Anal Cancer treatment in Iran
If you decide to have an Anal Cancer treatment in Iran, reading this article can improve your knowledge to a great extent and help you to choose the best city and hospital to treat your Anal Cancer in Iran.
What is Anal Cancer?
Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body. Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
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Before Anal Cancer Treatment
Symptoms of anal cancer
The symptoms of anal cancer are often similar to more common and less serious conditions affecting the anus, such as piles (haemorrhoids) and anal fissures (small tears or sores).
Symptoms of anal cancer can include:
. Bleeding from the bottom (rectal bleeding)
. Itching and pain around the anus
. Small lumps around the anus
. A discharge of mucus from the anus
. Loss of bowel control (bowel incontinence)
However, some people with anal cancer don’t have any symptoms.
See your GP if you develop any of the above symptoms. While they’re unlikely to be caused by anal cancer, it’s best to get them checked out.
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Causes of Anal Cancer
Anal cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).
Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority of anal cancers. HPV is thought to be the most common cause of anal cancers.
Risk Factors
Several factors have been found to increase the risk of anal cancer, including:
. Older age. Most cases of anal cancer occur in people age 50 and older.
. Many sexual partners. People who have many sexual partners over their lifetimes have a greater risk of anal cancer.
. Anal sex. People who engage in receptive anal sex have an increased risk of anal cancer.
. Smoking. Smoking cigarettes may increase your risk of anal cancer.
. History of cancer. Those who have had cervical, vulvar or vaginal cancer have an increased risk of anal cancer.
. Human papillomavirus (HPV). HPV infection increases your risk of several cancers, including anal cancer and cervical cancer. HPV infection is a sexually transmitted infection that can also cause genital warts.
. Drugs or conditions that suppress your immune system. People who take drugs to suppress their immune systems (immunosuppressive drugs), including people who have received organ transplants, may have an increased risk of anal cancer. HIV — the virus that causes AIDS — suppresses the immune system and increases the risk of anal cancer.
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Complications
Anal cancer rarely spreads (metastasizes) to distant parts of the body. Only a small percentage of tumors are found to have spread, but those that do are especially difficult to treat. Anal cancer that metastasizes most commonly spreads to the liver and the lungs.
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Prevention
There is no sure way to prevent anal cancer. To reduce your risk of anal cancer:
. Practice safer sex. Practicing safe sex may help prevent HPV and HIV, two sexually transmitted viruses that may increase your risk of anal cancer. If you choose to have anal sex, use condoms.
. Get vaccinated against HPV. A vaccine to protect against HPV infection is available. It’s recommended for adolescents, including both boys and girls, but may be given to adults, too.
. Stop smoking. Smoking increases your risk of anal cancer. Don’t start smoking. Stop if you currently smoke.
Diagnosis of Anal Cancer
Tests that examine the rectum and anus are used to diagnose anal cancer.
The following tests and procedures may be used:
. Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
. Digital rectal examination (DRE): An exam of the anus and rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.
. Endoscopy: An exam of the anus and lower rectum using a short, lighted tube called an endoscope.
. Proctoscopy: A procedure to look inside the rectum and anus to check for abnormal areas, using a proctoscope. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the rectum and anus. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
. Endo-anal or endorectal ultrasound: A procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
. Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If an abnormal area is seen during the endoscopy, a biopsy may be done at that time.
Certain factors affect the prognosis (chance of recovery) and treatment options.
The prognosis depends on the following:
. The size of the tumor.
. Whether the cancer has spread to the lymph nodes.
The treatment options depend on the following:
. The stage of the cancer.
. Where the tumor is in the anus.
. Whether the patient has human immunodeficiency virus (HIV).
. Whether cancer remains after initial treatment or has recurred.
Further Tests for anal cancer
After anal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the anus or to other parts of the body.
The process used to find out if cancer has spread within the anus or to other parts of the body is called staging. The information gathered from this staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests may be used in the staging process:
. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
. Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
. PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
. Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
Side Effects of Anal Cancer Treatment
Anal cancer treatments and cancer can cause side effects. Side effects are problems that occur when treatment affects healthy tissues or organs. Speak up about any problems you have. Your health care team can treat and/or talk with you about ways to reduce these side effects, so you feel better.
Learn about steps you can take to prevent or manage the side effects listed below:
. Anemia
. Appetite Loss
. Bleeding and Bruising (Thrombocytopenia)
. Constipation
. Delirium
. Diarrhea
. Edema (Swelling)
. Fatigue
. Fertility Issues in Boys and Men
. Fertility Issues in Girls and Women
. Flu-Like Symptoms
. Hair Loss (Alopecia)
. Infection and Neutropenia
. Lymphedema
. Memory or Concentration Problems
. Mouth and Throat Problems
. Nausea and Vomiting
. Nerve Problems (Peripheral Neuropathy)
. Immunotherapy and Organ-Related Inflammation
. Pain
. Sexual Health Issues in Men
. Sexual Health Issues in Women
. Skin and Nail Changes
. Sleep Problems and Insomnia
. Urinary and Bladder Problems
Keep in mind that side effects vary from person to person, even among people receiving the same type of cancer treatment.
During Anal Cancer Treatment
Stages of Anal Cancer
Key points
. After anal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the anus or to other parts of the body.
. There are three ways that cancer spreads in the body.
. Cancer may spread from where it began to other parts of the body.
. The following stages are used for anal cancer:
. Stage 0
. Stage I
. Stage II
. Stage III
. Stage IV
. Anal cancer can recur (come back) after it has been treated.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
. Tissue. The cancer spreads from where it began by growing into nearby areas.
. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if anal cancer spreads to the lung, the cancer cells in the lung are actually anal cancer cells. The disease is metastatic anal cancer, not lung cancer.
Stages of Anal Cancer Treatment
The following stages are used for anal cancer:
. Stage 0
In stage 0, abnormal cells are found in the mucosa (innermost layer) of the anus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called high-grade squamous intraepithelial lesion (HSIL).
. Stage I
In stage I, cancer has formed and the tumor is 2 centimeters or smaller.
. Stage II
Stage II anal cancer is divided into stages IIA and IIB.
. In stage IIA, the tumor is larger than 2 centimeters but not larger than 5 centimeters.
. In stage IIB, the tumor is larger than 5 centimeters.
. Stage III
Stage III anal cancer is divided into stages IIIA, IIIB, and IIIC.
. In stage IIIA, the tumor is 5 centimeters or smaller and has spread to lymph nodes near the anus or groin.
. In stage IIIB, the tumor is any size and has spread to nearby organs, such as the vagina, urethra, or bladder. Cancer has not spread to lymph nodes.
. In stage IIIC, the tumor is any size and may have spread to nearby organs. Cancer has spread to lymph nodes near the anus or groin.
. Stage IV
In stage IV, the tumor is any size. Cancer may have spread to lymph nodes or nearby organs and has spread to other parts of the body, such as the liver or lungs.
Anal cancer can recur (come back) after it has been treated.
The cancer may come back in the anus or other parts of the body, such as the liver or lungs.
Treatment Option Overview
Key Points
There are different types of treatment for patients with anal cancer.
Three types of standard treatment are used:
. Surgery
. Radiation therapy
. Chemotherapy
. New types of treatment are being tested in clinical trials.
. Radiosensitizers
. Immunotherapy
. Treatment for anal cancer may cause side effects.
. Patients may want to think about taking part in a clinical trial.
. Patients can enter clinical trials before, during, or after starting their cancer treatment.
. Follow-up tests may be needed.
Types of Anal Cancer Treatment
There are different types of treatment for patients with anal cancer.
Different types of treatments are available for patients with anal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
- Surgery
. Local resection: A surgical procedure in which the tumor is cut from the anus along with some of the healthy tissue around it. Local resection may be used if the cancer is small and has not spread. This procedure may save the sphincter muscles so the patient can still control bowel movements. Tumors that form in the lower part of the anus can often be removed with local resection.
. Abdominoperineal resection: A surgical procedure in which the anus, the rectum, and part of the sigmoid colon are removed through an incision made in the abdomen. The doctor sews the end of the intestine to an opening, called a stoma, made in the surface of the abdomen so body waste can be collected in a disposable bag outside of the body. This is called a colostomy. Lymph nodes that contain cancer may also be removed during this operation. This procedure is used only for cancer that remains or comes back after treatment with radiation therapy and chemotherapy.
- Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat anal cancer.
- Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
After Anal Cancer treatment
Follow-up care after treatment
After Anal cancer treatment, you will have follow-up care from your healthcare team to make sure everything is going well and find out if you have any concerns.
Having check-ups
After your treatment has finished, you will usually have regular follow-up appointments (check-ups), and possibly scans or x-rays.
The aim of your follow-up appointments is to make sure everything is going well and find out if you have any concerns. These appointments helps your doctor or nurse notice any possible problems early on.
How often you have follow-up care depends on different things. This includes the type and stage of the cancer, the types of treatment you have had and your individual needs. It also depends on the arrangements at the hospital you attend.
You may feel worried before an appointment. Going back to hospital can be a difficult reminder of what you have been through. But it can also be a positive reminder that you are getting back to everyday life. People are often reassured after their visit.
Types of follow-up care
There are different types of follow-up care. Most people are followed up at the hospital with their cancer doctor, surgeon or nurse. Other people may just see their GP for follow-up appointments.
Check-ups are usually every few months in the first year. After the first year, you will have fewer check-ups. You may not need to continue going to the hospital in the future.
Some people may have their follow-up over the telephone with a specialist nurse, instead of going to a clinic. Or you may be asked to contact your healthcare team when you need support or have a new problem or concern.
Your cancer doctor or nurse will usually tell you the type of follow-up care you will have. You may decide together what would be best for your situation.
Follow-up with your cancer team
Your cancer team may examine you and do some simple tests, such as taking a blood sample. They will usually ask questions about your recovery and any side effects or symptoms you have been experiencing.
If you want more information about your treatment or follow-up care, you can ask for copies of the letters your cancer team sends to your GP. You can also ask for your treatment summary to be sent to you.
It is very important to go to your appointments. If you cannot go because you are not feeling well, tell the clinic. They can arrange another appointment for you.
Your cancer team can refer you to other services if you need specialist help. For example, you may be referred to a psychologist or counsellor for emotional help, or a physiotherapist for advice on exercising.
Tips for getting the most from your follow-up appointment
. Write down your main questions before your appointment. You can also write down the answers when you are there, if it helps you remember them.
. Take someone with you for support and to help remember what was said.
. Always let your doctor or nurse know about any ongoing or new symptoms, or other health worries. Be open and honest with your doctors and nurses. They need information from you to give you the best care.
. Tell them how you are coping with your emotions. They can give you advice or direct you to the right place for support.
. Let them know about any prescribed or non-prescribed medicines you are taking. This includes vitamins, minerals, or herbal or complementary therapies. Occasionally, these can interfere with other drugs, including some anti-cancer treatments.
Follow-up with your GP
Some GPs may have an agreement with the hospital to share your cancer follow-up care after treatment. They may also prescribe some of the drugs you need.
Your cancer team will send your GP a report about your treatment. You should always tell your GP about any problems you need help with.
Remember to continue going to any regular checks you usually have at your GP surgery. It is important to look after your general health as you begin to recover.
Recovery after Treatment
Although you may feel ready to get on with life after treatment, it is common to have mixed feelings. You may have days when you feel anxious or uncertain about the future or less positive about your health. You may miss the routine of treatment, or the relationships you had with hospital staff. If your appearance has changed, you may be less confident about going out. For example, this could be because of hair loss or changes to your weight. These changes can be difficult to cope with, even if they are not obvious to everyone.
Recovery is a gradual process. Some days you will feel a little better than others. You need time to build up your physical strength and to process what you have been through.
The time after treatment is often a period of change. You are finding out what is now normal for you or what some people call their ‘new normal’. You need time to discover and adjust to what this means for you.
As part of your recovery, you may decide to think about ways to improve your well-being and long-term health. It is important to try and talk about how you feel. If you need extra support, contact a support group or ask your hospital team or GP to refer you to someone who can help.
Anal Cancer Treatment Surgeons
How can I find the best Anal Cancer Treatment surgeon in Iran?
It is important that you seek the assistance of experienced and skilled Anal Cancer Treatment surgeons in Iran who have provided a suitable condition for patients with limited budgets to treat their anal cancers in Iran easily. It is worth explaining that the quality provided by Iranian surgeons is far higher than other countries including Turkey and India.
Oncology Hospitals & Clinics in Iran
Tehran hospitals
- Imam Khomeini Hospital
- Pars Hospital
- Pasteurno Hospital
- Erfan Hospital
- Nikan Hospital
- Jam Hospital
- Roshana Cancer Center
Shiraz hospitals
- Shiraz Central Hospital
- Dena Hospital
- Amir Hospital
- Pardis Clinic
Mashhad Hospitals
- Razavi Hospital
- Reza Radiotherapy Oncology Center (RROC)
Cost of Anal Cancer Treatment in Iran
The cost of treating an anal cancer in Iran can vary according to each individual’s case and will be determined by the type of anal cancer treatment you have and an in-person assessment with the doctor.