Often considered wrongly as a shameful disease, cancer of the anus affects about 1000 people each year in France. What are the symptoms that can alert you?
Every year in France, about 1,000 people are affected by anal cancer, three times more than 30 years ago. However, even if the cases are more numerous, this disease remains unknown to the general public. Considered in the collective imagination as shameful, this cancer, which has nothing to do with colorectal, is largely under-publicized. It concerns women and men, especially after the age of 65. "While it was rare and only concerned older women, its incidence is increasing sharply, and it is now of interest to young men", warn doctors in a forum of World.
What are the symptoms of anal cancer?
The cancer of the anus develops in the anal canal, the terminal part of the digestive tract behind the rectum and manifests itself in the form of bleeding and anal pain. These signs are not very different from those observed during mild anal diseases such as hemorrhoidal attacks, which makes it "discreet". Especially since the first symptoms usually appear when the tumor has grown and invaded the surrounding tissues.
It is therefore important to consult a doctor if you have bleeding or if you see blood in your stool. Discomfort or pressure in the anal area can also alert you. As well as itching, a mass or a swelling near the anus or groin, as well as a narrowing of intestinal transit, such as narrowing stools. The fact that these symptoms last in time should put you on the alert.
The human papillomavirus responsible in 9 out of 10 cases
Nine times out of ten, it develops after infection with human papillomavirus (HPV). However, if the vaccine against this disease is very widely recommended for girls to prevent lesions and cancer of the cervix, boys seem to be left behind. Indeed, although since 2017, men under 26 who have sex with men (MSM) can receive the HPV vaccine and be reimbursed in France, this practice is still too confidential.
According to the National Cancer Institute (INCA), anal cancer is the third most common cancer among men living with HIV. "HIV infection promotes the appearance of HPV-related lesions and increases the risk of cancer.Anal mucosa is very vulnerable to entry of viruses, including HPV, penetration, but also any contact of the anal mucosa with a contaminated vector (finger, sex toy ...), is a means of transmission of HPV ", explain the doctors.
How to diagnose anal cancer?
As explained above, the diagnosis of anal cancer is complex. So there is a battery of exams to confirm it. Your doctor will start by asking you about your symptoms, a possible human papillomavirus (HPV) infection, your sexual behavior, including the number of sexual partners and anal intercourse you may have, or your family history. As detailed in the Canadian Cancer Society, during the physical examination, the doctor can examine your anal area to detect a mass or a region where the skin is abnormal, perform a digital rectal examination (DRE), you feel the groin for detect any swollen lymph nodes, or perform a pelvic exam or Palp test to check the condition of the vagina and cervix.
Finally, blood tests and an endoscopy can be performed. "Different types of endoscopy can be done to diagnose and stage the cancer of the anus, and their names vary according to the structures or organs they can examine," the site explains. "Anoscopy allows the doctor to observe the inside of the anal canal and the last part of the rectum using an anoscope.Rectoscopy allows to observe the entire rectum.Sigmoidoscopy allows to observe the rectum and sigmoid colon (the last part of the colon) ". Then it is also possible to perform a transrectal ultrasound, a biopsy or an HIV test.
"For the remaining 20% to 30% of patients with persistent or recurrent tumor, it is necessary to propose a very mutilating surgery: abdominoperineal amputation.As the name says a little, this procedure proceeds to the ablation from the rectum to the anal canal and carries the sphincter apparatus and the perianal skin ", warn the doctor in the World. Hence the advantage of consulting a doctor quickly, despite the inconvenience. Because diagnosed early, cancer of the anus can be treated easily.