This type of cancer occurs in around 7 out of every million people every year. Anal cancer is a rare cancer that is not easy to recognise because the symptoms are rather unspecific and can also occur in other far more harmless diseases.
Risk factors
The risk of developing anal cancer is increased if genital warts are present. Genital warts are caused by the human papilloma virus (HPV). The risk is particularly high in the presence of certain virus subtypes and concomitant immunodeficiency - for example HIV.
Symptoms
In the case of invasive anal cancer, treatment is discussed on an interdisciplinary basis in our tumour centre together with specialists from surgery, radiotherapy, pathology and medical oncology. Further examinations aim to determine the stage of the tumour and to rule out metastasis (tumour metastasis), particularly in lymph nodes.
In most cases, the treatment of choice for invasive anal cancer is a combination of radiotherapy and chemotherapy. Surgical removal of the rectum is only necessary if the cancer recurs (relapse). In the case of very small tumours on the anal verge, local surgical removal can be performed instead of radiotherapy if the risk factors are favourable.
Causes
Anal cancer develops via precursors, so-called anal dysplasia. A distinction is made between three degrees of severity of dysplasia (anal intraepithelial neoplasia I - III). Anal dysplasia can be diagnosed with a high-resolution anal and rectal endoscopy (microscope), cell sampling or tissue examination if there is suspicion or risk factors.
If anal dysplasia is present, it usually has to be removed depending on the degree of severity. Minor and moderate dysplasia in and around the anus can be destroyed. This is possible either by means of localised freezing (cryotherapy) or laser treatment. While cryotherapy is performed on an outpatient basis during consultation hours and usually does not require anaesthesia, laser treatment is performed under partial anaesthesia in the operating theatre. High-grade dysplasia must be surgically removed for histological examination.
Diagnosis
Once anal dysplasia has been diagnosed, regular follow-up care using high-resolution rectoscopy and smears is required depending on the severity and risk factors. This follow-up care is of great importance for the prevention of invasive anal cancer.
Therapy
Anal cancer develops via precursors, so-called anal dysplasia. A distinction is made between three degrees of severity of dysplasia (anal intraepithelial neoplasia I - III).
Anal dysplasia can be diagnosed with a high-resolution anal and rectal endoscopy (microscope), cell sampling or tissue examination if there is suspicion or risk factors. If anal dysplasia is present, it usually has to be removed depending on the degree of severity. Minor and moderate dysplasia in and around the anus can be destroyed. This is possible either by means of localised freezing (cryotherapy) or laser treatment. While cryotherapy is performed on an outpatient basis during consultation hours and usually does not require anaesthesia, laser treatment is performed under partial anaesthesia in the operating theatre. High-grade dysplasia must be surgically removed for histological examination.
Once anal dysplasia has been diagnosed, regular follow-up care using high-resolution anal microscopy and smears is required, depending on the severity and risk factors. This follow-up care is of great importance for the prevention of invasive anal cancer.
In the case of invasive anal cancer, treatment is discussed on an interdisciplinary basis in our tumour centre together with specialists from visceral surgery, radiotherapy, pathology and medical oncology. Further examinations aim to determine the stage of the tumour and rule out metastasis (tumour metastasis), particularly in lymph nodes.
In most cases, the treatment of choice for invasive anal cancer is a combination of radiotherapy and chemotherapy. Surgical removal of the rectum is only necessary if the cancer recurs (relapse). In the case of very small tumours on the anal verge, local surgical removal can be performed instead of radiotherapy if the risk factors are favourable.