Anus Cancer Or Rectal Cancer is a type of cancer that occurs in the anus or anal canal. Channel of the anus is a channel at the end of the rectum that serves to remove the feces from the intestine. Anal cancer is rare. Anal cancer occurs when cells in the anal area grow uncontrolled. This condition causes the cells to turn into cancer.
Most anal cancers originate from cells in the mucosal lining, especially gland cells in the mucous layer of the anus. The function of the glands in the anus is to produce mucus or mucus as a lubricant for the feces more easily pass through the anus. This type of anal cancer originating from this gland is called adenocarcinoma. In addition to adenocarcinoma, anal cancer may also include a type of squamous cell carcinoma, basal cell carcinoma and melanoma. Often anal cancer spreads from one part of the anus to another so it is difficult to know the area of origin of anal cancer.
In addition to malignant tumors (cancer), the anus can also appear benign tumor and pre-cancerous tumor, the tumor that originated from benign but in its journey can turn into malignant. Dysplasia is an example of a pre-cancerous tumor. Anal dysplasia occurs with anal intraepithelial neoplasia (AIN) and anal squamous intraepithelial lesions (SILs).
Symptoms of Anus Cancer
Symptoms that can appear in patients with anal cancer, among others are:
- Bleeding from the rectum or anus.
- Itching or pain in the anal region.
- Appears swelling or bumps on the anus.
- Exit the unusual fluid from the anus.
- Disease defecate (BAB) one of them is difficulty holding back defecation.
Causes of Anus Cancer
Anal cancer is caused by a genetic mutation in the anus cells that causes normal cells to become abnormal. The abnormal anus cells grow and multiply uncontrollably and form tumors. Cancer cells can invade surrounding tissue and spread to other body parts (metastasis).
Anal cancer is often associated with viral infections, namely Human Papilloma V irus (HPV). However, not everyone who suffers from HPV infection will develop anal cancer. HPV produces proteins that inactivate tumor suppressor proteins in normal cells. When this protein is inactive, the cell may turn into cancer.
Some things that can cause a person more susceptible to anal cancer, among others are:
- Age. Often anal cancer appears in the elderly.
- Have anal sex. Anal offenders are more vulnerable to anal cancer than people who do not have anal sex.
- Frequent sexual partners. People who frequently change sexual partners are more susceptible to anal cancer than people who never switch sexual partners.
- Have a history of cancer. Patients with cervical cancer , vulvar, or vaginal cancer have a higher risk of anal cancer.
- The condition of the immune system is weak. Weak immune systems, such as HIV infection or immunosuppressant drugs such as corticosteroids , can cause a person more susceptible to anal cancers than people whose immune systems are in good condition.
- Suffered warts on the anus. Warts on the anus caused by HPV infection increase a person's risk of anal cancer.
- Women are more vulnerable to anal cancer than men. But for the age group under 35 years, anal cancer is more common in men than in women.
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Diagnosis of anal cancer
To determine whether a person has anal cancer, the following checks will be required, including:
- Physical examination of the anus and rectum. This examination aims to check the condition of the rectum and anus, especially to find a lump in the anal tissue as a sign of cancer. Examination can be done with rectal plug and continued with the help of anuskop tool, which is a tubular tool hard to see abnormalities in the anal canal and rectum with more clearly.
- Endoscopy. An endoscopic examination is performed by inserting a thin flexible tube with a small camera at the end, into the anus. In this examination procedure, can also be taken samples of anal tissue that is suspected of having cancer (anal biopsy).
- Biopsy. The biopsy aims to take samples of anus tissue suspected of having cancer for examination using a microscope. In addition to a direct biopsy on the anus tissue, biopsy can also be performed by using a fine needle aspiration on the lymph nodes if there is enlarged lymph nodes .
- Transrectal ultrasound . In Transrectal ultrasound action, the transducer is directly placed on the rectum. This examination can see how deep the cancer has invaded the anal tissue.
In addition to these four tests, anal cancer can also be detected using the following checks, especially to determine the stage of cancer:
- MRI. This scan uses magnetic waves to get an image of the condition of organs in the body, in this case the inside of the anus. MRI can be used to detect enlarged lymph nodes around the cancer site, which is suspected of spreading.
- CT scan. This scan can map the condition of anal cancer using X-rays. In addition to detecting cancer, CT scan can also detect if the cancer has spread, either to the lymph nodes or to other organs.
- PET scan. This scan can describe the location of cancer and its spread throughout the body by using analysis of radioactive sugar absorption by cancer cells. Generally the doctor will combine PET scan with CT scan or MRI so that the resulting image more clearly.
As a measure of the extent of malignancy and spread of anal cancers, the following levels are used:
- Stage I. Anal cancer is less than or equal to 2 cm (the size of beans or smaller).
- Stage II. Anal cancer is larger than 2 cm in size but has not spread to other organs.
- Stage III A. Anal cancer has spread to lymph nodes near the anus or to other organs near the anus, such as the bladder, urinary tract (urethra), and vagina.
- Stage III B. Anal cancer has spread to lymph nodes near the anus and organs near the anus; or anal cancer has spread to other lymph nodes in the pelvic area.
- Stage IV. Anal cancer has spread to other body parts outside the pelvic area.
Treatment of Anus Cancer
Treatment of anal cancer given to the patient will depend on the patient's stage of cancer. Therefore, it is important to diagnose the stage of cancer before treatment for patients. Types of treatment that can be done, among others are:
- Radiotherapy Radiotherapy treatment is done by firing high-powered rays such as X-rays and protons to areas that have cancer. During radiotherapy, the patient will be placed on the table, then the beam is fired specifically into the anal region. Keep in mind that giving radiotherapy can also damage healthy cells around the cancer, so it can cause certain side effects. Some side effects that can arise, among others, namely:
- Burning sensation on the skin.
- Irritation and pain in the anus.
- Diarrhea .
- Feeling uncomfortable during bowel movements.
- Vaginal irritation in women that causes discomfort and discharge from the vagina.
- Chemotherapy. Chemotherapy is a method of treatment to kill cancer cells by using chemical drugs in pill form or infusion solution. Chemotherapy can kill rapidly growing cells, such as cancer cells. Therefore, chemotherapy can also cause death in rapidly growing healthy cells such as hair and digestive tract cells that cause side effects in patients. Some of the side effects that may arise from chemotherapy include:
- Nausea and vomiting.
- Hair loss.
- Loss of appetite.
- Decrease in the number of blood cells.
- Cancer tissue surgery. Surgery is performed to remove cancer tissue in the anus. Surgery can be performed at an early stage of cancer or at an advanced stage. Early stage cancer surgery is usually done by lifting the cancer tissue and a bit of healthy tissue around it. In early-stage cancer surgery, the doctor will try not to damage the anal sphincter muscles because these muscles function to regulate bowel movements. While in advanced cancer surgery, performed on cancer patients who have not responded to chemotherapy and radiotherapy. Advanced cancer surgery is done by cutting the anus, rectum and some of the large intestine. Remnants of the rectum and colon are then connected to the abdominal wall and made a hole (stoma) so that the feces can be discharged through the hole. Then the stool will be accommodated in the bag ( colostomy bag ) that is connected with the intestine in the stoma, before disposal.
Prevention of Anal Cancer
Anal cancer can not be prevented completely, but steps can be taken to reduce the likelihood of anal cancer in a person. Some steps to reduce the risk of anal cancer include:
- HPV vaccination. To prevent HPV infection that can trigger anal cancer, HPV vaccination can be done, both in men and in women.
- Performing safer and healthier sexual activities . To perform safe and healthy sexual activity, you should avoid having sexual intercourse with bergonta pair. Avoiding anal intercourse is also a good way to prevent HPV infection in the anus. However, if you want to have anal sex, you should use a condom.
- Quit smoking.