"If detected in early stages, anal canal cancer can be cured with appropriate treatment, mostly combined treatment with radiation and chemotherapy."

Diagnosis

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A thorough history and physical examination are very important in diagnosing anal canal cancer. This will include a local examination of the perianal area as well as a digital per-rectal examination. Certain additional tests may include;

Endoanal ultrasound - to determine the extent of the tumour spread within the wall of the anal canal in very early cases.
MRI Scan - to determine the extent of cancer both locally as well as to the regional lymph node spread.
PET/CT Scan - to determine any sites of spread of the cancer.

Treatment

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Radiation Therapy & Chemotherapy
combined use of radiation and chemotherapy is the treatment of choice for anal canal cancer that has not spread to other organs or non-regional nodes. It results in good rates of cure and avoids the permanent colostomy and bag that were associated with surgery for anal canal cancer in the bygone era. Complete response is obtained in around 64–86% of patients and the overall survival rate at five years is approximately 75% (66–92%).
Surgery
is usually reserved for salvage of cases that either doesn’t respond to or recur after chemo radiation.
Chemotherapy Alone
is usually the treatment of choice for cancers of the anal canal that have spread to other organs (metastasized). Several different combinations of drugs are used in this situation, with palliative intent.
Proton Therapy
Radiation therapy along with chemotherapy is the mainstay of curative treatment of anal canal cancers. The benefit of proton therapy in this setting is to reduce the toxicity to other organs and thus improve the tolerance of the treatment, especially when the patients are elderly as is often the case.