Anal Cancer

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with anal cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with anal cancer?

In 2023, an estimated 9,760 adults (3,180 men and 6,580 women) in the United States will be diagnosed with anal cancer. Worldwide, an estimated 50,685 people were diagnosed with anal cancer in 2020.

In the United States, the number of new cases has been increasing the past several years. The human papillomavirus (HPV) causes most squamous cell anal cancers. See the Risk Factors and Prevention section for more information on HPV. The average age of diagnosis for anal cancer is in the early 60s. Anal cancer is rare in people younger than 35.

It is estimated that 1,870 deaths (860 men and 1,010 women) from this disease will occur in the United States in 2023. In 2020, an estimated 19,293 people worldwide died from anal cancer.

What is the survival rate for anal cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from anal cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with anal cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with anal cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

Although the number of deaths from anal cancer has been increasing, the disease is often curable.

The 5-year relative survival rate for anal cancer in the United States is 70%.

The survival rates for anal cancer depend on many factors. These include the stage of cancer, a person’s age and general health, and how well the treatment plan works. Another factor that can affect outcomes is the type of anal cancer (see Introduction ).

If the cancer is diagnosed only in the anal area, the 5-year relative survival rate is about 83%. Approximately 45% of people are diagnosed at this stage. If anal cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is about 67%. If the cancer has spread to a distant part of the body, the 5-year relative survival rate is close to 36%.

Experts measure relative survival rate statistics for anal cancer every 5 years. This means the estimate may not reflect the results of advancements in how anal cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics .

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts & Figures 2023 ; the ACS website; the International Agency for Research on Cancer website; and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. (All sources accessed February 2023.)

The next section in this guide is Risk Factors and Prevention . It describes the factors that may increase the chance of developing anal cancer. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will find out more about screening for anal cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

• Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

• Lower the number of people who develop the disease

Learn more about the basics of cancer screening .

Screening information for anal cancer

Cancer screening is done to find cancer as early as possible in people who don’t yet have any signs of the disease.

Anal cytology is a test being developed that doctors can use for people who don’t have symptoms of anal cancer but do have a high risk of contracting a sexually transmitted disease (STD), such as HPV or HIV. The test is sometimes called an anal Pap test or anal Pap smear because it is similar to a cervical Pap test , which looks for cervical cancer. During this test, a health care provider swabs the anal lining for a sample. Those cells are then examined in a lab under a microscope to see if there are early cellular changes that might lead to cancer or if cancer has already developed.

Some health care providers are advocating the routine use of this test for people who have a higher risk of developing anal cancer. Talk with your primary care doctor about anal cancer screening if you are in any of these groups that have a higher risk of developing anal cancer:

• People who have HIV

• People who regularly have anal sex

• People who have a history of anal warts or precancerous cell growth on the anus

• People who have a history of abnormal cell growth caused by HPV on another part of the body

• People who have had another HPV-related cancer, like cervical cancer , vulvar cancer , or vaginal cancer

• People with a suppressed immune system from an autoimmune disorder, being a transplant recipient, or long-term use of medication that weakens the immune system

Because most adults in the United States have been exposed to HPV, it is important to talk with your doctor or other health care professional about your risk factors and whether or not anal cytology is right for you.

The next section in this guide is Symptoms and Signs . It explains what changes or medical problems anal cancer can cause. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread.

How anal cancer is diagnosed

There are many tests used for diagnosing anal cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

• The type of cancer suspected

• Your signs and symptoms

• Your age and general health

• The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose anal cancer:

• Digital rectal examination (DRE) . During this test, the doctor inserts a gloved finger into the anus to feel for any lumps or other abnormalities. General cancer guidelines suggest men have a DRE annually after the age of 50 and women have one during routine pelvic examinations. If you are at higher risk for developing anal cancer, your doctor may perform a DRE more often.

• Anoscopy. If the doctor feels a suspicious area during a DRE, this endoscopic test may be performed to take a closer look at the anus. An anoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an anoscope. Similarly, a proctoscope can be used to view the rectum in a procedure called a proctoscopy. The person may be sedated as the tube is inserted into the anus and/or rectum.

• Biopsy . A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

  The type of biopsy performed will depend on the location of the tumor. For instance, an excisional biopsy can remove the entire lump if the lump is small and has not grown into other tissues. Lymph nodes may also be removed and examined in a biopsy. Sometimes a biopsy to diagnose anal cancer can be done in an office with local anesthesia. If the area is very uncomfortable, it can be done in an operating room under general anesthesia. Anesthesia is medicine that keeps you from feeling pain during medical procedures.

• Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. In an anal ultrasound, an ultrasound wand is inserted into the anus to get the pictures.

• X-ray. An x-ray is way to create a picture of the structures inside of the body using a small amount of radiation.

• Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer then combines these pictures into a detailed, 3-dimensional or 3-D image that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

• Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

• Positron emission tomography (PET) scan or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan . However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages and Grades . It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with anal cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for anal cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How anal cancer is treated

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team . Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians and others.

For anal cancer, there are 3 main types of treatment: surgery, radiation therapy, and chemotherapy. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient's preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. These types of talks are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for anal cancer because there are different treatment options.

Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment, including possible bowel function, urinary function, and sexual side effects of the specific treatment plan.

Learn more about making treatment decisions .

The common types of treatments used for anal cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

• Surgery

• Radiation therapy

• Chemotherapy

• Physical, emotional, and social effects of cancer

• Metastatic anal cancer

• Remission and the chance of recurrence

• If treatment does not work

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. The type of surgery for anal cancer depends on the stage of the cancer. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Surgery for anal cancer may also be performed by a colorectal surgeon, who specializes in surgery on the colon or rectum.

Anal carcinoma in situ or early-stage cancer can often be treated by removing the abnormal cells and a small area of the surrounding healthy tissue, which is called a margin. Afterward, patients should regularly receive follow-up screening to watch for and remove any new abnormal cells.

Previously, most patients with later stages of anal squamous cell cancer were treated surgically before effective chemotherapy and radiation therapy were developed for anal cancer. However, studies have shown similar cure rates between surgical treatment and the combination of radiation therapy and chemotherapy. Now, most patients have a biopsy (which may require some level of surgery; see Diagnosis ) followed by chemotherapy and radiation therapy without further surgery. Many patients can avoid major surgery with this type of combined treatment.

If a patient cannot have chemotherapy or radiation therapy, surgery may be recommended. Surgery may also be recommended if the cancer remains after initial treatment or returns after treatment has been completed.

A persistent or recurring tumor may be treated with an abdominoperineal resection, which is the surgical removal of the anus, rectum, and part of the colon. This procedure results in the patient needing a colostomy , which is an opening on the abdominal wall to allow feces to be collected in a bag. During this procedure, lymph nodes may also be removed, which is called a lymph node dissection.

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery .

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Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist.

The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.

A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. Radiation therapy for anal cancer is often combined with chemotherapy. Typically, patients receive 5 to 6 weeks of radiation therapy, which is given daily, Monday through Friday. If there is irritation of the skin, sometimes a break from radiation therapy is needed for several days.

Side effects of radiation therapy may include fatigue, mild to severe skin reactions, upset stomach, urinary symptoms, temporary anal irritation, loose bowel movements, and discomfort when having a bowel movement. Scar tissue may form from the damage to anal tissue, which may interfere with bowel function. Most side effects go away soon after treatment is finished. Talk with the radiation oncologist about what side effects you can expect and how to reduce or relieve them.

Learn more about the basics of radiation therapy .

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Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. Medications may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy.

This type of medication is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications, be sure to ask your health care team how to safely store and handle it.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A person may receive 1 medication at a time or combinations of different medications given at the same time.

Chemotherapy for anal cancer usually consists of a combination of drugs. Common drugs for anal cancer include fluorouracil (5-FU, Adrucil) combined with either mitomycin C (Mitozytrex, Mutamycin) or cisplatin (Platinol). Chemotherapy is particularly effective for treating anal cancer when given in combination with radiation therapy, as discussed above. The combined treatment allows the use of lower radiation doses and improves the likelihood of completely destroying the tumor.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, lowering of blood counts (including cells that fight infection and help stop bleeding as well as anemia), risk of infection, nausea and vomiting, hair loss, loss of appetite, diarrhea, and sores in the mouth (mucositis). These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy .

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications.

It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases .

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Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

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Metastatic anal cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, radiation therapy, and therapies using medication. There may also be clinical trials for you to consider (see Latest Research ). Palliative care will also be important to help relieve symptoms and side effects.

For most people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program.

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Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence .

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

If a recurrence happens, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace.

Your doctor may suggest clinical trials that are studying new ways to treat recurrent anal cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope.

Learn more about dealing with cancer recurrence .

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If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning .

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss .

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The next section in this guide is About Clinical Trials . It offers more information about research studies that are focused on finding better ways to care for people with anal cancer. Use the menu to choose another section to continue reading this guide.

ON THIS PAGE: You will read about the scientific research being done to learn more about anal cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about anal cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for people through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

• Immunotherapy. Immunotherapy is designed to boost the body’s natural defenses to fight cancer. It uses materials either made by the body or in a laboratory to improve, target, or restore immune system function. Learn more about the basics of immunotherapy. Checkpoint inhibitors are an important type of immunotherapy recently shown to be beneficial when anal cancer has metastasized (spread to other organs). Two checkpoint inhibitors being studied for metastatic anal cancer include pembrolizumab (Keytruda) and nivolumab (Opdivo). Both drugs target PD-1, a receptor on tumor cells, preventing the tumor cells from hiding from the immune system.

• Radiosensitizers. Drugs that make tumor cells more susceptible to radiation therapy are being explored as a way to enhance the effectiveness of radiation therapy.

• Prevention/HPV vaccination. Because many anal cancers are likely caused by HPV, widespread use of an HPV vaccine (see Risk Factors and Prevention ) could potentially prevent many cases of anal cancer from occurring. Learn more about HPV and cancer .

• Early detection/anal cytology. As explained in Screening , anal cytology looks for abnormal cells in the anal lining. Research continues on how this test may help find anal cancer at the earliest, most treatable stages.

• Palliative care/supportive care . Clinical trials are underway to find better ways of reducing symptoms and side effects of current anal cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in anal cancer, explore these related items that take you outside of this guide:

• To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases .

• Visit the website of Conquer Cancer, the ASCO Foundation to find out how to help support cancer research. Please note that this link takes you to a different ASCO website.

The next section in this guide is Coping with Treatment . It offers some guidance on how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Regular examinations are important following treatment of anal cancer to find any recurrence of the cancer or spread to other parts of the body. The examinations usually are scheduled in the anus for every few months for the first 2 or 3 years following treatment, and then at less frequent intervals.

In addition to physical examinations, other procedures (such as a proctoscopy), imaging scans (such as CT scanning), and blood tests may be done, depending on the treatment given.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care .

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given. A physical exam including a DRE (see Diagnosis ) is always a part of follow-up care for anal cancer.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress .

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment ends. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them, and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship . It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you.

You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

• What type of anal cancer do I have?

• Can you explain my pathology report (laboratory test results) to me?

• What is the stage and grade of my cancer? What does this mean?

Questions to ask about choosing a treatment and managing side effects

• What are my treatment options?

• What clinical trials are available for me? Where are they located, and how do I find out more about them?

• What treatment plan do you recommend? Why?

• What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

• What are the possible side effects of each treatment, both in the short term and the long term?

• Who will be part of my health care team, and what does each member do?

• Who will be leading my overall treatment?

• How will this treatment affect my daily life? Will I be able to work, exercise, or perform my usual activities?

• Will I need a colostomy bag?

• Could this affect my bowel function? If so, for how long?

• Could this treatment affect my sex life? If so, how and for how long?

• Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

• If I’m worried about managing the costs of cancer care, who can help me?

• What support services are available to me? To my family?

• If I have questions or problems, who should I call?

Questions to ask about having surgery

• What type of surgery will I have? Will lymph nodes be removed?

• How long will the operation take?

• How long will I be in the hospital?

• Can you describe what my recovery from surgery will be like?

• Who should I contact about any side effects I experience? And how soon?

• What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy or chemotherapy

• What type of treatment is recommended?

• What is the goal of this treatment?

• How long will it take to give this treatment?

• Will I receive this treatment at a hospital or clinic? Or will I take it at home?

• What side effects can I expect during treatment?

• Who should I contact about any side effects I experience? And how soon?

• What are the possible long-term or late effects of having this treatment?

• What can be done to prevent or relieve the side effects?

Questions to ask about planning follow-up care

• What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

• What long-term side effects or late effects are possible based on the cancer treatment I received?

• What follow-up tests will I need, and how often will those tests be needed?

• How do I get a treatment summary and survivorship care plan to keep in my personal records?

• Who will be leading my follow-up care?

• What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources . It offers some more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.