Follow-up after treatment for anal cancer

Follow-up after treatment is an important part of cancer care. Follow-up for anal cancer is often shared among the cancer specialists (oncologists), the surgeon and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

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

  • bleeding from the anus
  • pain, or an increase in pain, especially in the groin, pelvis or abdomen
  • any new lump or swelling

Follow-up is especially important during the first 6 months after chemoradiation. During these follow-up visits, doctors 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 several months after chemoradiation is finished). This helps them decide if they need to give more treatment.

The chance of anal cancer recurring is greatest within 2 years, so close follow-up is needed during this time.

Schedule for follow-up visits

The first follow-up visit usually happens 8–12 weeks after chemoradiation to check how the cancer responds to treatment.

Follow-up visits after treatment is finished are usually scheduled every 3–6 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 you’re coping.

Your doctor may do a physical exam, including:

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

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

  • anoscopy or proctoscopy to check if any cancer was left behind or came back after treatment
  • CT scan of the chest, abdomen and pelvis
  • biopsy to confirm that any cancer found is anal cancer

Anoscopy or proctoscopy is usually done at the same time as a physical exam. A CT scan is usually done every year for 3 years if the primary tumour was large or cancer had spread to lymph nodes.

If a recurrence is found, your healthcare team will assess you to determine the best treatment options.

Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.

Expert review and references