Coping From Anal Cancer

A cancer diagnosis can be overwhelming and frightening. You can help yourself to feel more in control of your cancer and your emotions by taking an active role in your health care. To help you cope, try to:

1) Create a support network. Having friends and family supporting you can be valuable. You may find it helps to have someone to talk to about your emotions. Other people who may provide support include social workers and psychologists — ask your doctor for a referral if you feel the need to talk to someone. Talk with your pastor, rabbi or other spiritual leader. Other people with cancer can offer a unique perspective, so consider joining a support group — whether it's in your community or online. Contact the American Cancer Society for more information on support groups.

2) Take time for yourself when you need it. Let people know when you want to be alone. Quiet time to think or write in a journal can help you sort out your emotions.

3) Take care of yourself. Prepare yourself for treatment by making healthy lifestyle choices. For instance, if you smoke, quit smoking. Eat a variety of fruits and vegetables. Get exercise when you feel up to it, but check with your doctor before starting a new exercise program. Try to get enough sleep so that you wake feeling refreshed. Talk to your doctor if you're having trouble sleeping. Try to control stress by prioritizing what's important to you. These healthy choices make it easier for you to cope with the side effects of treatment.

Preventing Anal Cancer

There is no sure way to prevent anal cancer. In order to reduce your risk of anal cancer:

* Practice safer sex. Abstaining from sex or practicing safe sex may help prevent HPV and HIV, two sexually transmitted viruses that may increase your risk of anal cancer. If you choose to have anal sex, use condoms.

* Get vaccinated against HPV. The Food and Drug Administration approved a vaccine against HPV in early 2006. The HPV vaccine is approved only for girls and women. Doctors hope the vaccine will help prevent HPV-related cancers in women, including cervical cancer and anal cancer. Further study may reveal that the vaccine may also be appropriate for boys and men, but it isn't currently approved for that use.

* Stop smoking. Smoking increases your risk of anal cancer. Don't start smoking. Stop if you currently smoke.

Anal Cancer Treatment

What treatment you receive for anal cancer depends on the stage of your cancer, your overall health and your own preferences.

Combined chemotherapy and radiation
Doctors usually treat anal cancer with a combination of chemotherapy and radiation. Combined, these two treatments enhance each other and improve chances for a cure.

* Chemotherapy. Chemotherapy drugs are injected into a vein or taken as pills. The chemicals travel throughout your body, killing rapidly growing cells, such as cancer cells. Unfortunately they also damage healthy cells that grow rapidly, including those in your gastrointestinal tract and in your hair follicles. This causes side effects such as nausea, vomiting and hair loss.
* Radiation therapy. Radiation therapy uses high-powered beams, such as X-rays, to kill cancer cells. During radiation therapy, you're positioned on a table and a large machine moves around you, directing radiation beams to specific areas of your body in order to target your cancer. Radiation may damage healthy tissue near where the beams are aimed. Side effects may include skin redness and sores in and around your anus, as well as hardening and shrinking of your anal canal.

You typically undergo radiation therapy for anal cancer for five or six weeks. Chemotherapy is typically administered during the first week and the fifth week. Your doctor tailors your treatment schedule based on characteristics of your cancer and your overall health. Though combining chemotherapy and radiation increases the effectiveness of the two treatments, it also makes side effects more likely. Discuss with your doctor what side effects to expect.

People with HIV are more likely to experience side effects when undergoing chemotherapy and radiation, since treatments can weaken their already-vulnerable immune systems. Side effects make it more difficult to endure and complete treatment. For this reason, your doctor may recommend lower doses of chemotherapy and radiation if you have HIV.

Surgery
Doctors typically use different procedures to remove anal cancer based on the stage of the cancer:

* Surgery to remove early-stage anal cancers. Very small anal cancers that haven't spread beyond the anal canal may be removed through surgery. During this procedure, the surgeon removes the tumor and a small amount of healthy tissue that surrounds it. Because the tumors are small, early-stage cancers can sometimes be removed without damaging the anal sphincter muscles that surround the anal canal. Anal sphincter muscles control bowel movements, so doctors work to keep the muscles intact. Depending on your cancer, your doctor may also recommend chemotherapy and radiation after surgery.

If your cancer can't be removed without damaging the anal sphincters, your doctor may recommend trying combined chemotherapy and radiation first. Combined treatment may shrink your cancer to a size that allows your surgeon to perform sphincter-sparing surgery.

* Surgery for late-stage anal cancers or anal cancers that haven't responded to other treatments. If your cancer hasn't responded to chemotherapy and radiation, or if your cancer is advanced, your doctor may recommend a more extensive operation called abdominoperineal resection, which is sometimes referred to as an AP resection. During this procedure the surgeon removes the anal canal, rectum and a portion of the colon. The surgeon then attaches the remaining portion of your colon to an opening in your abdomen (stoma) through which waste will leave your body and collect in a colostomy bag.

Anal Cancer Causes and Risk Factors

Doctors don't know what causes anal cancer. What's known is that something occurs to create a genetic mutation within a cell that can lead to anal cancer.

In general, cancer begins with a genetic mutation that turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).

Several factors have been found to increase the risk of anal cancer, including:

* Your age. Most cases of anal cancer occur in people age 50 and older.

* Having many sexual partners. Men and women who have many sexual partners over their lifetimes have a greater risk of anal cancer.

* Anal sex. Men and women who engage in anal sex have an increased risk of anal cancer.

* Smoking. Smoking cigarettes may increase your risk of anal cancer. Former smokers have only a slightly elevated risk of anal cancer.

* Human papillomavirus (HPV). HPV infection increases your risk of several cancers, including anal cancer and cervical cancer. HPV infection is a sexually transmitted disease that can also cause genital warts. HPV may cause cells in the anal canal to appear abnormal — a condition called anal squamous intraepithelial lesions (ASIL). The abnormal cells associated with ASIL aren't cancer, but they may develop into anal cancer. However, some people with ASIL never develop anal cancer.

* Drugs or conditions that suppress your immune system. People who take drugs to suppress their immune systems (immunosuppressive drugs), including people who have received organ transplants, may have an increased risk of anal cancer. Long-term use of corticosteroids, such as those prescribed to control autoimmune disorders, also may increase the risk of anal cancer. HIV — the virus that causes AIDS — suppresses the immune system and increases the risk of anal cancer.

Anal Cancer: Cancer Of The Anus

Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body.

About 5,000 people in the United States are diagnosed with anal cancer each year, according to the National Cancer Institute. The incidence of anal cancer is increasing, though it isn't clear why.

Most cases of anal cancer are diagnosed at an early stage — when treatment provides the best chance for a cure. Most people with anal cancer are treated with a combination of chemotherapy and radiation.

Anal cancer signs and symptoms include:

* Bleeding from the anus or rectum
* Pain in the area of the anus
* A mass or growth in the anal canal
* Anal itching

Some people with anal cancer don't experience any signs or symptoms.

When to see a doctor
The signs and symptoms of anal cancer aren't specific to this disease. Some people mistake their signs and symptoms for more common conditions, such as hemorrhoids, and don't see their doctors. Talk to your doctor about any signs and symptoms that bother you, especially if you have any factors that increase your risk of anal cancer. Treatment for anal cancer is more likely to succeed if cancer is found at an earlier stage.

How To Treat And Cure Bone Cancer

As with other cancers, bone cancer treatment depends on the size, type, location and stage of the cancer, including whether it has spread to the lungs or other parts of your body, and your overall health.

Surgery
Surgery is the most common treatment for bone cancer. Surgery for cancer that hasn't spread involves removing the cancer and a rim of healthy bone surrounding it.

In the past, amputation was common for bone cancer in an arm or leg. Today, advances in surgical techniques and chemotherapy before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) and radiation therapy make limb-sparing surgery possible in many cases. With osteosarcoma, limb-sparing surgery involves replacing the cancerous bone with an artificial device (prosthesis) or bone from another part of your body or from another person (transplant).

A well-coordinated team of doctors — including surgeons, medical oncologists, radiation oncologists, and physical medicine and rehabilitation specialists who are familiar with treatment of sarcomas — is important for increasing the chance you'll be able to have limb-sparing treatment. Specialized centers for treatment of sarcoma exist in many areas.

If osteosarcoma spreads, treatment may involve surgical removal of both the bone tumor and the metastasized cancer.

Ewing's sarcoma has a tendency to metastasize rapidly. Treatment may involve chemotherapy with multiple drugs as well as radiation therapy and surgery to remove the primary tumor.

Radiation therapy
Radiation therapy — also called radiotherapy or X-ray therapy — involves treating cancer with beams of high-energy particles, or waves (radiation), such as gamma rays or X-rays. Although radiation can affect healthy cells as well as cancer cells, it's much more harmful to cancer cells. In addition, normal cells can recover from the effects of radiation more easily than cancer cells can.

Many people with cancer undergo some type of radiation therapy. Your doctor may suggest using radiation therapy at different times during your cancer treatment and for different reasons, such as before surgery to shrink a cancerous tumor or after surgery to stop the growth of any remaining cancer cells. Radiation may also be used at the same time as chemotherapy. In addition, doctors sometimes use radiation therapy to shrink tumors to decrease the pressure, pain or other symptoms they may cause.

Chemotherapy
Chemotherapy uses medications to kill rapidly dividing cells. These cells include cancer cells, which continuously divide to form more cells, and healthy cells that divide quickly, such as those in your bone marrow, gastrointestinal tract, reproductive system and hair follicles. Healthy cells usually recover shortly after chemotherapy is complete — so, for example, your hair soon starts growing again.

Unlike radiation therapy, which treats only the part of your body exposed to the radiation, chemotherapy treats the body as a whole (systemically). Its purpose is to treat cells that may have escaped from where the cancer originated.

Depending on the type of cancer you have and whether it has spread, your doctor may use chemotherapy to:

* Shrink the cancer prior to an operation, making the operation easier
* Eliminate all cancer cells in your body, even when cancer is widespread
* Prolong your life by controlling cancer growth and spread
* Relieve symptoms and enhance your quality of life

In some cases, chemotherapy may be the only treatment you need. More often, doctors use it in conjunction with other treatments, such as surgery or radiation, to improve results.