Anal cancer is fortunately rare. It involves the appearance of malignant tumors in the anal canal (the tube of tissue between the anus and the rectum) and the rings of muscle called anal sphincters (which control bowel movements). So, what is stage 3 anal cancer?
This form of cancer tends to appear more in women than men. Around half of cases are people aged 65 or above. It is believed that anal cancer can be the result of lifestyle and other risk factors, especially the presence of the human papilloma virus (HPV) infection. The latter links to a high percentage of cases.
As anal cancer cells multiply, they are described as passing through different stages. These are characterized by how big the original tumor is, and whether the cancer has spread to secondary sites. The stage reached informs medical professionals on how the cancer cells should be treated and what support care and medication you may need.
How each stage is measured on a system known as “TNM”. This covers:
T - size of the initial (primary) Tumor in cms and whether it has spread to neighboring organs
N - how far cancer cells have spread to other nearby regions and especially the lymph Nodes
M - to what extent the cancer cells have spread to other sites in the body, most commonly the liver and lungs. This process is known as Metastasized.
Using measurements from the TNM system, your medical team can gauge what stage you are at to inform treatment protocols.
Treatment also depends on the type of cancer you have and where it is in your body. When assessing the stage you have reached and how to proceed, your physician will also take into consideration your general health.
For example, if you have reached stage three anal cancer, you are likely to have a substantial amount of pain and discomfort and you may be experiencing additional symptoms. This must be taken into account to ensure that treatment is given at a level and speed that does not put you at risk of serious harm.
To set some context, what would proceed stage 3 anal cancer?
The base level for this illness – level 0 – is the presence of abnormal cells in the lining of your anus. This is not cancer, but it is a predisposition to develop cancer if left untreated. These abnormal cells could be in your anal canal or the skin around your anus (known as perianal skin).
There can be different levels of growth – depending on how far the pre-cancer cells have penetrated the surface layer. Diagnosis will look for whether the abnormal cells are in the lower one-third of the skin, lower two-thirds of the skin or the full thickness.
In the initial levels of penetration, it may be that active treatment is not necessary and your physician will arrange for regular checks ups. It may never progress any further.
However, if the abnormal cells are in the full thickness of the anus skin, surgery may well be recommended. There are also clinical trials taking place in using laser technology at to remove the cells.
In stage 1 anal cancer, the cells have become invasive and malignant. The tumor would be less than 2cm in size and isolated with no secondary sites.
The treatment might involve surgery (a procedure called a local resection) if it is near the top of your anus and less than 1 cm in size. Otherwise, chemotherapy, radiotherapy or a mixture of both may be used (called chemoradiotherapy).
At Stage 2, the tumor has grown but has not spread far. The advised treatment would chemoradiotherapy.
For some people, the cancer cells continue to multiply despite treatment, and after assessing the size and spread on the THM scale, your physician may be of the opinion that you have reached stage 3.
There are different frameworks for this particular stage – A and B. For a breakdown of the TNM scale for these, you may want to visit the American Cancer Society website [https://www.cancer.org/cancer/anal-cancer/detection-diagnosis-staging/staging.html].
Some people only receive a diagnosis when their anal cancer has already reached this stage, and treatment begins at this point.
Of course, early diagnosis increases the chances of a full recovery from anal cancer. However, if you find that your anal cancer is already at stage 3, then there is still a substantial survival rate.
As new protocols and treatments emerge all the time – and your individual prognosis depends on your own specific circumstances, you need to discuss your individual case with your medical team. Any statistics for this are general observations.
Stage 3 anal cancer usually means an aggressive course of chemoradiotherapy – chemical treatment chemotherapy - and use of radiotherapy equipment to attempt to kill the abnormal cells.
After this is complete, if the tumor isn’t gone – or it returns – the next option would be surgery.
If your anal cancer continues to grow you would enter what physicians refer to as stage 4. The focus at this stage may be to slow down the growth of the cancer and provide relief from the symptoms and additional health challenges it brings.