Treatments for stage 1 anal cancer

The following are treatment options for stage 1 anal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Chemoradiation is chemotherapy and radiation therapy given during the same time period. Chemotherapy uses drugs to destroy cancer cells. Radiation therapy uses high-energy rays or particles to destroy cancer cells.

Chemoradiation is used to treat stage 1 anal cancer when the tumour is too large to be completely removed with a wide local excision. Chemoradiation leaves the muscles of the anal sphincter in place (spares the muscles). If it's possible to avoid harming or removing these muscles, your overall quality of life after treatment will be better because you will be able to have bowel movements (poop) normally.

During chemoradiation, external radiation therapy is usually given once a day, 5 days a week, for 5 to 6 weeks. Chemotherapy is given every 3 weeks. The chemotherapy drug combination used for stage 1 anal cancer is fluorouracil (also called 5-fluorouracil or 5-FU) and mitomycin. Sometimes capecitabine is used instead of fluorouracil.

Extra radiation doses, called a radiation boost, may also be given if you haven't had the maximum dose of radiation.

Find out more about chemotherapy for anal cancer and radiation therapy for anal cancer.

You may be offered surgery as treatment for stage 1 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 you will need more surgery if cancer cells are found in the surgical margin.

If treatment with chemoradiation doesn't destroy all the cancer cells, your healthcare team may offer you surgery to remove the rest of the cancer (called salvage surgery). The type of surgery is an abdominoperineal resection, which removes the rectum, anal sphincter, anus and muscles around the anus.

Find out more about surgery for anal cancer.

Talk to your doctor about clinical trials open to people with anal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.