Anal cancer is a malignancy that arises from the lining of the anus.
Anal cancer is fairly rare, there are around 3,400 new cases a year in the U.S.
Men and women that are infected with the Human Papilloma Virus (HPV) are at risk.
HPV can be transmitted through vaginal and anal intercourse, as well as finger-genital,
and finger-anal contact.
However, not all cases of anal dysplasia/cancer are associated with HPV.
Condoms do NOT fully protect you from HPV transmission,
but they do protect from other STD’s.
Anal Intraepithelial Neoplasia (AIN) is pre-cancerous and is a precursor
to invasive anal cancer.
The grading of anal dysplasia is very similar to cervical dysplasia.
- AIN I: mild dysplasia, abnormal cells found in 1/3 of tissue
- AIN II: moderate dysplasia, abnormal cells found in 2/3 tissue
- AIN III: severe dysplasia, carcinoma in-situ, or stage 0 anal cancer, abnormal cells found in full thickness of tissue, but has not broken through bottom membrane
You can read about the staging of invasive anal cancer at ACO
People with anal dysplasia may or may not have symptoms,
such as itching, burning, irritation, and bleeding. Symptoms of invasive anal
cancer are lumps. Abscesses, discharge, ulcers, and an urge to use the
restroom frequently that is accompanied with pain or straining.
If you have any of these symptoms please make an appointment to see a doctor.
AIN can be detected via anal cytology. A physician can perform an anal pap.
(similar to a cervical pap) where a swab is inserted into the anus and a sample is t
aken from the lining of the anal canal and sent to pathology. However, we
find that many women have a very hard time finding a physician that is knowledgeable
or willing to perform this very simple and inexpensive test. Maybe it is because of the
stigma attached to anal cancer and/or anal sex, or maybe it is because there is a
legitimate lack of education and awareness of AIN.
If the anal pap reveals abnormal cells, your doctor will probably want to look at the
lining of your anal canal with an anoscope. The very small, lighted scope will be
inserted into your anus so the doctor may look for any lesions. An acetic wash (vinegar)
may be applied. Any abnormal areas will soak up the solution and this gives the doctor
an indication of where a biopsy might need to be taken. Once a biopsy is taken it is
sent of to pathology.
There are many different types of treatment based on extent of disease.
- Surgery
- Chemotherapy/Radiation
- Topical Creams
- Laser Ablation
Low grade AIN is usually not treated, but monitored very closely. AIN III, although not invasive, should be treated to stop progression.
If you have vulvar dysplasia/cancer, please pay close attention to your
perineum and anal area when perfoming monthly vulvar self-exams.
Many times this type of cancer can spread to the anus very easily, especially if the
dysplasia/cancer has gone untreated for a long time.
Also request that your doctor check the area thoroughly too.
