What is the first treatment for anal cancer?

This combined approach aims to treat the tumour and nearby cancer cells while preserving the anal sphincter when possible. Before treatment, the team reviews the tumour's size and position, nearby lymph nodes, and whether disease has spread. Radiotherapy directs high-energy treatment to the pelvis, while chemotherapy helps make cancer cells more sensitive to radiation or treats cells beyond the radiation field. The exact medicines, schedule, and radiation plan depend on your health and staging.

Attend the staging appointments and ask how the plan will protect bowel, skin, sexual, and bladder function. A treatment team may discuss [Radiotherapy](/treatments/radiation-oncology/radiotherapy/) and [Chemotherapy](/treatments/systemic-therapy/chemotherapy/). Surgery is not usually the opening treatment, but [Tumour Removal Surgery](/treatments/surgical-oncology/tumour-removal-surgery/) may be considered if cancer remains or returns. Tell the team about medicines, pregnancy possibility, bowel symptoms, and existing health conditions before treatment starts.

Contact your oncology team promptly for fever, uncontrolled diarrhoea, inability to drink, heavy rectal bleeding, worsening pain, or skin breakdown during treatment. Seek urgent care for severe bleeding, fainting, confusion, or trouble breathing. New anal pain, bleeding, a lump, or persistent change in bowel habits also merits medical assessment, although these symptoms can have causes other than cancer.

Which stage and tumour features shape my first treatment? How will chemotherapy and radiotherapy be scheduled together? What symptoms should I report the same day? What support is available for nutrition, skin care, bowel changes, and emotional wellbeing?