If you have symptoms of anal cancer, your GP will examine you and refer you to a specialist for tests.
If the tests show that you have anal cancer, the specialist will work out how far it has spread. This is known as staging.
Learn more about:
Tests
The main tests for diagnosing anal cancer are a physical examination and an endoscopy with biopsy.
| Physical examination | The doctor inserts a lubricated gloved finger into your anus to feel for any lumps or swelling. This is called a digital anorectal examination (DARE). |
| Endoscopy | The doctor inserts a narrow instrument called a sigmoidoscope or colonoscope into the anus to see the lining of the anal canal. This may be done under a light general anaesthetic (sedation). |
| Biopsy | Only a tissue sample (biopsy) from the area can be used to diagnose cancer. This sample may be collected during the endoscopy, and then sent to a pathologist who will check it for cancer under a microscope. |
| Imaging scans | These are used to check if cancer has spread. Scans may include a pelvic MRI, an ultrasound, a CT scan or, less often, a PET-CT scan. |
For more on this, see Tests and scans or call Cancer Council 13 11 20.
Staging and prognosis
Staging describes how far the cancer has spread. Knowing the stage helps doctors plan the best treatment for you. Anal cancer is staged using the TNM (tumour–nodes–metastasis) system.
| T (tumour) 0–4 | Indicates how far the tumour has grown into the bowel wall and nearby areas. T1 is a smaller tumour (2 cm or less); T4 can be any size but growing into surrounding organs. |
| N (nodes) 0–1c | Shows if the cancer has spread to nearby lymph nodes (small glands): N0 means no cancer is in the lymph nodes; N1 means cancer is in the lymph nodes around the rectum, groin and/or pelvis. N1 can be further divided into a, b or c, depending on which lymph nodes the cancer has spread to. |
| M (metastasis) 0–1 | Shows if the cancer has spread to other, distant parts of the body: M0 means cancer has not spread; M1 means cancer has spread. |
Many people feel understandably shocked and upset when told they have anal cancer. If you need support, call Cancer Council 13 11 20.
The diagnosis of anal cancer was a huge shock and overwhelming. Being poked and prodded there was initially intimidating. But my focus was on doing everything I could to get well.
Annie
→ READ MORE: Your health care team
Podcast: Tests and Cancer
Listen to more of our podcast for people affected by cancer
More resources
Glen Guerra, Colorectal Surgeon, Peter MacCallum Cancer Centre and St Vincents Hospital Melbourne, VIC; Holly Davey, 13 11 20 Consultant, Cancer Council Queensland; Prof Peter Gibbs, Laboratory Head, Walter and Eliza Hall Institute, The University of Melbourne, Medical Oncologist, Western Hospital, VIC; A/Prof Ian Faragher, The University of Melbourne, Head of Colorectal and General Surgery Unit, Western Health, VIC; Justin Hargreaves, Medical Oncology Nurse Practitioner, Bendigo Health Cancer Centre, VIC; Prof Richard Hillman, Senior Staff Specialist, HIV and Immunology, St Vincent’s Health Network, Sydney, Conjoint Professor, St Vincent’s Clinical Campus and The Kirby Institute, NSW; A/Prof George Hruby, Radiation Oncologist, Royal North Shore Hospital, Visiting Radiation Oncologist, Genesiscare and Dubbo Base Hospital, NSW; Annie Jacobs, Consumer; Mariad O’Gorman, Clinical Psychologist, Bankstown Cancer Therapy Centre, NSW; Terry Scully, Consumer.
View the Cancer Council NSW editorial policy.
