Anal Cancer

Anal Cancer

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Duke’s colorectal specialists in Raleigh and Durham use the latest medical and surgical advances to detect and treat anal cancer at the earliest possible stage. We give you the personalized care you need to maximize your quality of life and your colorectal health.

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The Best Care for Anal Cancer

If you or someone you know is concerned about anal cancer, you need an experienced and skilled healthcare team. The colorectal physicians and surgeons in our nationally-ranked cancer center work closely with anal cancer patients every day.

Our researchers are skilled in advanced diagnostic techniques that are available in only a handful of major medical centers. We continue to test new therapies, including new ways to deliver targeted radiation therapy that spares healthy tissue, and explore genomics, which studies genes, how they function, and their impact on health. Our goal is to provide you with more personalized colorectal treatment options.

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Duke Health offers locations throughout the Triangle. Find one near you.



Often used first, in combination with radiation, to slow or kill tumor growth, and recommended instead of surgery to shrink the tumor. May be recommended after surgery as well, if recurrence risk is high and cancer has spread to lymph nodes or beyond.

Abdominal Perineal Resection

We have extensive training and experience using minimally invasive techniques, including laparoscopic and robotic platforms to perform this procedure to remove the anus, rectum, and part of the colon. The intestine is sewn to an opening, and a permanent colostomy bag collects body waste. If cancer has spread, lymph nodes may also need to be treated or removed. The stage and position of the tumor determine whether this procedure is needed.

Pelvic Removal

When the tumor has spread to organs near the rectum, it may be necessary to remove the lower colon, rectum, and bladder. In some women, the cervix, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Our skilled surgeons create artificial openings that allow body waste to empty into a permanent colostomy bag.

Endoluminal Stent Placement

If a tumor is creating a blockage, a gastroenterologist may insert an expanding metal scaffolding device, called a stent, through a small lighted endoscope to clear the blockage.

Precise Radiation Therapy

Intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) allow maximum delivery of radiation to the tumor while minimizing radiation exposure of healthy tissue and organs. A computer-driven machine moves around your body while aiming radiation beams and delivering them to the cancer from several angles. Because radiation is delivered more precisely, fewer treatments are needed.

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Finding anal cancer early and obtaining an accurate diagnosis is key to your health. Several methods are used to detect and diagnose anal cancers.

Digital Rectal Exam

A physical exam during which your physician checks for abnormal growths.

Anal Pap Test

For people who are at high risk for anal cancer, a swab of tissue is taken and studied to detect cancer at early stages.

Blood and Stool Tests

Detecting anal cancer requires a combination of stool tests, which look for blood in the stool, and blood tests to look for certain antigens.

Internal Visual Exams

An internal exam of the anus and lower rectum will be performed using either an anoscope or proctoscope. Both are short, lighted tubes, in varying lengths, that are inserted into the rectum to view inside the body and assist in diagnosis. A biopsy may be performed during the exam to remove suspicious growth or obtain tissue that is analyzed for the presence of cancer.

Endoscopy Ultrasound

We are leaders in the use of this sophisticated technology that produces high-definition images inside the rectum and surrounding structures. Images are generated via a long tube inserted into the rectum, combined with high-frequency ultrasound waves. The technology is used to detect, remove, and sometimes biopsy polyps, tissue and suspicious lesions, and cancerous masses.

Imaging Studies

Noninvasive imaging tools, including MRI, PET, and CT colonography -- also known as virtual colonoscopy -- may be used to look inside the rectum to identify tumors and polyps.

Minimally Invasive Anal Biopsy

Fine-needle aspiration biopsy and sentinel node biopsy may be performed to determine if cancer has spread to lymph nodes and beyond. A fine-needle aspiration removes a small sample of fluid and tissue from the lymph node with a thin needle. If the cancer has been found in the lymph nodes, a sentinel node biopsy may be performed to determine how far the cancer may have spread.

Duke University Hospital is nationally ranked in 10 adult specialties
Among the Best Cancer Hospitals in U.S.
Where you receive your cancer care is important. Duke University Hospital's cancer program is ranked among the nation's best by U.S. News & World Report for 2019–2020.

Medical Advances in Anal Cancer

Choose Duke for your anal cancer treatment because we offer:

One-Day Evaluations
As a first-time patient here, you will undergo a thorough, day-long evaluation and consultation, and you'll leave with a comprehensive treatment plan that meets your needs. We can expedite the process even further if you bring the results of scans and/or blood work that were performed prior to your visit. If you need additional imaging or testing, those services are conveniently located within our facilities.

Targeted Radiation Treatments
Sophisticated technology allows us to better target the maximum dose of radiation directly to your cancer, while minimizing exposure and possible damage to surrounding healthy tissue. Because radiation is delivered more precisely, fewer treatments are needed.

A Nationally Ranked Program
We are a National Cancer Institute-designated Comprehensive Cancer Center and are part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.

Access to Our Clinical Trials
You may be eligible to participate in our ongoing clinical trials, which give you access to new anti-cancer targeted therapies, new surgical approaches, and ways to minimize common cancer-related symptoms, all before they become widely available at other hospitals.

High-Definition Colonoscopy
We routinely use high-resolution imaging scopes to create clearer images that better detect, and allow for removal of, polyps and cancer not seen with standard colonoscopy

More Minimally Invasive Procedures
Nearly 80 percent of surgeries are performed via minimally invasive techniques that may include laparoscopic and robotic platforms. This less-invasive method is used to identify, and sometimes remove, tumors. As a result, you’ll experience smaller wounds, less pain and scarring, and lower incidence of infection. It is also likely you'll leave the hospital sooner and recover faster.

A Team of Experienced Specialists
Our anal cancer specialists includes medical and radiation providers, colorectal surgeons, gastroenterologists, radiologists, and pathologists. They work with geneticists, specially-trained nurses, nutritionists, and social workers to regularly discuss your care, collect opinions, and offer coordinated surgical, medical, and follow-up care.

Support for You and Your Loved Ones
Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar.  

Reviewed: 09/25/2019