Anal cancer – Causes
Anal cancer incidence has increased significantly in recent years. This is attributed to the dissemination of the infection with the HPV and other aggravating factors such as the infection with the HIV and smoking. There are many predisposing factors which increase the incidence of anal cancer. Many sexual partners, anal intercourse, cervical dysplasia (CIN3), smoking, anal warts, immunosuppression, kidney’s transplantation, immunosuppressive drugs, chronic treatment with cortisone and of course, HIV infection are the most important of these factors. These groups should be checked regularly with anal cytology and High Resolution Anoscopy.
Anal cancer – Occurrence
Every small tumor in the anal area, especially if it is hard, painful and bleeds, should be checked with anoscopy and biopsy by a proctologist. Other indications are liquid discharge from the anus and altered bowel habits. If the biopsy confirms that, we must proceed to an intra-anal ultrasound examination in order to stage the disease and ascertain the extent of her and the penetration into the sphincters.
Ultrasonography – diagnosis of anal cancer
Anal cancer – Treatment
The tumor can be surgically removed, if the intra-anal ultrasound examination shows that the disease is limited and will not cause great damage to the anal sphincters resulting in fecal incontinence. If the extent of the disease is big with a risk of damage to the sphincters after performing a wide surgical excision, a combination of chemo- radiotherapy is selected because of its good results.
Anal cancer – Monitoring
After treating the anal cancer, and as regards the local disease, it is necessary to monitor clinically the patient with the intra-anal ultrasound in order to manage a direct diagnosis of any recurrence of the disease. The existing dysplasia may develop again in cancer or new cancer sites may appear, because the HPV remains in the anal area. Therefore, anal cytology and high resolution anoscopy have to be applied for monitoring of the HPV infection in the anal area.