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Research

Find out about the latest UK research and clinical trials looking at anal cancer.

Research into preventing anal cancer

Researchers are looking at medicines to prevent anal cancer. They are also looking at whether tests could be used for screening to find anal cancer early.

Medicines to prevent anal cancer

Vaccines have been developed to protect against the Human Papilloma Virus (HPV). HPV can increase your risk of getting anal cancer.

Researchers have been looking whether the HPV vaccine could reduce the risk of developing anal cancer in men who have sex with men. These men have an increased risk of developing anal cancer. A study showed that the vaccine reduced the rates of precancerous cell changes in the anus (AIN). AIN may develop into anal cancer in some people.

The Joint Committee on Vaccination and Immunisation (JCVI) advises the UK Department of Health. It has recommended an HPV vaccination programme for men who have sex with men.

Research into screening

Routine screening for anal cancer is not available at the moment. But doctors have been looking at whether there is a way that we can screen for anal cancer. 

The ANALOGY study is looking at whether screening people at an increased risk of anal cancer could help pick up changes early. The people taking part have a test for human papilloma virus (HPV).

Research into chemotherapy

Chemotherapy for anal cancer is usually a combination of the drugs fluorouracil (5FU) and mitomycin C. You have it with radiotherapy - this combination is called chemoradiotherapy. 

Research is looking into different types of chemotherapy and whether more chemotherapy at the end of treatment lowers the chance of the cancer coming back. 

There is also research comparing different types of chemotherapy for anal cancer that has spread or has come back after treatment. They are comparing cisplatin and 5-fluorouracil (5FU) with carboplatin and paclitaxel. They want to find out which combination works best and which has fewest side effects.

Radiotherapy research

Doctors are looking at ways to give radiotherapy with fewer side effects. Research is revealing that a type of radiotherapy called intensity modulated radiotherapy (IMRT) causes less severe side effects. Long term follow up will confirm if it works as well as standard radiotherapy.

Another type of IMRT is volumetric modulated arc radiotherapy (VMAT). With VMAT, the radiotherapy machine rotates around you during treatment, changing the intensity of the radiotherapy beam as it moves around the body. 

Research into surgery

Doctors have carried out trials for sentinel lymph node biopsy for people with anal cancer. Sentinel lymph node biopsy means removing the lymph node, or nodes, closest to the anus, which are checked for cancerous cells. The results help doctors to decide which treatment to offer next. 

The doctor can give radiotherapy to a smaller area of the body if there are no cancer cells in the sentinel lymph nodes. This will help to reduce side effects. Doctors are still experimenting with this procedure and there are no trials in the UK yet.

Research into scans

Some cancers have quickly growing cells that are resistant to treatment. Doctors think if they can find these cells they can treat them directly.

In the ART study, doctors use different types of scans to help to show the quickly growing cells. They use the scans before and during chemoradiotherapy.

Research into side effects

After radiotherapy to the pelvic area, some people have long term side effects, including bowel problems. They happen because the radiotherapy thickens the tissue in the treatment area (radiation fibrosis).

The PPALM trial is looking at the use of a palm oil supplement and a drug called pentoxifylline. Doctors think these may work well together to reduce radiation fibrosis and relieve symptoms caused by pelvic radiotherapy. The trial team wants to find out if this combination of treatment helps. They also want to learn more about the side effects.

Research into quality of life

The symptoms of cancer and side effects of treatment affect people's quality of life. Researchers are developing a quality of life questionnaire for anal cancer to find out how the cancer and its treatment affect peoples lives. 

Researchers are also looking at creating a set of measures (standards) that doctors can use when they look at the outcomes of treatment to include quality of life issues.

Last reviewed: 
16 May 2016
  • Cancer Research UK clinical trials database accessed May 2016

  • JCVI statement on HPV vaccination of men who have sex with men
    Department of Health
    November 2015

  • HPV vaccine against anal HPV infection and anal intraepithelial neoplasia
    JM Palefsky and others
    N Engl J Med. 2011 Oct 27;365(17)

  • EXTRA--a multicenter phase II study of chemoradiation using a 5 day per week oral regimen of capecitabine and intravenous mitomycin C in anal cancer.
    Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):119-26

    R Glynne-Jones and others

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