Important research into anal cancer is currently under way in many hospitals, medical centers, and other institutions around the country. Each year, scientists find out more about what causes the disease, how to prevent it, and how to improve treatment.
Causes and prevention
Research has identified the human papilloma virus (HPV) as a major factor in causing many cases of anal cancer. Researchers are learning how HPV affects molecules inside anal cells to cause them to become cancerous.
Improved understanding of the molecular changes inside anal cancer cells is expected to help scientists develop new drugs to fight this disease.
HIV treatment
The immune deficiency of people with HIV infections can contribute to getting anal cancer. Although modern drug treatments for HIV can improve the immune response in those infected with the virus, this has not lowered the risk of anal cancer.
Early detection
Ongoing research is being done on the value of screening tests for anal cancer, especially in people with major risk factors. The test studied most is anal cytology, sometimes called the anal Pap test. This test may be useful in early diagnosis of anal cancer and pre-cancer (called anal intraepithelial neoplasia (AIN). In this test, cells are gently scraped from the lining layer of the anus and checked under a microscope. Some doctors already recommend this test for people at high risk for anal cancers, such as those who are HIV positive.
Research is also in progress on treating AIN to help prevent cancer from developing.
Treatment
Radiation
In the past several years, studies have shown the benefits of combining radiation with chemotherapy. This approach has reduced the number of surgeries needed for anal cancer, including the need for permanent colostomies.
New radiosensitizing agents -- chemotherapy and other drugs that increase the effect of radiation therapy -- are being studied in clinical trials. Combining these treatments may allow people to get lower doses of radiation and chemotherapy, which could lessen the possible side effects.
Doctors are learning more about how to give external radiation more accurately and effectively and decrease the effects on normal healthy tissues. Other research is being done to learn about the possible benefits of combining external radiation and interstitial (internal) radiation therapy.
Drug treatment
New drug combinations are being studied. For example, clinical trials have looked at the value of giving more chemo in stage III cancers.
Some studies are looking at the use of newer targeted therapies to treat anal cancer. For example, doctors are trying to add the monoclonal antibody cetuximab (Erbitux), which is used in colorectal cancer, to see if it can help make chemotherapy work better.
Studies are also looking at using imiquimod cream to treat anal intraepithelial neoplasia (AIN). Imiquimod is FDA approved as a treatment for anal and genital warts. It acts by boosting the body’s immune response. It has been used “off-label” to treat AIN in HIV positive men with good results, and more recently was shown to be helpful in a clinical trial. Imiquimod is a cream that is applied to the problem area 3 times a week to treat AIN.
Surgery
Doctors are also studying ways to improve surgery and its side effects. For instance, studies are now looking at implanting an artificial bowel sphincter in people who have an extensive APR. The hope is that this artificial sphincter might allow people to avoid the need for a permanent colostomy. Currently such treatment is only available in carefully monitored trials.
Vaccines
The HPV vaccines available at this time help prevent HPV infection, but do not treat infections already present. Researchers have also been working on vaccines to treat women and men who already have HPV infections, by causing their body’s immune system cells to attack the HPV-infected cells. Another goal of this research is to help the immune system attack pre-cancers and even cancers that contain HPV. An experimental vaccine has shown promise so far in treating pre-cancers of the vulva, but results for anal cancer or AIN are not yet available.
Learn More
More information from your American Cancer Society
The following information may also be helpful to you. These materials may be ordered from our toll-free number, 1-800-227-2345.
After Diagnosis: A Guide for Patients and Families (also available in Spanish)
Caring for the Patient with Cancer at Home: A Guide for Patients and Families (also available in Spanish)
Living with Uncertainty: The Fear of Cancer Recurrence
Pain Control: A Guide for People With Cancer and Their Families (also available in Spanish)
Questions About Smoking, Tobacco, and Health (also available in Spanish)
Understanding Chemotherapy: A Guide for Patients and Families (also available in Spanish)
Understanding Radiation Therapy: A Guide for Patients and Families (also available in Spanish)
Books
The following books are available from the American Cancer Society. Call us at 1-800-227-2345 to ask about costs or to place your order.
American Cancer Society's Guide to Pain Control
Caregiving: A Step-By-Step Resource for Caring for the Person With Cancer at Home
Coming to Terms With Cancer: A Glossary of Cancer-Related Terms
Informed Decisions, Second Edition: The Complete Book of Cancer Diagnosis, Treatment, and Recovery
National Organizations and Web Sites*
In addition to the American Cancer Society, other sources of patient information and support include:
National Cancer Institute
Toll-free number: 1-800-4-CANCER (1-800-422-6237); TTY: 1-800-332-8615
Web site: www.cancer.gov
National Coalition for Cancer Survivorship
Toll-free number: 1-888-650-9127
1-877-NCCS-YES (1-877-622-7937) for some publications and Cancer Survivor Toolbox® orders
Web site: www.canceradvocacy.org
No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.
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