Beating bowel cancer together

Treatment for anal cancer

Anal cancer is different from colon and rectal cancer and has a different treatment pathway. The health professionals looking after you meet regularly as a team, called a multi-disciplinary team (MDT). They will look at your test results and your general health and talk about which treatments may be suitable for you. You will have an appointment with a member of the team to talk about your test results and the benefits and risks of the treatment options. You may be offered more than one of these treatments.

Radiotherapy for anal cancer

Radiotherapy is often the first treatment used in anal cancer, with or without chemotherapy. Radiotherapy uses repeated treatments of high energy X-rays in small doses to kill cancer cells. The treatments are given Monday to Friday over a period of five – six weeks, and usually as an outpatient.

  • External radiotherapy means radiotherapy beamed from the outside of your body.
  • Internal radiotherapy (brachytherapy) means radioactive material is placed next to the tumour, inside the body. You may have either type or a combination of both as treatment for anal cancer.

You may be given radiotherapy:

  • To get rid of the cancer –this is usually in combination with chemotherapy.
  • To shrink a tumour to make it easier to remove completely.
  • To control the cancer and relieve symptoms it may be causing.

Side effects of radiotherapy

All treatments carry a risk of side effects. Your healthcare team should give you written information about the possible side effects. At your hospital appointments, your healthcare team will ask you about the side effects you’re getting. You might want to keep a diary to help you remember the details.

Possible side effects include:

  • Sore skin
  • Bowel problems
  • Sexual problems
  • Vaginal dryness

If you have any new symptoms or have any worries, speak to your healthcare team who can advise you where to find further information or support.

Chemotherapy for anal cancer

Chemotherapy is usually offered alongside radiotherapy (chemoradiation) as it can enhance the effect of radiotherapy. The most common chemotherapy you will be offered is Mitomycin-C in combination with 5FU (fluorouracil). This is given intravenously (into your vein). Sometimes a drug called capecitabine is taken as a tablet instead of 5FU. A typical cycle of treatment would be five weeks, with chemotherapy being given during the first and fifth week alongside radiotherapy.

Side effects of chemotherapy

Some people experience side effects from this treatment. The most common side effects of Mitomycin-C include feeling sick (nausea) and being sick (vomiting). You may also experience changes to how your bowel works, such as diarrhoea or passing more wind. You are likely to feel very tired during the treatment, as it can affect your blood cell count and make you anaemic and prone to infections, and you may notice you bruise more easily. Chemotherapy can cause mouth ulcers and soreness, and this may put you off eating, although this is an important time to eat well. Other side-effects include hair loss or thinning of hair. Less common side-effects are kidney and liver problems, skin rashes and fertility problems.

If you have any new symptoms or have any worries, speak to your healthcare team who can advise you where to find further information or support.

Surgery

Surgery may be considered by your specialist anal multidisciplinary team, depending on the size and spread of the cancer. More simple surgery may be used to remove small tumours. You may also have surgery if the chemotherapy and radiotherapy doesn’t completely remove the cancer or if there are signs that the cancer has returned.

 

Updated August 2018. Due for review March 2019.

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