Which operation for anal cancer?
Find out about the different operations used for anal cancer.
Which operation for anal cancer?
Most people with anal cancer have a combination of chemotherapy and radiotherapy (chemoradiotherapy). If this treatment doesn't cure your cancer, you then have an operation. Your type of operation will depend on the type and size of your cancer, exactly where it is, and whether it has spread.
If you have a very early cancer of the anal margin you might need only surgery to remove the affected area. You will need to stay in hospital for a few days.
You may need an abdominoperineal resection if the cancer has come back. Or you might need it if the cancer hasn't gone completely after chemoradiotherapy. The surgeon will remove your anus, your rectum and some of the muscle tissue around it, and part of your colon. They might also remove some of the lymph nodes near your anus and in your groin.
With this operation you will need a colostomy. This is when the end of your bowel opens out on to the surface of your tummy. The opening is called a stoma. You wear a bag over it to collect your stools (faeces). A specialist stoma nurse teaches you how to care for your stoma and helps you to adjust to living with a colostomy.
You can view and print the quick guides for all the pages in the treating anal cancer section.
Most people have a combination of chemotherapy and radiotherapy (chemoradiotherapy) for anal cancer. But if that treatment doesn't get rid of the cancer completely you have surgery to remove it. You may hear this called salvage treatment.
The type of operation you have depends on
- Where your cancer is
- The type and size of your cancer
- Whether your cancer has spread
Before your operation, your doctor will talk to you about the best type of surgery for your cancer.
If you have a very early cancer of the anal margin, you might need only surgery to remove the affected area. This is called a local resection. It leaves the anal sphincter (muscle). So you will still be able to control your bowel as usual after the surgery. You need a general anaesthetic for this operation and usually stay in hospital for a few days.
When your surgeon removes your cancer they send it to the laboratory. A pathologist then examines the cancer cells under a microscope. They also check that the border of tissue around the tumour is free of cancer cells. This is called a clear margin of tissue.
This operation is called an abdomino perineal resection. You might have this surgery if the cancer has come back or if it hasn’t gone completely after chemoradiotherapy.
The surgeon removes your
- Part of your colon
They might remove the muscle tissue around the rectum as well, which is called an extralevator abdomino perineal resection. The tissues in the lower pelvis need support after this operation. Your surgeon will use muscle taken from another part of the body or a synthetic mesh material to create support.
They might also remove
- Some of the lymph nodes near your anus
- The lymph nodes in your groin
You might have part of this operation as keyhole (laparoscopic) surgery. The surgeon makes several small cuts in your abdomen (tummy). This is instead of one large cut as you'd have with open surgery. The surgeon passes a long, narrow tube (laparoscope), and other instruments, through the cuts. The laparoscope has a camera that shows pictures of the inside of the body on a video screen. The surgeon manipulates the instruments and watches what they are doing on the screen.
You might have one slightly larger cut in your tummy. Through the cut the surgeon carries out some of the surgery and takes out the tumour. With both open and laparoscopic surgery you will also have a wound around the anus, in the perineum.
Keyhole surgery seems to be as good as traditional open surgery at getting rid of the cancer. But the operation can take longer. People who have keyhole surgery may have less pain and get back to normal more quickly. You might also leave hospital sooner. Your surgeon will discuss the risks and benefits of both types of surgery with you.
Some surgeons may use a robotic machine to do part of the keyhole operation. The surgeon controls the machine using a specialised unit. Using the robotic machine gives the surgeon a better view of the inside of your tummy. It also allows for finer movements. Robotic surgery is still a new technique and not all hospitals in the UK have this. Doctors hope that robotic surgery will cause less damage to nerves and give fewer side effects.
Having a colostomy
As part of this surgery, you will need to have a colostomy. This is when the last part of your bowel opens out on to the surface of your tummy. The opening is called a stoma. You wear a bag over the stoma to collect your stools (faeces).
Read more about having a colostomy for anal cancer.
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