This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of anal cancer.

Note: Estimated new cases and deaths from anal cancer in the United States in 2006:[ 1 ] New cases: 4,660. Deaths: 660. Anal cancer is usually curable. The 3 major prognostic factors are site (anal canal vs. perianal skin),size (primary tumors <2 cm in siz

Squamous cell (epidermoid) carcinomas make up the majority of all primary cancers of the anus. The important subset of cloacogenic (basaloid transitional cell) tumors constitutes the remainder. These two histologic variants are associated with human papillom

The anal canal extends from the rectum to the perianal skin and is lined by a mucous membrane that covers the internal sphincter. The following is a staging system for anal canal cancer that has been described by the American Joint Committee on Cancer (AJCC)

Abdominoperineal resection leading to permanent colostomy was previously thought to be required for all but small anal cancers below the dentate line,with approximately 70% of patients surviving 5 or more years in single institutions.

Stage 0 anal cancer is carcinoma in situ. Rarely diagnosed,it is a very early cancer that has not spread below the limiting membrane of the first layer of anal tissue.

Stage I anal cancer was formerly treated with abdominoperineal resection. Current sphincter-sparing therapies include wide local excision for small tumors of the perianal skin or anal margin,or definitive chemoradiation (fluorouracil and mitomycin) for cancer

Stage II anal cancer was formerly treated with abdominoperineal resection. Current sphincter-sparing therapies include wide local excision for small tumors of the perianal skin or anal margin,or definitive chemoradiation (fluorouracil and mitomycin) for cance

Stage IIIA anal cancer presents clinically as stage II in most instances and is determined to be IIIA by clinically evident perirectal nodal disease or adjacent organ involvement. Endorectal or endoanal ultrasound may aid in pretreatment staging.

The presence of inguinal nodes that are involved with metastatic disease (unilateral or bilateral) is a poor prognostic sign,although cure of this stage of disease is possible.

Patients in this stage should be considered candidates for clinical trials. Information about ongoing clinical trials is available from the NCI Web site. There is no standard chemotherapy for patients with metastatic disease. Palliation of symptoms from the

Local recurrences and/or persistent disease after treatment with radiation therapy and chemotherapy or surgery as the primary treatment may be controlled by using the alternate treatment (surgical resection after radiation and vice versa).

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

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