After Anal Cancer Treatment

For some people with anal cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back (recurrence). This is very common if you've had cancer.

For others, the cancer never goes away completely. Some people may need treatments to try to control the cancer for as long as possible. Learning to live with cancer that does not go away can be difficult, but many people find ways to manage their health and maintain a good quality of life.

Follow-up care after treatment for anal cancer

During your follow-up appointments, your doctors will ask about any problems you might have and might examine you and order tests, which can include:

• A rectal exam,
• An exam of the anus
• An exam to see if any nearby lymph nodes are enlarged
• Blood tests and imaging tests 

These exams and tests are done to look for signs of the cancer returning or side effects from treatment.

Almost any cancer treatment can have side effects. Some might only last for a few days or weeks to months, but others might last a long time. Some side effects might not even show up until years after you have finished treatment. Your doctor visits are a good time to ask questions and to talk about any changes or problems you notice or concerns you have.

Doctor visit and test schedule

For people with no signs of anal cancer, many doctors recommend follow-up visits, which might include an anoscopy, with physical exams every 3 to 6 months for at least the first 3 years after treatment. CT scans or MRIs are also often done regularly for a certain period of time. These visits may happen less often (about every 6 months) for the next several years. Some doctors may advise different follow-up schedules.

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

If you have a colostomy

Most people treated for anal cancer don’t usually need extensive surgery, such as an abdominoperineal resection (APR). But if you do have this surgery, you will need 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 an enterostomal therapist can teach you how to care for your colostomy. You can also ask about programs offering information and support in your area.

Learn more:  About Colostomies

Talk with your doctor about developing a survivorship care plan for you. This plan can guide your next steps after treatment, including follow-up appointments and ways to stay healthy.

A survivorship plan can include:

• A summary of the diagnosis, tests done, and treatment given
• A suggested schedule for follow-up exams and tests
• A schedule for other tests that might be needed in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from anal cancer or its treatment
• A list of possible late or long-term side effects from treatment, including what to watch for and when to contact the doctor

Staying prepared and organized

Even if you’ve completed treatment, keeping your health records and health insurance coverage in order makes it easier to manage follow-up care, future checkups, and any new concerns that may come up.

Keep your health insurance

It’s very important to keep your health insurance. It can help cover the cost of follow-up visits, tests, and any care you may need in the future. No one wants to think about cancer coming back, but it’s best to be prepared.

Save your medical records

At some point, you may see a new doctor who doesn’t know your cancer history. If you have copies of your medical records,  you can easily share the details of your diagnosis and treatment when needed.

Can I lower my risk of the anal cancer progressing or coming back?

If you have or have had anal cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain diet, or taking nutrition supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.

Adopting other healthy behaviors such as eating well, getting regular physical activity, and staying at a healthy weight, may help as well, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of cancer.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of anal cancer progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If the cancer does recur at some point, your treatment will depend on where the cancer is located, what treatments you’ve had before, and your health and personal preferences. For more information on how recurrent cancer is treated, see Treatment of Anal Cancer, by Stage.

Learn more: Understanding Recurrence

Getting emotional support

Feeling some depression, anxiety, or worry is normal when anal cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.

Learn more: Life After Cancer