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For some people with anal cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You might be relieved to finish treatment, but find it hard not to worry about the cancer coming back. (When cancer comes back after treatment, it is called recurrence.) This is a very common concern in people who have had cancer.

It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. Our document Living with Uncertainty: The Fear of Cancer Recurrence gives more detailed information on this.

For other people, the cancer might never go away completely. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty. Our document When Cancer Doesn’t Go Away talks more about this.

Follow-up care

When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.

Follow-up doctor visits after treatment may be scheduled as often as every 3 months for at least 2 years, and then possibly less often after this. During these visits, your doctor will ask about any symptoms you’re having and will do a physical exam, which will include a rectal exam, an exam of the anus, and an exam to see if any nearby lymph nodes are enlarged. Blood tests and imaging tests such as CT scans (described in the section “How is anal cancer diagnosed?”) may also be ordered.

Close follow-up is extremely important in the first several months after treatment with chemoradiation, especially if not all of the cancer is gone. Some tumors continue to shrink after treatment, so the doctor will want to watch the cancer closely during this time to see if further treatment might still be needed.

It’s also very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

Should your cancer come back, treatment will depend on where it is, what treatments you’ve had before, and your overall health. For more information on how recurrent cancer is treated, see the section “Treatment of anal cancer by stage.” For more general information on dealing with a recurrence, our document When Your Cancer Comes Back: Cancer Recurrence can give you information on how to manage and cope with this phase of your treatment.

For patients with colostomies

Most people treated for anal cancer don’t need extensive surgery (known as an abdominoperineal resection, or APR). But if you do have an APR, you will need to have a permanent colostomy.

If you have a colostomy, follow-up is important. You might feel worried or isolated from normal activities. A wound, ostomy, continence nurse (WOCN) or enterostomal therapist (a health care professional trained to help people with their colostomies) can teach you how to care for your colostomy. You can also ask the American Cancer Society about programs offering information and support in your area. For more information on colostomies, see our document Colostomy: A Guide.

Seeing a new doctor

At some point after your cancer diagnosis and treatment, you might find yourself seeing a new doctor who won’t know anything about your medical history. It’s important that you be able to give your new doctor the details of your diagnosis and treatment. Gathering these details during and soon after treatment may be easier than trying to get them at some point in the future. Make sure you have the following information handy, and always keep copies for yourself:

  • A copy of your pathology report(s) from any biopsies or surgeries
  • If you had surgery, a copy of your operative report(s)
  • If you stayed in the hospital, a copy of the discharge summary that the doctor prepared when you were sent home
  • If you were treated with radiation, a copy of the treatment summary
  • If you were treated with chemotherapy (or other drugs), a list of your drugs, their doses, and when you took them
  • Copies of imaging tests (CT or MRI scans, etc.), which can usually be stored digitally (on a DVD, etc.)
  • The names and contact information of the doctors who treated your cancer

Last Medical Review: 04/09/2014
Last Revised: 01/20/2016