Thursday, 30 August 2012

Anal Cancer Surgery



Anal Cancer
Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus. The anus is the end of the large intestine, below the rectum, through which stool (solid waste) leaves the body. The anus is formed partly from the outer, skin layers of the body and partly from the intestine. Two ring-like muscles, called sphincter muscles, open and close the anal opening to let stool pass out of the body. The anal canal, the part of the anus between the rectum and the anal opening, is about 1½ inches long.

Anatomy of the lower digestive system, showing the colon and other organs.
The skin around the outside of the anus is called the perianal area. Tumors in this area are skin tumors, not analcancer.
Being infected with the human papillomavirus (HPV) can affect the risk of developing anal cancer.

Types of anal cancer

Squamous cell cancer
About 9 out of 10 (90 anal cancers are squamous cell cancers, sometimes called epidermoid cancers.
There are 3 types of squamous cell anal cancer
* Large cell keratinising
* Large cell non keratinising (also called transitional)
* Basaloid
Non keratinising and basaloid cancers are sometimes grouped together as ‘cloacogenic\' anal cancer. A keratinising cancer has keratin (the protein that forms your hair and nails) in the cancer cells. This type of anal cancer starts in the transitional zone of the anal canal, where the squamous cells meet the glandular cells. All the squamous cell types of anal cancer are treated in the same way.

Non epidermoid cancer
The other 1 out of 10 anal cancers (10 are adenocarcinoma, small cell cancers, \' undifferentiated\' cancers (known as basaloid cancers) and melanomas. This group is known as non-epidermoid cancers. They behave differently to squamous cell anal cancers, so the treatment is different.
Cancers that start at the anal margin, usually look more like normal cells (they are \' well differentiated\'). Anal margin tumours are more common in men than women. Cancers that start higher up in the anal canal are more common in women.

This is a rare type of anal cancer that affects the glandular cells that produce mucus in the anal canal. Only 5of anal cancers are this type. This type of anal cancer is treated in the same way as rectal cancer. Basal cell carcinoma

This is a type of skin cancer and it develops in the area around the anus. You can find information about treatment of basal cell cancers in the skin cancer section of CancerHelp UK.

This is another type of skin cancer. These cancers develop from the cells that produce melanin, the pigment or colour for the skin. Treatment is the same as for other melanomas.

Diagnosis of Anal Cancer
Possible signs of anal cancer include bleeding from the anus or rectum or a lump near the anus.
These and other symptoms may be caused by anal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: -
* Bleeding from the anus or rectum.
* Pain or pressure in the area around the anus.
* Itching or discharge from the anus.
* A lump near the anus.
* A change in bowel habits.
Tests that examine the rectum and anus are used to detect (find) and diagnose anal cancer.

The following tests and procedures may be used: -
* Physical exam and history: - An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient\'s health habits and past illnesses and treatments will also be taken.
* Digital rectal examination (DRE): - An exam of the anus and rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.
* Anoscopy: - An exam of the anus and lower rectum using a short, lighted tube called an anoscope.
* Proctoscopy: - An exam of the rectum using a short, lighted tube called a proctoscope.
* Endo-anal or endorectal ultrasound: - A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
* Biopsy: - The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If an abnormal area is seen during the anoscopy, a biopsy may be done at that time.

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