Number stages of anal cancer
Anal cancer can start in different cell types. This information is for which is the most common type of anal cancer.
Find out more about anal cancer that starts in other cell types
The stage of a cancer tells the doctor about its size and whether it has spread. It helps your doctor decide on which treatment you need.
There are 4 number stages of anal cancer numbered 1 to 4. Stage 1 anal cancer means that the cancer is 2cm or smaller. And it hasn't spread to any nearby tissue, or other organs
Doctors also use another staging system for anal cancer. They call this the TNM staging system. It stands for tumour, node and metastasis:
T describes the size of the tumour
N describes whether there are any cancer cells in the nearby lymph nodes
M describes whether the cancer has spread elsewhere in the body
The TNM system describes the cancer in detail. The number staging system puts these details together to give an overall stage.
Number stage 1 is the same as T1, N0 and M0 in the TNM staging system.
Knowing the stage of the cancer helps your doctor to decide which treatment is best for you. Treatment can also depend on:
whether the cancer is in the or anal canal
if the cancer involves your sphincter muscles
your general health
You might have an operation called a local excision if the cancer is in the anal margin. And if the cancer doesn't involve the sphincter muscles. These are the muscles that control your bowel movements.
During the operation, your surgeon removes the cancer and a healthy area of tissue around it. This area is called the margin.
Some people may have a combination of chemotherapy and radiotherapy (chemoradiotherapy) after a local excision. This is normally if their doctor thinks there are still some cancer cells nearby.
You need to be generally fit and well to have an operation. If you are not able to have surgery, your doctor will talk to you about other treatment options. This may include chemoradiotherapy instead of an operation.
Read more about local excision for anal cancer
You normally have chemoradiotherapy if the cancer involves either your:
anal sphincter muscles
anal canal
This is usually instead of a local excision.
When you have finished your treatment, your doctor will check that the cancer has completely gone.
Find out more about chemoradiotherapy for anal cancer
If your doctor thinks there is any cancer left after chemoradiotherapy, they take a sample of tissue (biopsy) from the area. If this contains cancer cells, they will talk to you about further treatment. This may include a large operation called an abdominoperineal resection (APR). Your surgeon and will make sure you are well enough to have this surgery.
Read more about having surgery for anal cancer
Last reviewed: 08 May 2025
Next review due: 08 May 2028
Anal cancer is when abnormal cells in the anus divide in an uncontrolled way. It can start in different parts of the anus and different types of cell.
If you have symptoms of anal cancer you should see your GP. They might ask you to have some tests and may refer you to a specialist.
Chemotherapy combined with radiotherapy is called chemoradiotherapy. It is the most common treatment for anal cancer that hasn't spread to other parts of your body.
You may need surgery if anal cancer comes back. Or hasn't all gone after chemoradiotherapy. Some people have surgery as the main treatment for stage 1 cancer in the anal margin.
Survival for anal cancer depends on different factors. Because this cancer is rare, survival is harder to estimate than for more common cancers.
Anal cancer is cancer that starts in the anus. The anus is also called the anal canal.
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