Anal Cancer - Stages Of Anal Cancer And Their Treatment Options

This article is one of the article series on Anal Cancer. This article discusses the different stages of anal cancer and the available treatment options at each stage. Please read the other articles for a comprehensive knowledge on Anal Cancer.

 

 

Anal Cancer - What is Anal Cancer?

 

 

Stage 0 (carcinoma in situ)

 In stage 0, abnormal cells are found in the innermost lining of the anus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Treatment of stage 0 is usually local resection.

Stage I Anal Cancer

In stage I, cancer has formed and the tumor is 2 centimeters or smaller.

 

Treatment of stage I anal cancer may include the following:

• Local resection.
• External-beam radiation therapy with or without chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid the need for a permanent colostomy.
• Internal radiation therapy.
• Abdominoperineal resection, if cancer remains or comes back after treatment with radiation therapy and chemotherapy.
• Internal radiation therapy for cancer that remains after treatment with external-beam radiation therapy.

Patients who have had treatment that saves the sphincter muscles may receive follow-up exams every 3 months for the first 2 years, including rectal exams with endoscopy and biopsy, as needed.

Stage II Anal Cancer

 In stage II, the tumor is larger than 2 centimeters.

Treatment of stage II anal cancer may include the following:

• Local resection.
• External-beam radiation therapy with chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid the need for a permanent colostomy.
• Internal radiation therapy.
• Abdominoperineal resection, if cancer remains or comes back after treatment with radiation therapy and chemotherapy.
• A clinical trial of new treatment options.

Patients who have had treatment that saves the sphincter muscles may receive follow-up exams every 3 months for the first 2 years, including rectal exams with endoscopy and biopsy, as needed.

Stage III (A) Anal Cancer

In stage III (A), the tumor may be any size and has spread to either:

• lymph nodes near the rectum; or
• nearby organs, such as the vagina, urethra, and bladder.

Treatment of stage III (A) anal cancer may include the following:

• External-beam radiation therapy with chemotherapy. If cancer remains after treatment, additional chemotherapy and radiation therapy may be given to avoid the need for a permanent colostomy.
• Internal radiation therapy.
• Abdominoperineal resection, if cancer remains or comes back after treatment with chemotherapy and radiation therapy.
• A clinical trial of new treatment options.

Stage III (B) Anal Cancer

In stage III (B), the tumor may be any size and has spread:

• to nearby organs and to lymph nodes near the rectum; or
• to lymph nodes on one side of the pelvis and/or groin, and may have spread to nearby organs; or
• to lymph nodes near the rectum and in the groin, and/or to lymph nodes on both sides of the pelvis and/or groin, and may have spread to nearby organs.

Treatment of stage III (B) anal cancer may include the following:

• External-beam radiation therapy with chemotherapy.
• Local resection or abdominoperineal resection, if cancer remains or comes back after treatment with chemotherapy and radiation therapy. Lymph nodes may also be removed.
• A clinical trial of new treatment options.

Stage IV Anal Cancer

In stage IV, the tumor may be any size and cancer may have spread to lymph nodes or nearby organs and has spread to distant parts of the body.

Treatment of stage IV anal cancer may include the following:

• Surgery as palliative therapy to relieve symptoms and improve the quality of life.
• Radiation therapy as palliative therapy.
• Chemotherapy with radiation therapy as palliative therapy.
• A clinical trial of new treatment options.

Treatment Options for Recurrent Anal Cancer

Recurrent anal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the anus or in other parts of the body. 

Treatment of recurrent anal cancer may include the following:

• Radiation therapy and chemotherapy, for recurrence after surgery.
• Surgery, for recurrence after radiation therapy and/or chemotherapy.
• A clinical trial of radiation therapy with chemotherapy and/or radiosensitizers. 

Symptoms and factors affecting recovery