to nearby organs, such as the lymph nodes or the liver, additional symptoms may be noted, such as weight loss, fatigue, or swollen lymph nodes in the groin.Symptoms With HPVMost cases of anal cancer are caused by the human papillomavirus (HPV). Anal cancer caused by HPV infection presents with symptoms similar to anal cancer not caused by HPV. The virus itself, especially the HPV 16 and HPV 18 subtypes, can lead to the development of anal cancer. Cancers caused by HPV often have a precancerous growth, called a high-grade squamous epithelial lesion (HSIL). One study has shown that people who had treatment of HSIL through ablation (destruction of the abnormal tissue) or surgical removal were less likely to develop anal cancer. One of the most common signs of HPV-positive anal cancer is bleeding, which may be noticeable after bowel movements or be present as blood on toilet paper after wiping. Other early symptoms include persistent itching, discomfort, or pain around the anus.HPV-related anal cancer can also cause small lumps or growths that might be felt around the anal area, which could be mistaken for hemorrhoids.GI and Bowel Comorbidities Anal cancer can cause gastrointestinal (GI) and bowel-related comorbidities, especially as the cancer progresses and affects the structures of the digestive system.One issue commonly seen is bowel dysfunction, which can appear as long-term constipation, diarrhea, or a change in stool consistency. These symptoms develop due to the tumor blocking the anus or rectum, making it difficult for stool to pass through normally. Rectal tenesmus may be experienced as well. This is a frequent urge to have a bowel movement but not being able to pass much stool. This is often due to the pressure of the tumor.As anal cancer grows and possibly spreads to other areas, further complications can occur. These can include:Bowel incontinence Difficulty controlling bowel movementsFistula development (abnormal connection between the anus and surrounding organs) PainHome Management for SymptomsManaging anal cancer symptoms can be done to improve pain and discomfort. However, before attempting any management at home, it should be discussed with a healthcare provider. Symptoms that become worse should not be ignored. Report new or worsening symptoms right away. Over-the-counter (OTC) and prescription pain medications may be used to help reduce pain. Sitz baths, done by soaking the anal area in warm water, may provide comfort and reduce itching in the anal area. It is also important to keep the area clean and dry to prevent infection, especially if bleeding or leakage occurs. Sometimes, dietary changes can be helpful for constipation and diarrhea. However, these should be discussed with a healthcare provider to ensure there aren’t reasons to avoid a special diet. Dietary interventions may include eating a high-fiber diet and avoiding spicy or greasy foods. Anal Cancer TreatmentThe treatment for anal cancer depends on the stage of the cancer, which considers the size of the tumor and if it has spread to any other areas. The goal of treatment is often to cure the cancer while still preserving the ability to use the anus.Surgical removal may be recommended when tumors are small and haven’t spread. However, a combination of radiation therapy and chemotherapy is often the treatment approach. Radiation therapy uses high-energy beams to target and shrink the tumor, while chemotherapy involves medications that help destroy cancer cells and make them more sensitive to radiation.For advanced cases in which the cancer has spread or does not respond well to other treatments, a more extensive surgery may be required. This involves removing the anus and part of the rectum, and requires a permanent colostomy. (The colon is connected to a stoma in the abdomen where stool exits the body and is collected in an appliance).It’s important to discuss all treatment options with your healthcare provider to understand what treatment is recommended and why.Symptoms and Side Effects From TreatmentWhile treatments for anal cancer can be effective, they can also cause side effects. A common side effect of radiation therapy is skin irritation in the treated area. The skin around the anus can become red, sore, and tender, like a sunburn. This can make sitting or using the bathroom uncomfortable.Radiation can cause fatigue, which tends to get worse as treatment goes on, leaving people feeling unusually tired even after rest. Diarrhea or a change in bowel habits are also common side effects of radiation.Chemotherapy can cause side effects, which can vary by the chemotherapy medications given. Some side effects of chemotherapy are:Fatigue Hair lossMouth soresNauseaVomitingWeakened immune systemWhile treatment-related side effects may be bothersome, they are often temporary and can improve or resolve after the treatment has ended. Summary Anal cancer symptoms may initially be attributed to less serious conditions like hemorrhoids. Common symptoms include rectal bleeding, itching, and changes in bowel habits. As the cancer progresses, these symptoms can worsen. Advanced cases may cause GI issues, fistulas, and severe pain. Treatment options vary by stage, and may include surgery, radiation, and chemotherapy. Early detection improves treatment outcomes, so it’s important to notify your healthcare provider with any concerns, or new or worsening symptoms. Read the original article on Verywell Health.
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