Chemotherapy for anal cancer

Chemotherapy uses anticancer, or cytotoxic, drugs to destroy cancer cells. Most people with anal cancer have chemotherapy. It may be used alone, but it is usually given during the same time period as radiation therapy. This is called chemoradiation.

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is given for different reasons. You may have chemotherapy to:

• destroy cancer cells in the body
• treat any cancer that is 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 usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the anus.

Chemotherapy drugs used for anal cancer

Chemotherapy for anal cancer is given by a needle in a vein (intravenously), as a pill by mouth (orally) or both. The most common chemotherapy drugs used to treat anal cancer are:

• 5-fluorouracil (5-FU, Adrucil) and mitomycin (Mutamycin)
• capecitabine (Xeloda) and mitomycin
• 5-fluorouracil and cisplatin (Platinol AQ)
• paclitaxel (Taxol) and carboplatin (Paraplatin, Paraplatin AQ)

Side effects

Side effects can happen with any type of treatment for anal cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. Side effects can develop any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Some common side effects of chemotherapy drugs used for anal cancer are:

• nausea and vomiting
• loss of appetite
• diarrhea
• sore mouth and throat
• skin problems, such as irritation and sensitivity
• hair loss
• low white blood cell count and a fever (called febrile neutropenia)
• pain at the injection site, including extravasation
• kidney damage

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Information about specific cancer drugs

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

Questions to ask about chemotherapy

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.