Anal cancer
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 have the advanced training and expertise needed to perform sphincter-sparing procedures that remove anal tumors while reducing your chance of having a permanent colostomy bag to collect the waste that leaves your body. We give you the personalized care you need to maximize your quality of life and your colorectal health.
Medical advances in 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.
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 consistently ranked among the best cancer programs in the nation by U.S. News & World Report. 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.
- Comforting environment. Our Duke Cancer Center features spacious waiting areas, a Quiet Room, large infusion rooms, and a rooftop garden area where patients — based on their treatment regimen — can receive chemotherapy outdoors.
- 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 with a thin, lighted tube called a laparoscope, which is inserted in the body through small incisions. 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 — medical, radiation and surgical oncologists, gastroenterologists, radiologists, pathologists, geneticists, specially trained nurses, nutritionists and social workers — meet regularly to discuss your care, collect opinions, and offer coordinated and advanced 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.
ANAL CANCER
Treatments
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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 if cancer has spread to lymph nodes or beyond.
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We are one of few centers in the region to perform this minimally invasive procedure which requires no surgical incision. A small, lighted tube, called an endoscope, is inserted into the anus to remove anal cancers and large rectal polyps that were once only accessible through major abdominal surgery. There are no visible scars, you recover faster, and experience minimal pain.
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We have extensive training and experience using a laparoscope to perform this minimally invasive procedure to remove the anus, the 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 removed. The stage and position of the tumor determine whether this procedure is needed.
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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.
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Performed by a gastroenterologist on less invasive cancers and large polyps that are not cancerous. The mass is removed through a small, lighted tube called a proctoscope, which is inserted in the rectum. An electrified needle cuts and removes the suspicious area and surrounding healthy tissue.
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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.
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Intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) allow maximum delivery of radiation to the tumor while minimizing radiation exposure to healthy tissue and organs. A computer-driven machine moves around your body while delivering and aiming radiation beams at the cancer from several angles. Because radiation is delivered more precisely, fewer treatments are needed.
ANAL CANCER
Tests
Finding anal cancer early and obtaining an accurate diagnosis is key to your health. Several methods are used to detect and diagnose anal cancers.
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A physical exam during which your physician checks for abnormal growths.
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For people who are at high risk for anal cancer, a swab of tissue is taken and studied to detect cancer at early stages.
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Detecting anal cancer requires a combination of stool tests, which look for blood in the stool, and blood tests to look for certain antigens.
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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 tissue that is analyzed for the presence of cancer.
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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.
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Non-invasive 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.
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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.