Chemoradiation for anal cancer

Also known as chemoradiotherapy, this treatment combines a course of radiation therapy with some chemotherapy sessions. The chemotherapy makes the cancer cells more sensitive to the radiation therapy.

For anal cancer, a typical treatment plan might involve a session of radiation therapy every weekday for several weeks, as well as chemotherapy on some days during the first and fifth weeks. This approach avoids surgical removal of the anus in most people and allows for lower doses of radiation therapy.

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Radiation therapy

Also known as radiotherapy, this treatment uses targeted radiation to kill or damage cancer cells so they cannot grow, multiply or spread. The radiation is usually in the form of x-ray beams. Treatment is carefully planned to do as little harm as possible to the normal body tissue around the cancer. During a treatment session, you lie under a machine that delivers radiation to the treatment area. It can take 10–20 minutes to set up the machine, but the treatment itself takes only a few minutes and is painless. You will be able to go home afterwards.


This is the treatment of cancer with anti-cancer (cytotoxic) drugs. It aims to kill cancer cells while doing the least possible damage to healthy cells. For anal cancer, the drugs are usually given into a vein through an intravenous (IV) drip.

Side effects of chemoradiation

Both chemotherapy and radiation therapy can have side effects. These can occur during or soon after the treatment (early side effects), or many months or years later (late side effects).

Early side effects

These usually settle down in the weeks after treatment. They may include:

  • tiredness
  • nausea, vomiting, appetite loss – can usually be prevented with medicines
  • bowel changes, such as diarrhoea and more frequent, urgent or painful bowel movements
  • passing urine more often, leaking urine (incontinence) or painful urination
  • skin changes, with redness, itching, peeling or blistering around the anus, genital areas and groin – can be managed with creams that your treating team will recommend
  • low resistance to infection – if you have a temperature over 38°C, contact your doctor or go to a hospital emergency department
  • loss of pubic hair.

Late side effects

These can occur more than six months, or even years, after treatment ends. They vary a lot from person to person, but may include:

  • bowel changes, with scar tissue in the anal canal or rectum leading to problems with bowel movements
  • dryness, shortening or narrowing of the vagina (vaginal stenosis) – can be prevented or minimised by using vaginal dilators regularly
  • impacts on sexuality, including painful intercourse, difficulty getting erections, or loss of pleasure
  • effects on the ability to have children (fertility).

For more information on treatments and managing these side effects, you can read our radiation therapy and chemotherapy pages.

Chemoradiation for anal cancer can have a range of effects on sexuality and may also affect fertility. Ask your doctor about ways to manage these changes, as early treatment and support can help. See Fertility and cancer for more information.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.

Video: What is radiation therapy?

Watch this short video to learn more about radiation therapy.

This information was last reviewed in June 2018
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