Anal cancer

] cite web | Morten Frisch, Jorgen H. Olsen, Andrea Bautz, and Mads Melbye | title =Benign Anal Lesions and the Risk of Anal Cancer | url=http://content.nejm.org/cgi/content/full/331/5/300 | year = 1994 | publsiher=N Engl J Med 1995; 332:190-191, Jan 19, 1995 | accessdate=2008-01-22]
*Men who have sex with men are 17 times more likely to develop anal cancer than men who do not have sex with men.cite web |url=http://www.cdc.gov/std/hpv/STDFact-HPV-and-men.htm |title=STD Facts - HPV and Men |accessdate=2007-08-17]

Prevention

Since many, if not most, anal cancers derive from Human Papilloma Virus infections, and since the HPV vaccine prevents infection by several strains of the virus, scientists surmise that HPV vaccination will prevent anal cancer. [http://www.iht.com/articles/2007/01/31/healthscience/sncancer.php]

creening

Anal pap smears similar to those used in cervical cancer screening have been studied experimentally for early detection of anal cancer in high-risk individuals. [Cichoki, Mark. [http://aids.about.com/cs/conditions/a/analpaps.htm "Anal Papilloma Screening"] on About.com] [cite journal |author=Chiao EY, Giordano TP, Palefsky JM, Tyring S, El Serag H |title=Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review |journal=Clin. Infect. Dis. |volume=43 |issue=2 |pages=223–33 |year=2006 |pmid=16779751 |doi=10.1086/505219]

Treatment

Localized disease

Anal cancer is most effectively treated with surgery, and in early stage disease (i.e., localized cancer of the anus without metastasis to the inguinal lymph nodes), surgery is often curative. The difficulty with surgery has been the necessity of removing the anal sphincter, with concomitant fecal incontinence. For this reason, many patients with anal cancer have required permanent colostomies.

In more recent years, physicians have employed a combination strategy including chemotherapy and radiation treatments to reduce the necessity of debilitating surgery. This "combined modality" approach has led to the increased preservation of an intact anal sphincter, and therefore improved quality of life after definitive treatment. Survival and cure rates are excellent, and many patients are left with a functional sphincter. Some patients have fecal incontinence after combined chemotherapy and radiation. Biopsies to document disease regression after chemotherapy and radiation were commonly advised, but are not as frequent any longer. Current chemotherapy active in anal cancer includes cisplatin and 5-FU; mitomycin has also been used, but is associated with increased toxicity.

Metastatic or recurrent disease

Up to 10% of patients treated for anal cancer will develop distant metastatic disease. Metastatic or recurrent anal cancer is difficult to treat, and usually requires chemotherapy. Radiation is also employed to palliate specific locations of disease that may be causing symptoms. Chemotherapy commonly used is similar to other squamous cell epithelial neoplasms, such as platinum analogues, anthracyclines such as doxorubicin, and antimetabolites such as 5-FU and capecitabine. J.D. Hainsworth developed a protocol that includes Taxol and Carboplatinum along with 5-FU.

Prognosis

See also

*Anal warts and itching

References

External links

* [http://www.gaphr.org/AnalWarts.htm Anal Warts, Anal Cancer, and Anal Pap Smears]
* [http://www.lgbthealthchannel.com/msmcancer/ Anal Cancer and HPV in Men Who Have Sex With Men]
* [http://www.nci.nih.gov/cancertopics/pdq/treatment/anal/healthprofessional National Cancer Institute (U.S.): Anal Cancer: Information for Health Professionals]
* [http://www.cancer.net/anal/ Cancer.Net: Anal Cancer]
* [http://www.webmd.com/cancer/news/20061013/farrah-fawcett-is-fighting-cancer Farrah Fawcett fighting cancer]