Surgery is no longer the standard option for most people with anal cancer. In people who do need surgery, the type of operation depends on the type and location of the tumor.

Local resection

Local resection is used most commonly to treat cancers of the anal margin. A local resection is an operation that removes only the tumor, plus a small margin of the normal tissue around the tumor. Local resection can be used if the cancer is small and has not spread to nearby tissues or lymph nodes. In most cases, local resection preserves the sphincter (the muscular ring that opens and closes the anus). This allows the bowels to move (and be controlled) normally after the surgery. Many small tumors of the anal margin can be treated with local resection.

Abdominoperineal resection

Abdominoperineal resection (APR) is a more extensive operation. In this surgery, the surgeon makes incisions in the abdomen and around the anus to remove the anus and the rectum. The surgeon may also take out some of the lymph nodes in the groins during this operation, although this step (called a lymph node dissection) can also be done later.

Because the anus (and the anal sphincter) is removed, a new opening needs to be made to let stool leave the body. This opening is called a colostomy, or an ostomy. It is a permanent opening in the abdomen where the end of the colon is attached so that feces can exit the body. A bag to collect the feces is attached to the body over the opening. For more information on colostomies, refer to our document, Colostomy: A Guide.

An APR was commonly done in the past for cancers of the anal canal, but it can almost always be avoided by treating the patient with combined radiation therapy and chemotherapy instead. It is now more often used as an option if other treatments don't get rid of the cancer or if the cancer comes back after treatment.

Last Medical Review: 08/17/2009
Last Revised: 08/17/2009