Surgery for Anal Cancer

MSK surgeon Emmanouil Pappou in the operating room

MSK’s team of colorectal surgeons, including Emmanouil Pappou, are experts at removing anal cancer and will do everything possible to help you preserve your quality of life.

Radiation therapy is often the main treatment for anal cancer. Your doctor may discuss surgery with you too depending on the size and location of the tumor.

If you and your care team decide that surgery is the best approach, it’s important that your procedure is performed by an experienced surgeon. When you come to MSK for anal cancer surgery, you will be cared for by some of the most experienced colorectal and anal cancer surgeons in the world. We believe in a less-is-more approach. We will do everything we can to remove the cancer while leaving important organ functions intact.

Our surgeons have extensive experience in caring for people with all stages and types of anal cancer. We will offer you options that are tailored to your personal situation. We have particular expertise in treating anal cancer that has come back (recurred). We can also help if your disease has not responded to other treatments.

There are two main types of surgery to treat anal cancer: local resection and abdominoperineal resection.

Local Resection for Anal Cancer

Your doctor may recommend a local resection if the tumor is small, located in the outermost layer of the anus (called the anal margin), and has not spread to other parts of the body. During a local resection, your surgeon removes the tumor as well as a small amount of tissue around the tumor to make sure no cancer cells are left behind. Most people can have normal bowel movements after a local resection.

In rare cases, bowel function may be temporarily altered after a local resection. If needed, our expert team of colorectal surgeons, physician assistants, and nurses will help you adjust and adapt after surgery so that you can get back to normal bowel function as soon as possible.

Abdominoperineal Resection for Anal Cancer

In the past, abdominoperineal resection (APR) was the main treatment for anal cancer, but now chemoradiation is the primary therapy.   

If anal cancer does not respond to radiation or chemotherapy, or if it comes back after initial treatment, APR may be the right option for you.

During an APR, your surgeon removes the anus, rectum, and bottom part of the colon. You may have the nearby lymph nodes removed too if the tumor has spread. Your surgeon creates an ostomy after the cancer has been removed so that your body has a new way to release stool.

Minimally invasive, robot-assisted methods are often used for an APR. The surgeons at MSK are leaders in this area. We perform the most robot-assisted rectal cancer and anal cancer procedures in the country. Whenever possible, we use these advanced techniques. People who have minimally invasive surgery have faster and less-painful recoveries and a reduced risk of complications.

Before an APR, you will meet with a specialized nurse who is trained in ostomy care. At MSK, we have some of the most experienced and knowledgeable stoma therapists in the world. We will help you adjust to living with a permanent colostomy. We can also connect you to a rich network of people who have had an APR so that you will better understand life after an APR.