Your doctor considers a number of factors when deciding which treatment you need. Find out how they make the decision, the types of treatment you might have and treatment by stage.
Deciding which treatment you need
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).
The treatment you have depends on:
- where your cancer is
- how far it has grown or spread (the stage)
- the type of cancer
- how abnormal the cells look under a microscope (the grade)
- your general health and level of fitness
Your doctor will discuss your treatment, its benefits and the possible side effects with you.
The main treatments are:
- chemoradiotherapy (chemotherapy and radiotherapy together)
You have one or more of these treatments depending on the stage of your cancer.
Treatment by stage
Stage 0 (anal intraepithelial neoplasia)
For low grade AIN (AIN 1 or AIN 2) you might not need treatment. The abnormal cells might go back to normal without treatment. Your doctor will arrange regular checks to monitor your AIN.
For high grade AIN (AIN 3) you will need treatment because the abnormal cells are less likely to get better on their own. Doctors usually use surgery to remove some of the skin around the anus. Research has looked at other treatments, such as lasers to destroy the cells (laser ablation) and skin ointment (imiquimod).
Stage 1 cancer
You might have surgery if your cancer is less than 1 cm in size and is near the anal margin. The operation is called a local resection.
You might have a combination of chemotherapy and radiotherapy (chemoradiotherapy) if your cancer
- is larger than 1 cm
- involves the anal canal
- involves the anal sphincter
You might have surgery if the cancer comes back or hasn't gone completely after chemoradiotherapy.
Stage 2 and 3 cancer
You are likely to have chemoradiotherapy – a combination of chemotherapy and radiotherapy.
You might have surgery if the cancer hasn't gone completely or comes back after chemoradiotherapy.
Stage 4 cancer
You might have chemotherapy, radiotherapy or surgery, or a combination of any of these. The aim of treatment is to slow down the growth of the cancer or to shrink it. Treatment will also try to relieve any symptoms you have.
Clinical trials to improve treatment
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.