Stage 1 anal cancer
Stage 1 anal cancer means that the cancer is less than 2cm in size. And it hasn't spread to any nearby tissue, 
or other organs.
Anal cancer can start in different cell types. This information is for which is the most common type of anal cancer.
TNM staging
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.
Treatment for stage 1 anal cancer
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
anal margin or anal canal - if the cancer involves your sphincter muscles
- your general health
Cancer in the anal margin
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.
Cancer in the anal canal or affecting the sphincter muscles
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.
If your doctor thinks there are still cancer cells
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.
