Being diagnosed with anal cancer

Your GP will feel your tummy (abdomen) and may examine your back passage. This may be uncomfortable but it helps if you relax. If your GP thinks you may have anal cancer, they will refer you to hospital to have more tests.

At the hospital, you will usually see a surgeon or a bowel specialist (gastroenterologist). They will examine you again and ask about your general health and medical history.

The specialist will examine the area for any signs of cancer. They will put a thin tube (anoscope) into your back passage to examine the anal canal. The tube has a tiny light and magnifier on the end so they can see clearly. They may examine the rectum as well, and will use a slightly longer tube called a proctoscope for this. They will also take a small sample of cells (biopsy) from any abnormal areas. This examination may be painful so it is usually done under a general anaesthetic.

You should get the results of your tests within two weeks. Waiting for them can be a stressful time. Talking about your worries with someone can help.

How anal cancer is diagnosed

You usually start by seeing your GP. They will feel your tummy (abdomen) and examine your back passage (rectal examination). Your GP will gently place a gloved finger into your back passage to feel for any lumps or swellings. This may be uncomfortable, but it doesn’t take long. It will be less uncomfortable if you are able to relax. Let your GP know if you find the examination painful, because it’s important for them to tell the hospital specialist.

You may have blood tests. This is to check for anaemia (a low number of red blood cells) or to check how well your liver and kidneys are working.

Your GP will refer you to a hospital specialist. This is usually either a surgeon or a specialist in bowel conditions (gastroenterologist). If your GP thinks you might have cancer, you should be seen at the hospital within two weeks.


At the hospital

At the hospital, the specialist will ask about your general health and any previous medical problems. They will feel your tummy and examine your back passage in the same way your GP did. Then they will talk to you about the tests you need to have.


Examination and biopsy

The specialist will examine the area for any signs of cancer. In women, this usually includes an internal examination of the vagina, as it very close to the anal canal.

Having an examination of the anus may be painful, so it is usually done under a general anaesthetic. Occasionally it may be done in the hospital outpatients department using a local anaesthetic.

Doctors use a thin tube called an anoscope to examine the anal canal. If they want to examine the rectum as well, they use a slightly longer tube called a proctoscope.

You lie on your left side with your knees drawn up towards your chest. The doctor gently passes the tube, which has a light and a magnifier on the end, into your back passage to find any abnormal areas. They may apply a liquid to these areas to help them show up more clearly. The doctor removes a small sample of cells (biopsy) from any abnormal areas, so they can be examined under a microscope.

You should be able to go home as soon as the test is over or when you’ve recovered from the general anaesthetic.

Sometimes doctors can take a biopsy of the anal margin without using an anoscope or proctoscope. If you have this biopsy taken, you will have a local anaesthetic to numb the area first.


Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

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