If anal cancer is suspected, several tests may be performed or ordered to diagnose and stage anal cancer.
- Medical history and physical exam. A comprehensive physical exam will include checking for signs of disease, such as lumps or anything else that seems unusual. A full medical history including health habits and past illnesses and treatments is also taken.
- Lymph node exam. Physicians may examine the lymph nodes in the groin to check for swelling. Samples of lymph tissue may also be removed through a needle biopsy.
- Digital rectal exam. A physician or nurse examines the anus and rectum by lubricating a gloved finger and palpating the lower part of the rectum to feel for lumps or anything else unusual.
- Proctoscopy. A proctoscopy is an exam of the rectum using a short, lighted tube called a proctoscope.
- Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working. Different types of imaging tests include:
- Endoscopic ultrasound (EUS). This type of ultrasound uses sound waves to create a picture of the internal organs. This procedure is often done at the same time as the upper endoscopy.
- Computed tomography (CT) scan. A CT scan combines a series of X-ray views with computer processing to create a detailed, cross-sectional, three-dimensional image of the inside of the body that shows any abnormalities or tumors. CT scans are used to see if the tumor has spread. Sometimes, a contrast medium (dye) is used to provide better detail.
- Chest X-ray. A chest X-ray causes an energy beam to pass through the body in order to create a picture of areas inside the body. If anal cancer is found, a chest X-ray may be done to determine if the cancer has spread to the chest.
- Biopsy. If other tests find a change that may be attributed to cancer, a sample of the suspicious area is removed and viewed under a microscope. A biopsy is the only way to tell if cancer is really present.
- Needle biopsy. A thin needle is inserted into a lymph node to remove a small sample of lymph fluid. This is usually done in the groin or anus area if cancer is suspected.