Follow-up after treatment for anal cancer

Last medical review:

If you have been treated for stage 1, 2 or 3 anal cancer, your healthcare team will arrange follow-up visits to see how well you are responding to treatment. If you have stage 4 anal cancer, your healthcare team will talk to you about care and treatment for advanced cancer.

Follow-up care lets your healthcare team keep track of your health for a period of time after treatment ends. This important part of cancer care is often shared among the cancer specialists and your family doctor. They will help you recover from treatment side effects and monitor you for any signs that the cancer has come back (recurred).

Follow-up care may not seem that important to you, especially if your treatment was long or very hard. You may find the idea of follow-up care stressful because it reminds you of your cancer experience or because you are worried about what a test might reveal. Talk to your healthcare team about how you feel and about why follow-up matters. Your healthcare team is there to help.

Not all follow-up visits will be in the hospital or clinic. Your healthcare team may also keep in touch with you with phone calls and video calls.

Schedule for follow-up visits

Don't wait until your next scheduled appointment to report any new symptoms or symptoms that don't go away. Tell your healthcare team if you have:

  • pain or an increase in pain
  • itching around the anus
  • bleeding or discharge from the anus
  • a new lump in your groin
  • a new cough or shortness of breath
  • lost weight without trying

The chance that anal cancer will come back is greatest within 2 years, so you will need close follow-up during this time.

Follow-up is especially important during the first 6 months after chemoradiation. During these follow-up visits, your healthcare team will check how the cancer responded to treatment. They want to know if the anal cancer is completely gone or if it is still shrinking.

Tumours can continue to shrink for several months after chemoradiation is finished. Follow-up helps your healthcare team decide if you need more treatment.

Follow-up visits for anal cancer are usually scheduled:

  • 8 to 12 weeks after chemoradiation to check how the cancer responds to treatment
  • 3 to 6 weeks after surgery
  • then every 3 to 6 months for 5 years

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how well you are coping.

Your doctor may do a physical exam, including:

  • a digital rectal exam (DRE)
  • feeling the lymph nodes in the groin

Tests are often part of follow-up care. You may have:

  • an anoscopy or proctoscopy to check if any cancer was left behind or if it has come back after treatment
  • a biopsy to confirm that any cancer found is anal cancer

An anoscopy or a proctoscopy is usually done at the same time as a physical exam.

If the primary tumour was large or cancer had spread to lymph nodes at the time of diagnosis, you will usually have a CT scan every year for 3 years.

If the cancer has come back, you and your healthcare team will discuss your treatment and care.

Find out more about follow-up

The following are questions that you can ask your healthcare team about follow-up after treatment for cancer. Choose the questions that fit your situation and add questions of your own. You may find it helpful to take the list to your next appointment and to write down the answers.

  • What is the schedule for follow-up visits?
  • How often is follow-up scheduled with the cancer specialist?
  • Who is responsible for follow-up visits?
  • What will happen at a follow-up visit?
  • What tests are done on a regular basis? How often are they done?
  • Are there any symptoms that should be reported right away? Who do I call?
  • Who can help me cope with long-term side effects of treatment?

Expert review and references

  • Shahid Ahmed , MD, FRCPC, PhD, FACP
  • Ahmed S, Eng C, Messick CA. Squamous cell carcinoma of the anal canal. Yalcin S, Phillip PA (eds.). Textbook of Gastrointestinal Oncology. Springer Nature Switzerland; 2019: 10:171–180.
  • Cancer Research UK. Follow-up for Anal Cancer. 2019:
  • MacMillan Cancer Support. Understanding Anal Cancer. 2020:
  • Gotfrit J, Goodwin R, Asmis T, et al. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2019. Current Oncology. 2021: 28:1988–2006.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Anal Carcinoma Version 1.2022 . 2022.
  • Rao S, Guren MG, Khan K, et al. Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2021: 32(9):1087–1100.
  • Hosni A, Elamir A. Princess Margaret Cancer Center Clinical Practice Guidelines: Gastrointestinal: Anal. University Health Network; 2019.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on, nor do we endorse any service, product, treatment or therapy.

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