Treating Anal Cancer

After the cancer is found and staged, your cancer care team will talk with you about treatment options. A key goal of treatment is to save the muscles of the anal sphincter so you can control your bowels, and maintain your overall quality of life.

Your treatment options depend on many factors. The location, type, and stage (extent of spread) of the tumor are important. In choosing your treatment plan, you and your cancer care team will also consider your age,  overall health, and  personal preferences.

How is anal cancer treated?

There are many ways to treat anal cancer. Often the best approach combines two or more treatments. In the past, surgery was the only way to cure anal cancer, but now most anal cancers are treated with a combination of radiation and chemotherapy. Surgery is often not needed.

Treatment of anal cancer, by stage

The type of treatment your cancer care team will recommend depends on the type of anal cancer, where it is, and how far it has spread (the stage).

Anal canal cancer and perianal cancer, are managed differently.  Anal canal cancer is usually linked with HPV and is most often treated with combined chemotherapy and radiation. Surgery is used only if the cancer comes back or doesn’t go away.  Perianal cancer, which grows in the skin around the anus, acts more like skin cancer and is often treated with surgery if it’s small and can be removed. Radiation or chemotherapy may be added if the tumor is larger, can’t be fully removed, or comes back.

Because anal canal cancer makes up the majority of anal cancers and is more common than perianal cancer, the treatment of anal canal cancer is given below.

Who treats anal cancer?

Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:

• A radiation oncologist: a doctor who treats cancer with radiation therapy
• A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy and immunotherapy
• A surgical oncologist: a doctor who uses surgery to treat cancer

You might have many other specialists on your treatment team as well, including physician assistants, nurse practitioners, nurses, nutrition specialists, social workers, and other health professionals.

Learn more: Who is the Cancer Care Team?

Making treatment decisions

Your treatment plan will depend on many factors, including your overall health, personal preferences, and whether you plan to have children. Age alone isn’t a reason to avoid treatment—older people often tolerate ovarian cancer treatment well.

Talk with your cancer care team about all your treatment options, their goals, and possible side effects. Ask questions if there's anything you’re not sure about.

Other things to consider

• If time allows, consider getting a second opinion to feel more confident about the treatment plan you choose.
• Clinical trials study new treatments and may offer access to promising options not widely available. They are also how doctors learn better ways to treat cancer. Ask your doctor about clinical trials you may qualify for.
• You may hear about ways to relieve symptoms or treat your cancer such as herbs, diets, acupuncture, massage, or many others. Integrative (holistic) methods are used with standard care, while alternative ones replace it. Some may help with symptoms, but many aren’t proven to work and could even be harmful. Talk with your care team first to make sure they’re safe and won’t interfere with treatment.

Help getting through cancer treatment

People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.

Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services - including rides to treatment, lodging, and more - to help you get through treatment. Contact the ACS cancer helpline for more information.

Choosing to stop treatment or choosing no treatment at all

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but it’s important to talk to your doctors as you make that decision. Remember that even if you choose not to treat the cancer, you can still get care to help with pain or other symptoms.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with your doctor or a member of your supportive care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families.