Chemoradiotherapy for anal cancer

Also known as chemoradiation, chemoradiotherapy combines a course of radiotherapy with some chemotherapy sessions. The chemotherapy makes the cancer cells more sensitive to the radiotherapy.

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

If you smoke, it is worth making every effort to quit before chemoradiotherapy begins. Smoking can make side effects worse and treatment less effective. Call 13 QUIT (13 7848) for support or see our list of resources to help you quit.

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Chemotherapy 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 chemotherapy drugs will usually be given into a vein through an intravenous (IV) drip.


Radiotherapy uses radiation, such as high-energy x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells so they cannot grow or multiply. The radiation is targeted to the location of the cancer, and 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.

Side effects of chemoradiotherapy

Both chemotherapy and radiotherapy can have side effects, but many side effects are temporary and there are ways to prevent or reduce them.

Side effects of chemoradiotherapy can include:

  • tiredness
  • nausea, vomiting and diarrhoea
  • appetite loss
  • needing to pass urine more often or leaking urine (incontinence)
  • loss of pubic hair
  • low resistance to infection – if you have a temperature over 38°C, contact your doctor or go to the emergency department
  • sensitivity to light (photosensitivity) and gritty eyes
  • sore, reddened skin and ulcers around the anus, genital areas and groin – this can cause intense pain when sitting and during bowel movements
  • narrowing and closing up of the vagina (which can be managed with regular use of vaginal dilators after treatment)
  • effects on sexuality, including painful intercourse and loss of erections
  • effects on fertility.

For more information on treatments and managing these side effects, you can read our radiotherapy and chemotherapy pages, or download Cancer Council’s Understanding Radiotherapy and Understanding Chemotherapy booklets. For detailed information about radiotherapy and managing side effects, visit

Effects on sexuality and fertility

Chemoradiotherapy for anal cancer can have a range of effects on sexuality, including:

  • loss of interest in sex (low libido)
  • changes to the vagina or to the anus and rectum that can cause pain or loss of pleasure during intercourse
  • difficulty getting and maintaining an erection (erectile dysfunction).

Ask your doctor about ways to manage these changes. You can also ask for a referral to a sexual therapist.

You may be advised to use contraception during chemoradiotherapy as the treatment could harm a developing fetus. The treatment may also affect fertility, so talk to your doctors before treatment begins if you may want to have children in the future. It is sometimes possible to store sperm or eggs for future use, or to move ovaries away from the treatment area.

For women who have not yet been through menopause, radiotherapy to the pelvic region may cause periods to stop permanently. This is known as early menopause and can lead to symptoms such as hot flushes, dry skin and vaginal dryness. Talk to your doctor about hormone replacement therapy (HRT) and other treatments for these symptoms.

For more information about the impact of cancer treatment on fertility and sexuality, call Cancer Council 13 11 20  or download Cancer Council’s Sexuality, Intimacy and Cancer and Fertility and Cancer booklets.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.

Video: What is radiotherapy?

Watch this short video to learn more about radiotherapy.

This information was last reviewed in June 2016
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