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Information on anal cancer

MedicineWorld.Org: Anal cancer
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Anal cancer

      In the United States the incidence of anal cancer is higher among women compared to men. This is usually a disease of the older population, and 80 percent of all anal cancers occur in people over the age of 60.

      The commonest symptoms of anal cancer are bleeding, pain and a feeling of fullness. Most often these symptoms are attributed some other problems like hemorrhoids or anal fissures with a subsequent result of delay in the diagnosis.

How is anal cancer diagnosed?
      Anal cancer is found as a mass on rectal examination, or endoscopic examination. An incision biopsy will usually lead to the diagnosis. A CT scan may be ordered to evaluate for pelvic nodes. If the inguinal nodes are enlarged this should be evaluated for metastatic disease.

      The most common type or anal canal cancer is squamous cell in origin. There are different subtypes of squamous cell, namely, cloacogenic, basaloid, transitional cell, and mucoepidermoid carcinomas. Unusual tumor types may arise is the anal area and would include small cell, anal melanoma, and adeno-carcinoma. These are managed differently and are not included in this discussion. The following section is limited to discussion regarding squmous cell carcinoma of the anal canal.

Staging of anal cancer
      Stage is the most important predictor of survival in anal cancer. A staging work up may include CT scan of the pelvis, chest X-ray and liver function tests.

Treatment of anal cancer
      Surgery may be done if the anal cancer is detected at an early stage, but this is not the preferred mode of therapy. Currently surgery for anal cancer is indicated only in those patients who have failed to combination of chemotherapy and radiation therapy.

Radiation therapy alone
      This mode of treatment was used in Europe for early anal cancer lesions, but is associated with higher complication rates compared to combination of chemotherapy and radiation therapy, which is the preferred treatment in anal cancer.

Combined chemo-radiation
      This is the preferred mode of treatment for most patients with anal cancer. About 80 to 90 percent of patients usually experience complete remission (complete disappearance of tumor) with this mode of treatment and most of these patients are cured. Most commonly used chemotherapy combination is 5-FU plus mitomycin. The cancer can continue to regress for 3 to 4 months following chemo-radiation. Those patients who does not experience a complete remission following chemo-radiation should undergo surgical treatment.

MedicineWorl.Org: Anal cancer

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