Anal cancer


Anal cancer

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Surgery involves removing tissues or organs from the body. The type of surgery you have depends on your cancer. You may also hear surgery called an operation or a procedure.

Every operation is different. Ask your surgeon about what to expect.

What you need to know

Anal cancer surgery

The main purpose of surgery is to remove the cancer. The surgery that is performed will depend on:

  • the type of anal cancer you have
  • the location of the cancer
  • the stage and grade of the cancer
  • your general health
  • your personal preferences.

There are two main types of surgery used to treat anal cancer:

Local excision

Some anal cancers can be removed with surgery called a local excision. With this surgery the cancer and some healthy tissue around it is removed.

This can only be done if the cancer hasn’t spread and if it doesn’t involve the anal sphincter. With this type of surgery the anus is not removed.

Abdominoperineal resection

This is major surgery, which is used for people whose cancer has returned after chemoradiation or who are not suitable for chemoradiation.

During an abdominoperineal resection, the surgeon removes the anus, rectum and lower part of the large bowel.

The surgeon then brings the end of the remaining bowel through the abdominal wall to create a stoma.  Bowel contents (faeces or poo) come out of the stoma into a bag or pouch.  The stoma created during anal cancer surgery will be permanent.

If you need to have a stoma (also known as a colostomy) there is support and help available. Bowel Cancer Australia have bowel care nurses and dietitians that you can contact on 1800 555 494.

Where you have surgery

Some small procedures can be done in an outpatient clinic or a doctor’s rooms, e.g. having a biopsy. However, larger operations take place in an operating theatre in a hospital.

People with some less common cancers, or cancers that require complex surgery, should be treated at a recommended hospital. This may involve some travel.

Your surgeon will discuss with you when and where you can have your operation, and any costs involved. They, or one of their team members, will also give you instructions about what to do before your surgery and what to expect afterwards.

The surgical team for anal cancer

Health professionals who work as part of the surgical team include:

  • colorectal surgeon
  • anaesthetist
  • nurse
  • stomal therapist
  • allied health professional.

What to ask or talk about

Side effects of anal surgery

Your surgeon will discuss any risks of the surgery with you before your operation. Most hospitals will also give you written information about the surgery and who to contact if you have any concerns.

Possible side effects and complications from any surgery include:

  • pain
  • infection
  • bleeding
  • tiredness (fatigue)
  • loss of appetite
  • blood clots.

Possible side effects and complications of anal surgery also include:

  • Changes in bowel and bladder function - There can be short or long-term changes that include difficulty controlling bowel or bladder function (incontinence) or having diarrhoea or constipation.
  • Blockage in the bowel – This can be caused by scar tissue forming adhesions. If this happens it may cause constipation, pain and bloating of your tummy. 
  • Changes in sexual function - Men that have had bowel surgery may have difficulty getting an erection. Women may experience pain during sex.
  • Problems digesting some foods- Depending on the type of surgery, you may need to change your diet and avoid some foods.

The surgical team looking after you during and after your operation will take care to reduce your risk of side effects, and treat any that you get.

Every operation is different. Ask your surgeon about what to expect and see our checklist of questions to ask.

checklist Checklists

Use our checklists to find helpful tips or questions to ask.

Next steps

Preparing for surgery

Before surgery, you will need to sign a consent form. It is important you understand what you are consenting to and the possible risks of the surgery.

Some things you should know are:

  • whether you need to have tests and a preoperative assessment
  • whether you need to change or stop any medications, e.g. blood thinners like aspirin
  • when you have to stop eating and drinking
  • when you have to be there
  • whether you need time off work
  • whether you need someone to care for you at home after surgery (if you are having day surgery you will need someone to drive you home).
If you smoke, you should stop before any operation as your risk of complications from surgery is higher.

Where to get help

There are people you can talk to for more information or support.

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