Anal Cancer

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Duke’s colorectal specialists 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

The colorectal physicians and surgeons in our nationally-ranked cancer center are experienced and care for 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. We also study genes, how they function, and their impact on health. Our goal is to provide you with more personalized anal cancer treatment options.

Our Locations

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

Treatments for Anal Cancer


Often used first in combination with radiation, chemotherapy can slow or kill tumor growth. It may be recommended instead of surgery to shrink your tumor. Chemotherapy may be used after surgery as well, if recurrence risk is high and the 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 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.

Tests for Anal Cancer

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

During this physical exam, your doctor manually checks for abnormal growths.

Stool and Blood 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 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 growths or obtain tissue to be analyzed for 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

These biopsies 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. 

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

One-Day Evaluations
As a first-time patient, 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 previous scans and/or blood work. If you need additional imaging or testing, those services are conveniently located in 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 targeted therapies, surgical approaches, and ways to minimize common cancer-related symptoms, all before they become widely available at other hospitals.

More Minimally Invasive Procedures
Nearly 80% of surgeries are performed via minimally invasive techniques that may include laparoscopic and robotic platforms. These less-invasive methods are 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 include medical and radiation providers, colorectal surgeons, gastroenterologists, radiologists, and pathologists. They meet 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 cancer 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.  

This page was medically reviewed on 05/03/2023 by