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Anal carcinoma

Anal carcinomas are rare malign carcinomas of the skin on the anal rim and in the anal canal. The grade of malignity depends on localisation, magnitude, extension in depth and the consistence of the tissue. Therefore, the carcinomas of the anal rim, which are attributed to skin tumors, have a better chance of recovery, not least because they are usually diagnosed at an early stage. A carcinoma of the anal canal, however, is often diagnosed late.

Carcinomas of the lower anal canal and anal rim are diagnosed on men three to four times more as on women. Anal carcinomas of the upper anal canal are more often detected on women.

Anal carcinomas are mainly detected at the beginning of the 60th year of life. These carcinomas can occur at an earlier age in immunodeficiency (AIDS, blood cancer, immunosuppressed organ transplant patients)

What are the causes?

Various factors play a role in the development of anal cancer, such as arises from a carcinoma of the anal rim, precancerous lesions (so-called precancerous lesions) which persist sometimes over many years might be mistaken for eczema. The cancer development can be promoted with a weakened immune system caused by certain types of virus (HPV). Anal warts could change into an anal carcinoma.
Risk factors include immunodeficiency (e. g, AIDS), passive anal intercourse and smoking.

What complaints occur in case of an anal carcinoma?

Anal bleeding and nodular indurations at and in the anus can indicate an anal carcinoma. Spasmodic pain, irregular bowel movements, spontaneous stool as well as enlarged inguinal lymph nodes suspect an advanced stage of anal carcinoma.

How does a doctor diagnose it?

Examination and palpation of the external and internal region of the anus lead to a diagnosis. A biopsy will certify it.

Tumors in the anal canal need an examination by instruments.

What treatments are possible?

An operative treatment is given priority when smaller, mainly superficial tumors particularly on the anal rim are diagnosed. A combination treatment of radiation and chemo therapy is indicated when an enlargement in the depth and/or tumors are localized in the upper anal canal.

Today, a colectomy  and construction of an artificial anal exit are very rarely done.

Is posttherapeutical care recommended?

Within the first five years a regular after-care examination is recommended.