Stephen J. Schueler, M.D.

Cancer of the Anus Home Care

Home care for anal cancer includes:

  • Drink plenty of liquids.
  • Regular exercise program.
  • Acetaminophen for pain
  • Nonsteroidal anti-inflammatory medications for pain:
  • Narcotic pain medications
  • Colostomy care:
    • For those with a colostomy after surgery
  • High fiber diet
  • Take your medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Avoid running out of your medication. Refill your prescriptions early.
    • Don't stop taking your medication just because you feel better.
    • If you feel worse, talk to your doctor before you stop your medication.
    • Be aware of the common side effects that may be caused by your medication.
    • Do not stop prescription medications without talking to your doctor.
  • Learn everything you can about anal cancer:
    • The more you know about your condition, the easier it will be to participate with your doctor in making treatment decisions.
    • Ask your doctor about good sources for information.
    • Write down questions to ask your doctor
  • Create a support group:
    • Include family and friends
    • Learn about support groups in your community or contact your local chapter of the American Cancer Society.

Cancer of the Anus Anorexia

Many patients with anal cancer will suffer from anorexia.

Anorexia means loss of appetite. Anorexia is a problem with many forms of cancer, because cancer can affect the body's hormones, digestive system and brain. It is also a common side effect of chemotherapy and radiation therapy.

Good nutrition is an important part of successful cancer treatment. Adequate nutrition can boost the immune system and help increase the effectiveness of cancer therapy.

Home care for anorexia includes:

  • Avoid stomach irritants such as aspirin or ibuprofen.
  • Avoid excessive caffeine and other stimulants.
  • Check with your doctor about drinking alcohol.
  • Do not force yourself to eat at standard times. Eat when you are hungry instead.
  • Concentrate on eating a healthy diet. Avoid junk foods.
  • Select healthy, high-calorie foods that you enjoy.
  • Eat more frequent, smaller meals.
  • Get some exercise every day.
  • Keep a daily log of your weight.
  • Don't smoke. Nicotine can suppress the appetite.
  • Ask your doctor or nutritionist about dietary supplements.
  • Ask your doctor if any medications you may be taking can cause anorexia.
  • Take any prescribed medications as directed.
  • Anti-nausea medications:
  • Appetite stimulants:

Cancer of the Anus Colostomy

Home care of and prevention of colostomy problems in someone with anal cancer includes:

  • Daily activities: many people find only minor changes are needed.
  • Diet: increased fluids and avoiding certain foods is usually helpful.
  • Ostomy appliance and skin care: daily care to protect the skin and stoma.
  • Prevention and treatment of bowel problems: constipation, diarrhea and excessive gas may require corrective measures.
  • Medications: the absorption of certain medications may be affected by an ostomy.

For more information:

Cancer of the Anus Diet

A person with anal cancer may benefit from the following diet.

Cancer and Chemotherapy Diet
Adequate nutrition is essential for the body to fight cancer. Unfortunately, cancer and its treatment can cause anorexia, weight loss and malnutrition.

There are two main goals for a cancer diet:

  • Achieve and maintain a reasonable weight.
  • Prevent and correct poor nutrition.

Strategies for evaluating weight loss and anorexia include:
  • Determine symptoms that might cause loss of appetite.
  • Learn what foods stimulate the appetite.
  • Provide nutritional and dietary counseling.

Practical dietary guidelines:
  • Atmosphere does make a difference: an attractively set table can help take your mind off a poor appetite.
  • Aromas may also help stimulate the appetite, such as freshly baked bread and cookies.
  • A glass of wine or beer prior to meals may stimulate the appetite.
  • Avoid foods that do not interest you.
  • Discuss your eating problems with your doctor.
  • Give food a chance: food that sounds unappealing today may sound good tomorrow.
  • Stay away from raw eggs and raw meats.
  • Take advantage of a good appetite.
  • Eat when you feel hungry: do not wait for mealtime.

Benefits of proper nutrition during chemotherapy:
  • Improves your tolerance to therapy: a well-nourished body is stronger and more resilient than a poorly nourished one
  • Increases the effectiveness of therapy
  • Regulates your weight
  • Speeds recovery from treatment

Cancer of the Anus High Fiber Diet

A person with anal cancer may benefit from the following high fiber diet.

Fiber is one of the best ways to soften the stool. Dietary fiber is a plant material that humans cannot digest. Fiber works by increasing the amount of water in your stool and keeps the stool soft. The most well known fiber is bran. Common fiber supplements include Citrucel and Metamucil. It is important to drink plenty of water when you eat fiber.

Fiber comes in two forms, based on whether it will dissolve in water. Soluble fiber dissolves in water and insoluble fiber does not dissolve in water. About 3/4 of fiber intake should be the insoluble fiber.

Water Soluble Fiber

ExamplesDietary Sources
Pectins, gums, & mucilagesfruits, vegetables, oats, bran, barley, legumes

Insoluble Fiber
ExamplesDietary Sources
Cellulose, hemicellulosevegetables, wheat bran, & whole grains

Fiber tends to bind water, which leads to softer stools and a more rapid passage of material through the intestines. This may reduce exposure to toxic substances and improve bowel health. Fiber can also bind fat and cholesterol. As an added benefit, high fiber foods usually contain important vitamins and minerals.

Use of a High Fiber Diet
A healthy diet should include more than 25 grams of fiber each day. In general, every extra gram of fiber eaten each day can lower the risk of heart disease by as much as five percent.

A high fiber diet can prevent and treat the following:

General Guidelines
In general, fruits, vegetables and whole grains are high in fiber. Raw foods tend to have more fiber than cooked, canned or pureed items. Dried fruits, beans, black-eyed peas, bran and oatmeal are very high in fiber. Peeling the skin from fruit and vegetables removes fiber.

Unprocessed wheat bran can be added to meals and baked foods. Bran is the outer layer of the wheat grain, and is present in 'whole grain' foods. Adding 2-3 teaspoons of bran per serving is a great way to increase the fiber content of casseroles, meat loaf, and baked goods. Whole grain flour has 6 times the fiber of standard, bleached flour. Oat bran can be used in place of about 1/3 of regular flour when baking.

Change your diet slowly. Rapid changes in the diet can cause bloating, gas and diarrhea.

Example High-Fiber Diet
Eat at least 3 to 10 servings of whole grain food every day. Each serving should contain 3 grams of fiber.

Examples include:
  • Barley
  • Brown rice
  • Oatmeal or oat bran
  • Rye bread
  • Wheat germ
  • Whole grain bagels
  • Whole grain breads
  • Whole grain muffins
  • Whole grain or bran cereals
  • Whole grain pita bread
  • Whole wheat crackers
  • Whole wheat pasta

Eat 3-4 servings of fruit each day. Dried fruits are high in fiber.

Examples include:
  • Apple
  • Banana
  • Berries
  • Grapefruit
  • Nectarine
  • Orange
  • Peach
  • Pear

Eat at least 3-5 servings of raw, unpeeled vegetables per day.

Examples include:
  • Asparagus
  • Broccoli
  • Cabbage
  • Carrots
  • Green beans
  • Green pepper
  • Onions
  • Peas
  • Potatoes with skin
  • Snow peas
  • Spinach
  • Squash
  • Sweet potatoes
  • Tomatoes
  • Zucchini

Meat substitutes:
Meat has no fiber, and contains cholesterol and saturated fat. Many high-fiber foods can replace meat in the diet.

Examples include:
  • Almonds
  • Brazil nuts
  • Cashews
  • Garbanzo beans
  • Kidney beans
  • Lentils
  • Lima beans
  • Peanut butter
  • Peanuts
  • Pinto beans
  • Sesame seeds
  • Soybeans, but not tofu
  • Split peas
  • Sunflower seeds
  • Veggie burgers
  • Walnuts

Cancer of the Anus Pain Medications

Medications commonly used to control pain and inflammation in adults with anal cancer include:

  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.





NSAID Precautions

Cancer of the Anus Taking Control

The successful treatment of anal cancer requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Cancer of the Anus Warning Signs

Notify your doctor if you have anal cancer and any of the following:

Continue to Cancer of the Anus Prevention

Last Updated: Feb 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Cancer of the Anus References
  1. Clark MA, Hartley A, Geh JI. Cancer of the anal canal. Lancet Oncol. 2004 Mar;5(3):149-57. [15003197]
  2. Sato H, Koh PK, Bartolo DC. Management of anal canal cancer. Dis Colon Rectum. 2005 Jun;48(6):1301-15. [15793642]
  3. Welton ML, Sharkey FE, Kahlenberg MS. The etiology and epidemiology of anal cancer. Surg Oncol Clin N Am. 2004 Apr;13(2):263-75. [15137956]
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