For most people, chemoradiation cures anal cancer, meaning there's no evidence of disease. If your cancer is not completely gone after these treatments, surgery remains an option. Your team may recommend surgery if your cancer either doesn’t respond to chemoradiation or comes back after treatment.
Anal cancer surgery for Fred Hutch patients is performed by colorectal surgeons at University of Washington Medical Center who are specially trained to do this operation.
Abdominoperineal resection
The exact procedure you need will depend on many factors. You and your team will discuss your options and decide together what is best for you.
Abdominoperineal resection is a typical procedure for anal cancer in the anal canal (from teh anal skin to the rectum) that doesn’t respond to chemoradiation or that recurs. This means removing the anus, rectum, part of the colon and lymph nodes.
After this surgery, stool cannot move out of your body along the normal pathway. Instead, you will need a colostomy. The surgeon creates an opening (stoma) in your abdomen. They bring the open end of your colon through the opening and sew it to the skin. They attach a bag to the skin on the outside to collect waste.
We help you learn how to care for your colostomy and adjust so you can go on with normal activities comfortably. We have a specially certified wound ostomy nurse who understands the physical and emotional impact of ostomies and can work closely with you, your family and your doctors. Our survivorship clinic also plays an integral part in your ongoing care.
Wide local excision
If you have perianal cancer (in the skin around the anus), your surgeon will operate to remove the tumor itself and a margin of healthy tissue around it.
Colostomy
An opening into the colon from the outside of the body. A colostomy provides a new path for waste material, such as urine and feces, to leave the body after part of the colon has been removed.