The preferred treatment for anal / ano-rectal cancer is chemotherapy and radiation. Side effects of this treatment include inflammation of the anus with ulcer formation, narrowing and damage to the lining. Other side effects are diarrhea and damage to the bone marrow. Surgery is indicated under following circumstances -
The cancer is very small and superficial - in this case, only the growth is removed
The cancer has spread to other parts of the body
The sphincter function of the anus is lost
The patient cannot tolerate radiation
The cancer recurs
In the latter four cases, the anal growth is removed with a part of the intestine, the anus is closed, and the lower end of the intestine is brought out through the abdomen through a surgical opening called a colostomy. The feces that exit through this opening are collected in a disposable bag attached to the abdomen.
Though chemotherapy and radiation have their side effects, their cure rate is similar to that of surgery. The patient can thus avoid a colostomy and have a better quality of life.
Combining various types of treatment depends on the stage of the cancer.
In Stage 0 cancer - surgical removal of the abnormal area is adequate.
Stages I, II and III, are treated with radiation with/without chemotherapy. Surgery is carried out in these cases if the tumor is small and has not spread, or if it has recurred.
Treatment of stage IV does not result in a cure. Surgery, radiation and/or chemotherapy may be administered to reduce the patient’s symptoms.
The patient should undergo regular examinations even after apparent cure to prevent cancer recurrence.