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Early anal cancers often have signs and symptoms that lead people to see a doctor. Unfortunately, some anal cancers may not cause symptoms until they reach an advanced stage. Other anal cancers can cause symptoms like those of diseases other than cancer. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancers stage when talking about survival statistics. anal cancer is categorized into five stages stage 0 is very early cancer that is found only in the top layer of the lining of the anus. Stage i tumors are small (less than two centimeters, or smaller than the size of a peanut) and have grown deeper into the lining of the anus. Stage ii cancer means the tumor is larger than two centimeters but has. At this stage, the cancer is still only in the inner lining of the anus and has not grown into deeper layers. Stage 0 tumors can often be removed completely by surgery (local resection). The goal is to take out all of the cancer as well as edge (margin) of healthy cells around it. The most common staging system for anal cancer is the tnm system. For anal cancer there are 5 stages stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the roman numerals i, ii, iii and iv. Generally, the higher the stage number, the more the cancer has spread. Previously, anal cancer was treated with surgery, and in early-stage disease (i. , localised cancer of the anus without metastasis to the inguinal lymph nodes), surgery is often curative. The difficulty with surgery has been the necessity of removing the internal and external anal sphincter , with concomitant fecal incontinence. People who experience bleeding, itching, or pain in the anus often go to the doctor before anal cancer progresses past stage one. Identifying anal cancer in its earliest stage is incredibly important. Although, it can be very hard to do so since many symptoms of anal cancer are not present until later.