Surgery for anal cancer

Surgery is sometimes used to treat anal cancer. The type of surgery you have depends mainly on the size of the tumour, the stage of the cancer and if you have had other treatments.

Surgery may be done for different reasons. You may have surgery to:

  • completely remove the tumour
  • remove any cancer that is left behind or that comes back (recurs) after the first treatment
  • reduce pain or ease symptoms (called palliative treatment)

The following types of surgery are used to treat anal cancer. You may also have other treatments before or after surgery.

Wide local excision

Wide local excision is also called local resection. It is surgery to remove the tumour and a small amount of tissue around it (called the surgical margin). The surgeon may use special equipment, such as an anoscope, to do wide local excision.

Doctors use wide local excision to treat stage 0 or stage 1 anal cancer. It is often the only treatment needed for these early stages. Wide local excision may also be used for more advanced anal cancer if the tumour causes symptoms like pain and bleeding.

Abdominoperineal resection

An abdominoperineal resection is a type of bowel resection. During this surgery, the surgeon makes one incision, or cut, in the abdomen and another in the perineum (the area between the anus and vulva in women or between the anus and scrotum in men). The surgeon then removes the rectum, anus, anal sphincter and muscles around the anus. A permanent colostomy is needed because the anal sphincter is removed.

An abdominoperineal resection is done if chemoradiation didn’t destroy all the cancer cells or if cancer comes back (recurs) after chemoradiation.

Diagram of abdominoperineal resection
Diagram of abdominoperineal resection

Find out more about bowel resection, including abdominoperineal resection, and about colostomy.

Inguinal lymph node dissection

An inguinal lymph node dissection is surgery to remove lymph nodes from the groin. It may be done after an abdominoperineal resection to treat stage 3B anal cancer.

Find out more about inguinal lymph node dissection.

Side effects

Side effects can happen with any type of treatment for anal cancer, but everyone’s experience is different. Some people have many side effects. Other people have only a few side effects.

Side effects can develop any time during, immediately after or a few days or weeks after surgery. Sometimes late side effects develop months or years after surgery. Most side effects will go away on their own or can be treated, but some may last a long time or become permanent.

Side effects of surgery will depend mainly on the type of surgery, the effects of other treatments (such as radiation therapy) and your overall health.

Surgery for anal cancer may cause these side effects:

Tell your healthcare team if you have these side effects or others you think might be from surgery. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Questions to ask about surgery

Find out more about surgery and side effects of surgery. To make the decisions that are right for you, ask your healthcare team questions about surgery.

Expert review and references