If you are experiencing symptoms of anal cancer, Dr. Albert Chung, MD, is here to help. As a highly trained colorectal surgeon in Santa Margarita, CA, Dr. Chung offers comprehensive diagnostic evaluations and personalized treatment options for patients facing symptoms or a confirmed diagnosis of anal cancer. Early detection and expert care are crucial for the best outcomes. Call (714) 988-8690 to schedule a consultation at our Santa Ana clinic today.
Anal cancer develops when abnormal cells grow uncontrollably in the anal canal. It's far less common than colorectal cancer, but it shares an important trait: outcomes depend heavily on how early it's found. Most patients diagnosed at an early stage do well with treatment, often without needing surgery.
Anal cancer arises in the anal canal, the short tube at the end of the digestive tract. The most common type by far is squamous cell carcinoma, which begins in the cells lining the anus. Less common types include adenocarcinoma, basal cell carcinoma, and melanoma.
Although anal cancer is uncommon (around 9,000 to 10,000 new US cases each year), the rate has been slowly rising. Awareness of the symptoms and risk factors is what gets people in the door before a small problem becomes a big one.
The single biggest driver of anal cancer is human papillomavirus (HPV), the same virus most responsible for cervical cancer.
Most people exposed to HPV clear it without consequence. In some, the virus persists and causes cellular changes (anal dysplasia) that, over years, can develop into cancer. Recognizing this connection is what makes anal cancer one of the more preventable cancers, especially for people in higher-risk groups.
Some patients have no symptoms at all. Others notice changes that warrant a closer look. Common signs include:
These symptoms are far more often caused by benign conditions like hemorrhoids or fissures. But because they overlap, an evaluation is the only way to know for sure. Persistent symptoms deserve a real exam.
Several factors raise the likelihood of developing anal cancer.
If symptoms or risk factors warrant evaluation, Dr. Chung may recommend one or more of the following:
Treatment depends on the stage of the disease and your overall health. Modern care has shifted dramatically in the last few decades, with chemoradiation now the first-line approach for most cases.
Dr. Chung will work closely with you and any oncology team involved to determine the best strategy based on your specific stage, health, and goals.
Outcomes for anal cancer have improved significantly with modern treatment. When found before it has spread, the majority of patients respond well to chemoradiation and avoid surgery entirely. Even more advanced cases have meaningful treatment options.
The biggest factor in a good outcome is catching it early. That's why every persistent or unexplained anal symptom deserves an evaluation, and why high-risk groups should talk to a specialist about appropriate screening.
Anal cancer is one of the few cancers with a true precancer stage that can be found and treated. High-grade squamous intraepithelial lesions (HSIL), caused by persistent HPV infection, precede most anal cancers by years. The ANCHOR trial, published in 2022, showed that treating HSIL rather than watching it reduced progression to anal cancer by more than half. As a result, screening is now recommended for people living with HIV, organ transplant recipients and others on long-term immunosuppression, women with a history of cervical, vaginal, or vulvar precancer or cancer, and men who have sex with men. Screening starts with an anal Pap test, and abnormal results are evaluated with high-resolution anoscopy, a magnified exam that identifies lesions for biopsy and treatment in the office.
| Screening step | What it involves | Where it happens |
|---|---|---|
| Anal cytology (anal Pap) | A swab of the anal canal, similar to a cervical Pap. Takes seconds. | Office visit |
| Digital rectal exam | Feels for masses or thickening in the anal canal. | Office visit, same appointment |
| High-resolution anoscopy (HRA) | Magnified examination with acetic acid and iodine staining to reveal abnormal areas; biopsies taken of anything suspicious. | Office, 20 to 30 minutes, no sedation |
| Treatment of HSIL | Office-based ablation (infrared coagulation or electrocautery) or topical therapy for confirmed high-grade lesions, followed by surveillance HRA. | Office |
Anal cancer is diagnosed late more often than it should be, and the reason is that its symptoms look like hemorrhoids: bleeding, itching, a lump, discomfort. Patients treat themselves with creams, and sometimes physicians treat them for hemorrhoids without an exam. The distinguishing features are persistence and progression. Hemorrhoid symptoms come and go with bowel habits; a cancer keeps growing. A lump that hardens or enlarges over weeks, bleeding or pain that does not respond to two to three weeks of hemorrhoid care, a change in the shape of your stool, or symptoms in anyone with the risk factors listed above deserves an anoscopy. Dr. Chung performs one at the first visit, and it takes two minutes to tell the difference. Read Hemorrhoids or Something Worse?
Because chemoradiation rather than surgery is the primary treatment for most anal cancers, care is shared between the colorectal surgeon, a radiation oncologist, and a medical oncologist. Dr. Chung makes the diagnosis, stages the tumor with exam and imaging, presents the case to the tumor board, and follows you through and after treatment. He performs the examinations that confirm the cancer has responded, manages the anal and skin side effects of radiation, and operates when surgery is needed: local excision for very small tumors at the anal margin, and salvage surgery for the minority of cancers that persist or return after chemoradiation.
Dr. Chung evaluates higher-risk patients in his Rancho Santa Margarita office, arranges anal Pap testing and high-resolution anoscopy when they are indicated, and performs the anoscopy that answers the question most people arrive with: whether the symptom they have been treating as a hemorrhoid is something else.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
Current guidelines recommend screening for people living with HIV, transplant recipients and others on long-term immunosuppression, women with a history of cervical, vaginal, or vulvar cancer or high-grade precancer, and men who have sex with men. Screening starts with an anal Pap test in the office and, if abnormal, high-resolution anoscopy.
Yes, and it frequently is, because both cause bleeding, itching, a lump, and discomfort. The difference is persistence: hemorrhoid symptoms fluctuate with bowel habits, while a cancer keeps growing. Any anal symptom that has not improved after two to three weeks of hemorrhoid care should be examined with an anoscopy.
Most anal cancers are cured, particularly when found early. Chemoradiation cures the majority of localized cancers without surgery and preserves normal bowel function. Even locally advanced cancers respond well, and surgery remains an option for the minority that persist or recur.
Usually not as the primary treatment. Chemoradiation is the standard of care for most anal canal cancers. Surgery is used for very small tumors at the anal margin that can be removed with a clear margin, and as salvage treatment for cancers that do not respond to chemoradiation.
Yes. The HPV vaccine protects against the strains responsible for most anal cancers. It is recommended for everyone through age 26 and can be given up to age 45 after a discussion with a physician. It is most effective when given before HPV exposure but still offers protection later.
A magnified examination of the anal canal using a colposcope, with acetic acid and iodine staining to highlight abnormal areas. It allows precancerous lesions that are invisible to the naked eye to be identified, biopsied, and treated in the office. It takes about 20 to 30 minutes and does not require sedation.
If you're noticing symptoms or have risk factors for anal cancer, getting evaluated quickly is the single most important thing you can do. Dr. Chung handles these conversations with the matter-of-factness they deserve.
Book a consultation Call (714) 988-8690Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
