Chemotherapy for anal cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Most people with anal cancer have chemotherapy. If you have chemotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

You may have chemotherapy to:

• treat an anal cancer tumour
• destroy cancer cells that are left behind after other treatments (called salvage therapy)
• treat cancer that comes back, or recurs
• relieve pain or control the symptoms of advanced anal cancer (called palliative chemotherapy)

Chemotherapy is most often given along with radiation therapy during the same time period to treat anal cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own. Chemoradiation is used to treat early-stage (stages 1, 2 and 3) anal cancer.

Chemotherapy is not often used by itself to treat anal cancer. But you may be given chemotherapy on its own if you have already been treated with radiation therapy for anal cancer.

Anal cancer is usually treated with a combination of chemotherapy drugs. The combination of drugs used will depend on where the cancer is in the body.

The most common chemotherapy combination for anal cancer is fluorouracil (also called 5-fluorouracil or 5-FU) and mitomycin. This combination is used along with radiation therapy as part of chemoradiation.

Other chemotherapy combinations that may also be used are:

• carboplatin and paclitaxel
• capecitabine and mitomycin
• fluorouracil and cisplatin
• cisplatin, leucovorin and fluorouracil
• docetaxel, cisplatin and fluorouracil
• oxaliplatin, leucovorin and fluorouracil

Side effects of chemotherapy will depend mainly on the drug, the dose, how it's given and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common side effects of chemotherapy drugs for anal cancer include:

• nausea and vomiting
• loss of appetite
• diarrhea
• sore mouth and throat
• skin problems, such as redness and sensitivity
• hair loss
• low white blood cell count
• pain at the injection site
• kidney damage
• nerve damage

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.