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Anal and Rectal Cancer

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Anal and Rectal Cancer

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It wasn't long ago that tumors in the lower third of the rectum often required removal of the anal sphincter muscle and a colostomy, a drainage site routed to the abdomen where a bag collected solid waste. Today, there are many different treatment options. Your specific options will be matched to your individual case, including any pertinent clinical trials.

The different types of anal cancer are based on the type of anal cells in which the cancer develops. Types of anal and rectal cancers include:

  • Squamous cell carcinoma: the most common kind of anal cancer, which starts to form in the anal canal's outer lining
  • Cloacogenic carcinoma: makes up about 25 percent of all cases of anal cancers, which develops between the outer part of the anus and the lower part of the rectum
  • Adenocarcinoma: occurs in the mucus-producing glands situated under the anal lining
  • Basal cell carcinoma: a kind of skin cancer that can appear on the skin around the anus
  • Melanoma: starts in the pigment-producing cells that are found in the skin or anal lining

Why Choose Sylvester Comprehensive Cancer Center?

One of only 71 NCI-designated cancer centers in the United States. Sylvester is one of only two cancer centers in Florida that have been recognized by the National Cancer Institute. The team earned this distinction through its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

Colorectal cancer survival rates above the national average. Sylvester’s survival rates are up to 19 percent higher than the national average for both early- and late-stage colorectal cancer. We can help you achieve a longer, higher quality of life.

Advanced radiation oncology tools. Sylvester is one of only five medical centers in the country with ViewRay — MRI-guided radiation therapy. And, our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). This leads to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.

More cancer clinical trials than any other South Florida hospital. We offer you ease of access and the newest ways to treat and potentially cure your cancer.

Treatment that preserves normal bowel function. Sylvester surgeons can now safely remove many cancers not directly involving the sphincter muscle or pelvic floor, so only a limited number of patients require colostomies.

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Treatments

  • Surgery

    Due to advances in radiation and chemotherapy, surgery is rarely used anymore in anal cancer. In many cases, Sylvester specialists can use radiation or chemotherapy or a combination to cure or control the cancer without disrupting bowel function.

    Sylvester surgeons can now safely remove many cancers not directly involving the sphincter muscle or pelvic floor, while preserving normal bowel function. Only a limited number of patients will still require colostomies; those who do will be supported by experienced and knowledgeable enterostomal therapists to teach them how to manage them.

  • Radiation Therapy

    Sylvester’s radiation oncologists use the most advanced technology to deliver radiation externally or internally to colorectal tumors.

    • External beam radiation: This radiation therapy approach is delivered from outside the body using specialized equipment. Most colorectal cancer treatment at Sylvester uses this technique. We use RapidArc® to provide intensity modulated external radiation therapy (IMRT), which shortens treatment times to one-half to one-eighth that of conventional radiation therapy. This results in more precise tumor targeting and reduces damage to nearby healthy tissue.
    • Internal radiation: Called brachytherapy, this type of radiation is used for smaller primary tumors, with clean, healthy skin around them and no evidence of cancer in the lymph nodes. Brachytherapy involves temporarily implanting a radiation applicator into the tumor site and delivering doses of radiation locally, at certain intervals. It allows the radiation oncologist to keep the radiation dose away from sensitive organs.

  • Chemotherapy (Systemic Medical Therapy)

    Chemotherapy is usually a combination of cancer-fighting medicines and can be administered intravenously or by a pill. If you require intravenous (infusion) chemotherapy, you can receive it at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami. It's a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you can also have your infusion treatments at the Kendall, Hollywood, Coral Springs, Coral Gables, or Deerfield Beach locations.

    • Before surgery (Neoadjuvant): Sometimes, a rectal tumor is too large or marginal to avoid damaging the sphincter muscle with surgery. In cases like these, neoadjuvant chemotherapy with or without radiation are given before surgery to shrink the tumor so it's easier to remove.
    • After surgery (Adjuvant): Most chemotherapy is provided after surgery. Sometimes, chemotherpy includes combinations of medicines that have been shown to work well together for your type of cancer. Your specialist may also recommend using a standard therapy coupled with a clinical trial drug.

       

    • HIPEC (hyperthermic intraperitoneal chemoperfusion): Sylvester is the first center in South Florida to deliver heated chemotherapy to cancers that have spread through the abdominal cavity. The one-time treatment is done in the operating room, right after the cancer is removed. HIPEC allows a higher concentration of chemotherapy without the systemic side effects, increasing disease-free survival much better than systemic chemotherapy. For some people, HIPEC can offer a total cure.

       

  • Targeted Therapy

    Targeted therapies are designed to attack the molecular alterations that make the cancer cell grow and spread. They have the potential to be more effective and with fewer side effects than chemotherapy. Some of these medicines are given along with chemotherapy medicines, while others are used by themselves.

     

  • Clinical Trials

    As a colorectal cancer patient at Sylvester, you have access to more novel or advanced treatments than anywhere else in South Florida.  Your doctor will recommend any clinical trials that are right for you.

     

Tests


Early detection and an accurate diagnosis are essential to a successful colon or rectal cancer treatment. Along with reviewing your medical history and blood work, the following tests may be recommended to help us diagnose your cancer.

  • Colonoscopy

    Colonoscopy uses a small, flexible tube with a camera at the end to check the full length of your inner colon. If polyps or other precancerous lesions are found, they can be removed during the test, preventing cancer from forming.

    • A colonoscopy should be performed every 10 years in those who are over the age of 50 and who have a normal level of risk.
    • People with a strong family history of colorectal cancer or a genetic predisposition, they should be screened more often and screening should start at an earlier age.

  • Flexible Sigmoidoscopy

    This exam is similar to a colonoscopy. It utilizes a small and flexible tube to check just the lower part of the colon. The procedure is performed without sedation and should be done every five years. If polyps or cancer are found, you will need a colonoscopy.

  • Virtual Colonoscopy (Colonography)

    Although the same bowel preparation is required for clear viewing of the colon, for some people, virtual colonoscopy provides an alternative to traditional colonoscopy. Colonography is a type of CT scan that creates a 3D image of the inside of the colon. While you are awake, a small tube is inserted into your rectum, which slowly inflates the colon with air so it can be properly scanned. The procedure doesn’t involve the use of any instruments, so any polyps or suspicious areas found can’t be removed or biopsied — this would require a colonoscopy.

  • Biopsies

    If your imaging exam or colonoscopy reveals a polyp or suspicious lesion, your doctor will remove the polyp or take a tissue sample to examine. This is the only definitive way to know if a growth is cancerous.

     

  • Multigene Tests

    Multigene tests are performed after a biopsy. Because no tumor has a single mutation, genomic profiling allows us to identify groups of mutations in your tumor tissue sample and create a tumor profile for you. This enables us to develop and deliver treatments that target those mutations. The profile can help us predict if your cancer is likely to spread to other parts of your body.

     

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

Accepted Insurance