While anal cancer is uncommon in the general population, it is far more common in high-risk populations, such as men who have sex with men (msm) and those who have HIV infection. in up to 90% of cases anal cancer is linked to human papillomavirus (hpv) infection. [1]anal cancer is a rare condition, although its incidence has been increasing over the past several decades, particularly in women.2 The anatomic definitions for anal cancer (canal versus margin) square measure created supported the connection of the growth to the anal verge. This methodology had LED to confusion for a few suppliers. A modification within the word is planned that has intra-anal, perianal, and skin as classes. The reason behind anal malignant neoplastic disease remains to be totally elucidated, and HPV looks to play a central role during this method. The incidence of anal cancers has hyperbolic, that is said to the evolution of HIV and AIDS, and their treatment. The correct pathologic analysis of anal tumors is complicated and is considerably power-assisted by shut communication between practician and medical specialist. 3
Epidemiology
Over the past several years, the prevalence of anal canal cancer has steadily increased, especially in women. In the United States, anal cancer accounts for 0.5% of all cancer diagnoses at this time. According to estimations, there were 1160 fatalities and 8580 cases (sixty-eight women and two thousand males) in the United States annually in 2018. The majority of cases of anal cancer occur in older persons, with an average age in the early 60s. Nonetheless, the illness manifests itself early in HIV-positive individuals.2
Clinical presentations
Symptoms sometimes mirror a minimum of a regionally advanced cancer. body part hurt is that the commonest displays of body part cancer. in later stages of the malady, different symptoms like muscle spasm, incomplete stool evacuation, diminished caliber of stools cramping, girdle and body part pain or preventive symptoms may gift.4
Risk factors – Human papilloma virus infection. Hiv infection. Chronic immunosuppression not due to hiv. Multiple sexual Partner. Receptive anal intercourse. Female gender. History of cervical, vulvar, or vaginal carcinoma. Smoking. Crohn’s disease.5
Differential diagnosis
- chancroid
- anal fissure/fistula
- hemorrhoids
- condylomata acuminatum
- psoriasis
Diagnosis
Rectal examinations or signs and symptoms might raise the possibility of rectal cancer. A colonoscopy or imaging investigation is necessary if it is suspected. It could also be found via the screening process. After a suitable staging has been determined, a histologic tissue evaluation is necessary to confirm the diagnosis.
Two frequently used diagnostic and screening techniques for rectal malignancies are sigmoidoscopy and colonoscopy. Even though flexible sigmoidoscopy is a reliable diagnostic technique for rectal malignancies, a colonoscopy is still necessary to check for synchronous colonic polyps or tumors, which are detected in 4% of patients, in other colonic regions.6
Complications are chiefly related to treatment and include the following:
- side effects of radiation
- adverse effects of chemotherapy
- decreased libido
- bowel dysfunction
- proctitis
- rectal bleeding
- surgery-associated strictures, fistulas, and wound infections.7
Homoeopathic treatment8,9,10,11
Aceticum acidum-especially indicated in pale, lean persons, with lax, flabby muscles. wasting and debility. acetic acid has the power to liquefy albuminous and fibrinous deposits. epithelial cancer, internally and locally.
Carboneum sulphuratum
burning; itching; ulcers; small wounds fester. useful to restrain the growth of cancer. better, in open air. worse, after breakfast; bathing. sensitive to warm, damp, weather.
Carduus marianus
prolapse or rectum, burning pain in anus and rectum, hard and knotting, clayey stools. profuse diarrhœa due to rectal cancer.
Cinnamomum ceylanicum
cancer where pain and fetor are present. best when skin is intact. its use in hæmorrhages has abundant clinical verification. nosebleed. hæmorrhages from bowels, hæmoptysis, etc. a strain in loins or false step brings on a profuse flow of bright blood. post-partum hæmorrhage. flatulency and diarrhœa. feeble patients with languid circulation.
cistus canadensis- lupus, caries; open, bleeding cancer.
Cundurango stimulates the digestive functions and thus improves the general health. allays the pain in gastralgia accompanying cancer of stomach.
Corydalis formosa
tongue clean, broad, and full. tissues flabby, doughy, cold. gastric catarrh. lymphatic glands swollen on stomach.
Cundurango
chronic gastric catarrh, syphilis, and cancer. tumors; stricture of śsophagus. painful affections of the stomach; ulceration. vomiting of food and indurations, constant burning pain. stricture of śsophagus, with burning pains behind sternum, where food seems to stick. vomiting of food, and indurations in left hypochondrium with constant burning pain.
Graphites
cancer of pylorus. duodenal ulcer.
Hydrastis canadensis
prolapsed; anus fissured. constipation, with sinking feeling in stomach, and dull headache. during stool, smarting pain in rectum. ulcers and cancer. gastritis.
Reference
1. zandberg dp, bhargava r, badin s, cullen kj. the role of human papillomavirus in nongenital cancers. ca cancer j clin. 2013;63:57–81. doi: 10.3322/caac.21167.
2.place rj, gregorcyk sg, huber pj, simmang cl. outcome analysis of hiv-positive patients with anal squamous cell carcinoma. dis. colon rectum. 2001 apr;44(4):506-12.
3.Welton M, Sharkey F, Kahlenberg M. The etiology and epidemiology of anal cancer. Surgical Oncology Clinics of North America. 2004;13(2):263-275.
4. wilkes g, hartshorn k. clinical update: colon, rectal, and anal cancers. seminars in oncology nursing. 2012;28(4):e1–22. doi: 10.1016/j.soncn.2012.09.012.
5.salati s. anal cancer : a review. international journal of health sciences. 2012;6(2):206-230.
6.mulder sa, kranse r, damhuis ra, de wilt jh, ouwendijk rj, kuipers ej. et al. prevalence and prognosis of synchronous colorectal cancer: a dutch population-based study. cancer epidemiology. 2011;35(5):442–7. doi: 10.1016/j.canep.2010.12.007.
7. babiker h.m.; kashyap s.; r. mehta s.; reddy lekkala m.; cagir b.. anal cancer
8.Boericke W. Pocket manual of Homoeopathic materia medica. 13th ed. New Delhi: B. Jain publishers; 2013.
9. Allen HC, Allen’s Keynotes Rearranged & Classified. B. Jain Publishers. 2002.
10.Clarke, J.H. A Dictionary of Practical Materia Medica. New Delhi: B. Jain Publishers; 1999.
11.Nash EB. Leaders in Homoeopathic Therapeutics with Grouping and Classification. Low price edition. New Delhi: B.Jain Publishers (P); 2014.
