Anal cancer is usually diagnosed when patients experience pain, bleeding, or notice a nodule or mass near the anus. The first-line treatment is usually with chemotherapy and radiation. The Colorectal Surgeon will usually help with diagnosis and post-treatment follow-up. If the cancer cannot be cured with the chemotherapy and radiation treatment, surgical removal of the anus is required and this is performed by a colorectal surgeon. Most patients will never require surgery for anal cancer if it is cured by the chemoradiation treatment.