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Anal cancer

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Treatments for stage I anal cancer

The following are treatment options for stage I anal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery

You may be offered surgery as the main treatment for stage I anal cancer if the tumour is small and it isn’t in the anal sphincter. The surgeon will do a wide local excision to remove the tumour and a small amount of tissue around it (called the surgical margin). Sometimes more surgery is needed to remove any cancer left behind or if cancer cells are found in the surgical margin.

An abdominoperineal resection may be done if chemoradiation was the main treatment but it didn’t destroy all the cancer cells. This surgery removes the rectum, anus, anal sphincter and muscles around the anus.

Chemoradiation

Chemoradiation may be offered as the main treatment for stage I anal cancer if the tumour is too large to be completely removed by surgery or the tumour is in the anal sphincter. This treatment combines chemotherapy with radiation therapy. The 2 treatments are given during the same time period. Some types of chemotherapy make radiation therapy more effective.

Chemoradiation is usually given as daily treatments of external beam radiation therapy for 5–6 weeks. The drugs most commonly given during this time period are 5-fluorouracil (5-FU, Adrucil) and mitomycin (Mutamycin). Sometimes capecitabine (Xeloda) is used instead of 5-fluorouracil.

Sometimes more treatment is given if chemoradiation didn’t destroy all the cancer cells. This may be called salvage therapy. It is usually chemotherapy alone or with radiation therapy. The chemotherapy drugs used most often in salvage therapy are 5-fluorouracil and cisplatin (Platinol AQ). When more radiation therapy is given, it’s called a radiation boost.

Clinical trials

You may be asked if you want to join a clinical trial for anal cancer. Find out more about clinical trials.

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