An anal canal is the area of the intestine a few centimeters long, in which the large intestine passes into the anus. This area is - unlike the rest of the gut - very sensitive and anatomically complicated.
The protective mucous membrane of the rectum disappears slowly and passes into the skin of the anus. Usually, an anal carcinoma is assigned to the group of colon tumors. Regarding its biology and its response to therapy, anal cancer is more like skin cancer.
The main cause of anal carcinoma is untreated infections. Mechanical stress on the anal canal also massively increases the risk of disease.
Also fistulas or fissures, ie changes or small, painful cracks of the tissue also contribute to the development of an anal carcinoma. Another cause is condylomata. Condylomas are benign growths caused by HPV viruses 16 and 18. HPV is usually transmitted through intercourse to the affected regions.
Genetic susceptibility, nutritional deficiencies and other typical causes causing cancer such as smoking or overconsumption of alcohol have not yet been confirmed as the cause of anal cancer.
Self-diagnosis is difficult because the first symptoms can easily be confused with the symptoms of hemorrhoids. These symptoms include pain during bowel movements, bloody blood in the stool, increased itching in the area of the anus, fecal incontinence or abnormally shaped stool.
If these symptoms occur, a doctor will first rule out hemorrhoids. If the doctor is unable to do so, he will first perform a thorough physical examination. He scans the anal canal with his finger. An experienced doctor will discover an anal carcinoma by means of this palpation examination. If the initial suspicion of an anal carcinoma is confirmed, followed by a reflection of the rectum. Smaller tumors are removed directly.
In addition, it is clarified at what stage the cancer is located, whether it has affected other organs and the size of each herd. The chances of a cure for an anal carcinoma are very good, provided the cancer was detected early and has not yet metastasized. The 5-year chance of survival is about 80%, in the case of an anal carcinoma in the area of the anus even 90%.
As part of a subsequent rehabilitation, a patient learns to live with the consequences of his illness. Unfortunately, many patients suffer from radiation damage, ie burns in the area of the lower abdomen, fecal incontinence or even an artificial intestinal outlet, which remains permanently.
Tumors on the anal margin are usually surgically removed and thereby cured. This is especially true when it comes to superficial tumors. Complications are rare in these cases. Other anal tumors are usually treated with combined chemoradiation. The tumor and lymph nodes in the pelvis and groin are irradiated.
At the same time, the patient undergoes chemotherapy. However, the cytostatic agents used in this case not only have a toxic effect on cancer cells, but on all rapidly dividing cells. Therefore, the complications commonly associated with the treatment of anal cancer are often side effects of chemotherapy.
Hair loss, nail damage and mucosal problems are common. In addition, tiredness, fatigue, nausea and depression are often observed. In women premature admission of menopause is possible. The cytostatic agents can also affect the formation of blood in the bone marrow. Whether and to what extent these complications occur depends on the dosage as well as the individual disposition of the patient.
Although the treatment is much gentler today than it was a few years ago, the irradiation of the affected areas can also lead to complications. Sometimes there are diarrhea and severe urinary symptoms. Furthermore, skin inflammations occur in the anal area. These side effects are usually not permanent and resolve several weeks after the end of radiotherapy again. In cases where combined chemoradiotherapy does not work, it usually requires the installation of an artificial intestinal outlet.
An anal carcinoma is a malignant tumor that needs to be treated promptly. A doctor's visit is advised at the latest when complaints such as chair irregularities, itching or pain during bowel movements occur. Regular constipation and other problems with defecation should also be clarified to rule out anal cancer and other disorders of the gastrointestinal tract or intestinal output. If there is clear evidence of carcinoma in the anal area, a prompt visit to the doctor is recommended.
If a proliferation develops in a relatively short time, which may even be accompanied by blood leakage or sensory disturbances in the affected region, medical advice is needed. This is especially true if other symptoms such as severe pain or fatigue occur. In general, growths, fistulas or cysts whose cause is not clear should be medically examined and, if necessary, removed.
Anyone who has ever been affected by anal fissures, hemorrhoids or anal cancer should have regular check-ups. At the first sign of a new disease in the anal area, the family doctor must be consulted. Further contacts are the gastroenterologist and the coloproctologist.
In most cases, surgical removal of the tumors is first performed. In many cases, it will be necessary to establish an artificial bowel outlet, which can not be relocated in all cases after successful therapy. Following the surgery, chemotherapy will be used in combination with radiation.
Part of a chemotherapy are cytostatics, drugs that prevent the growth of cells. Cytostatic drugs are cell toxins and have an effect on, among other things, the formation of mucous membranes and blood formation.
The patient therefore suffers from the typical side effects - nausea, vomiting, hair loss - that involves chemotherapy. Since chemotherapy is not permanently effective in an anal carcinoma disease, it is additionally irradiated. Again, unfortunately, with side effects expected.
Since anal cancer is a cancer, the further course of the disease depends heavily on the time of diagnosis and treatment. As a rule, there is then a positive course of the disease when the treatment of anal cancer begins at an early stage. Complications occur largely in a late diagnosis, if metastases have formed, if necessary.
The patients suffer from the anal carcinoma primarily due to a bloody bowel movement. In many people, a bloody bowel movement leads to panic attacks or sweats. It can also cause pain during bowel movements and itching in the anus. These symptoms are very uncomfortable and severely limit the patient's quality of life. Likewise, the bowel movement is irregular.
In most cases, an anal carcinoma is removed by surgery. It usually comes to a positive disease course. Similarly, those affected continue to rely on chemotherapy to completely reduce the cancer. It usually comes to various side effects. It can not generally be predicted whether anal cancer will reduce life expectancy.
Although a direct connection between a healthy lifestyle and the exclusion of an anal carcinoma could not be confirmed, a healthy lifestyle, so healthy diet, a lot of sports and exercise, as well as the renunciation of alcohol and nicotine is advisable. In addition, attention should be paid to a sexual hygiene during anal intercourse. Condoms prevent the transmission of HP viruses and should therefore always be used. At the first signs that indicate an anal carcinoma, a doctor should be consulted immediately.
Anal cancer (anal cancer) is a disease that belongs in the doctor's hands. At follow-up, the patient is also involved in consultation with the physician. The doctor with whom the aftercare is discussed may be a proctologist, oncologist, the treating surgeon and also the family doctor.
Aftercare is about regenerating the anal area from the consequences of treatment such as surgery and radiotherapy, promptly detecting a possible relapse and also restoring the patient's physical and mental well-being. There is a bundle of measures tailored to the patient as part of an individual aftercare concept.
The follow-up appointments with the attending physicians must be strictly adhered to. Care and cleansing of the stressed anal region must be closely coordinated with the doctors. In general, however, dispensing with spicy surfactants or moist toilet paper makes sense. Post-care chair regulation is important because both constipation and diarrhea have a negative effect on the regeneration of the tissue.
The chair regulation often succeeds with sufficient drinking volume and a high-fiber diet, which can be supplemented in consultation with the physicians with psyllium husks. The immune system can be stabilized through healthy diet, exercise and adequate sleep. Mental well-being can often significantly improve conversations with psycho-oncologists, psychologists or even friends. Self-help groups also offer valuable support.
If you suspect an anal carcinoma, consult a doctor as soon as possible. Anal cancer requires immediate treatment, not only medically and surgically, but also through therapeutic measures. The patient can support the treatment by complying with the physician's diet, personal hygiene, and physical exertion.
After an operation, the person concerned is protected and warms the bed. By changing the diet can be avoided that the surgical wound ruptures again due to too firm chair. Typically, a gentle diet with plenty of fruits and vegetables, light diet and lean meat is recommended in the first days after surgery. To stimulate the activity of the gastrointestinal tract, sufficient water should be drunk. Also, the healing process must be checked after surgery at regular intervals. This is achieved by close medical supervision.
After the treatment has been completed, annual screening for colorectal cancer screening should be sought. Especially elderly patients and patients with chronic diseases of the intestine should be examined regularly. Thus, any recurrences can be detected early and treated before metastasis occurs.