Anal cancer arises from the uncontrolled division of cells of the anus and is distinct from colon cancer. Anal cancer is usually of squamous cell origin. Anal cancer is most effectively treated with surgery and if the disease is localised to the anus without spread to the inguinal lymph nodes, surgery is often curative. The major drawback with surgery is that it necessitates the removing the anal sphincter leaving the patient with a colostomy. Recently a combination strategy utilising chemotherapy and radiation have reduced the need for debilitating surgery. This "combined modality" approach has led to the increased preservation of an intact anal sphincter, and therefore improved quality of life. Survival and cure rates are good and many patients are left with a functional sphincter.