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Anal Cancer Diagnosis

If you have symptoms that may signal anal cancer, your doctor will examine you and ask you questions about your health, your lifestyle, including smoking and drinking habits, and your family history.

One or more of the following tests may be used to find out if you have anal cancer and if it has spread. These tests also may be used to find out if treatment is working.

Imaging tests, which may include:

  • Anoscopy: A short tube with a camera is inserted into the anus and lower rectum. The doctor examines the anus and can biopsy tissue.
  • Proctoscopy: A short tube with a camera is inserted into the anus to the rectum. The doctor examines the anus and can biopsy tissue.
  • Double contrast barium enema (DCBE): Barium is a chemical that allows the bowel lining to show up on an X-ray. You will be given an enema with a barium solution, and then X-rays will be taken.
  • Colonoscopy
  • Virtual colonoscopy or CT (computed tomography) colonoscopy
  • CT (computed tomography) scans; also called CAT scans
  • MRI (magnetic resonance imaging) scans
  • PET/CT (positron emission tomography) scans
  • Endo-anal or endorectal ultrasound: An endoscope is inserted into the anus. A probe at the end of the endoscope bounces high-energy sound waves (ultrasound) off organs to make an image (sonogram). Also called endosonography.
  • Chest X-Ray

Fine-needle aspiration biopsy: Anal cancer may spread through the lymph system, and sometimes it is found in lymph nodes. A tiny needle is placed into a lymph node, and cells are removed and looked at with a microscope. A positive lymph node biopsy may help the doctor decide what areas to treat with radiation therapy. 

Anal Cancer Staging

If you are diagnosed with anal caner, your doctor will determine the stage of the disease. Staging is a way of talking about how much disease is in the body and where it has spread. This information helps the doctor treat the cancer.

Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.

Anal Cancer Stages

(source: National Cancer Institute)

Stage I: Cancer has formed. The tumor is 2 centimeters or smaller.

Stage II: Tumor is larger than 2 centimeters but not greater than or equal to 5 centimeters

Stage IIIA: Tumor is 5 centimeters or greater and/or has spread to either:

  • Lymph nodes near the rectum
  • Nearby organs, such as the vagina, urethra or bladder

Stage IIIB: Tumor is 5 centimeters or greater and/or may be any size and has spread to:

  • Nearby organs and lymph nodes near the rectum
  • Lymph nodes on one side of the pelvis and/or groin and may have spread to nearby organs
  • Lymph nodes near the rectum and in the groin and/or lymph nodes on both sides of the pelvis and/or groin and may have spread to nearby organs

Stage IV: Tumor may be any size and may have spread to lymph nodes or nearby organs and has spread to distant parts of the body.

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Knowledge Center

Find the latest news and information about anal cancer in our Knowledge Center, including blog posts, articles, videos, news releases and more.