Surgery for Anal Cancer

Surgery is a treatment option for early-stage anal cancer, particularly stage 0, as well as some stage I and II anal cancers. You and your surgeon would discuss the pros and cons of surgery before deciding if it’s an appropriate option for you. There are two surgical procedures for anal cancer, depending on the type and location of the tumor:

Local Resection

Local resection treats cancers of the anal margin. Local resection may be an option for early stage anal cancer that has not spread to the lymph nodes or surrounding tissue. It is mainly used to remove small tumors not involving the sphincter. During the procedure, your surgeon would remove the tumor and a small amount of surrounding normal tissue. The sphincter is left intact to allow for normal bowel movements after surgery. Chemotherapy and radiation therapy may follow the surgery.

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Abdominoperineal Resection (APR)

During an APR, the entire anal cancer, adjacent normal rectum, rectal sphincter or anus, and surrounding lymph nodes are removed through  an incision in the lower abdomen and the perineum (the skin around the anus). Following removal of the anal cancer, the incision in the perineum is sewn shut. The cut end of the large intestine is attached to an opening in the abdominal wall, called a colostomy. This opening is covered with a bag, which serves to collect stool as it passes through the large intestine and through the colostomy. The colostomy is permanent.

Not all patients can undergo a local excision (see Local Excision below).