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Anal cancer

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Treatments for stage IV anal cancer

There is no standard treatment for stage IV anal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. The goal of treatment is to control the disease and relieve symptoms (called palliative therapy).

Your treatment plan may include one or more of the following treatments.


You may be offered chemotherapy for stage IV anal cancer. It may be given alone or as part of chemoradiation.

The chemotherapy drugs used most often are5-fluorouracil (5-FU, Adrucil) and cisplatin (Platinol AQ). These drugs are usually given intravenously every 4 weeks. Treatment usually continues as long as the cancer doesn’t grow or spread any farther and you can cope with the side effects.


Chemoradiation may be offered for stage IV anal cancer. It is used to manage symptoms like pain and bleeding caused by the anal tumour. 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.

How long chemoradiation is given depends on how well it manages your symptoms. It is usually given as daily treatments of external beam radiation therapy along with one of the following combinations of chemotherapy drugs:

  • 5-fluorouracil and cisplatin
  • capecitabine (Xeloda) and cisplatin


You may be offered surgery for stage IV anal cancer. Local excision is done to remove a tumour that causes symptoms like pain and bleeding.

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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