+ -Text Size

Surgery is not usually the first option for most people with anal cancer. In people who do need surgery, the kind of operation depends on the type and place of the tumor.

Local resection

A local resection may be done if the cancer has not spread to nearby tissues or lymph nodes. In this operation, only the tumor and a small area of tissue around the tumor are removed. In most cases the muscle that opens and closes the anus (called the sphincter muscle) is saved. If so, you will be able to have bowel movements as usual afterwards.

Abdominoperineal resection (APR)

This extensive surgery is rarely used as the first treatment, but it is sometimes an option if other treatments don’t get rid of the cancer.

For this surgery, the doctor makes a cut through the belly (abdomen) and another around the anus. Then the anus and part of the rectum are removed, sometimes along with nearby lymph nodes.

After an APR you will need to have a new opening made in your lower belly (abdomen) to let stool leave the body. The end of the colon is attached to a small opening in the abdomen called a colostomy. Stool passes through this opening into a bag attached outside the body. For more about colostomies, see our document Colostomy: A Guide.

Risks and side effects of surgery

The possible side effects of surgery depend on many factors, including the extent of the operation and the person’s health before surgery. Most people have at least some pain after the operation, but usually it can be controlled with medicines if needed. Other problems can include reactions to anesthesia, damage to nearby organs during the surgery, bleeding, blood clots in the legs, and skin infections where incisions were made.

After an APR, you might get scar tissue (called adhesions) in the belly that can cause organs or tissues to stick together. This can sometimes cause pain or problems with food moving through the bowels, which can lead to problems like bloating, changes in bowel habits, or nausea and vomiting.

As noted above, people need a colostomy after an APR. This can take some time to get used to and may require some lifestyle changes.

If you are a man, an APR may stop your erections or orgasms, or your pleasure at orgasm may be less intense. An APR can also damage the nerves that control ejaculation, leading to “dry” orgasms (orgasms without semen). If you are a woman, APR usually does not cause a loss of sexual function, but adhesions (scar tissue) can sometimes cause pain during sex. For more on the sexual impact of cancer and its treatment, see our documents Sexuality for the Man With Cancer and Sexuality for the Woman With Cancer.

For more about surgery as a cancer treatment, see Understanding Cancer Surgery: A Guide for Patients and Families.

Last Medical Review: 06/10/2014
Last Revised: 01/20/2016