What are the early symptoms of anal cancer. How is anal cancer diagnosed. What are the main causes and risk factors for anal cancer. What are the different types of anal cancer. How is anal cancer treated. Can anal cancer be prevented. What is the prognosis for people diagnosed with anal cancer.

Understanding Anal Cancer: Definition and Overview

Anal cancer is a rare form of cancer that develops in the tissues of the anus. The anus consists of two main parts: the anal canal, which is a short tube approximately 3-4 cm (1.5 inches) long, and the anal margin, also known as perianal skin, which is the opening where feces exits the body. Anal cancer can occur in either of these areas, leading to different types of anal cancer.

While relatively uncommon, anal cancer affects approximately 1.8 per 100,000 people in the United States annually. It tends to be more prevalent in older adults, particularly those between 50 and 80 years of age, and is slightly more common in women than in men.

What makes anal cancer unique?

Anal cancer is distinct from other types of cancer due to its location and the specific tissues it affects. Unlike colorectal cancer, which develops in the colon or rectum, anal cancer specifically targets the anal region. This distinction is important for both diagnosis and treatment purposes.

Types of Anal Cancer: Understanding the Varieties

Anal cancer is not a single disease but rather a group of cancers that can develop in the anal region. These cancers are often categorized into two main groups based on their location:

• Cancers of the anal margin: These develop in the cells of the anal margin, which is partially visible as darker skin on the outside of the body. They are more common in men and generally have a better prognosis.
• Cancers of the anal canal: These originate in the cells of the anal canal, which connects the rectum to the anal margin. They are more prevalent in women and typically have a less favorable prognosis.

Within these categories, there are several specific types of anal cancer:

1. Carcinoma in situ: Considered by some doctors to be the earliest form of anal cancer, while others view it as a precancerous condition. It involves abnormal cells on the surface layer of the anus that have not spread to deeper layers.
2. Squamous cell carcinomas: The most common type, accounting for 80-90% of anal cancer cases. These cancers start in the squamous cells lining the anal margin and anal canal.
3. Adenocarcinomas: Making up about 15% of anal cancers, these may originate in glands in the anal area or in cells lining the part of the anus near the rectum.
4. Skin cancers: A small portion of anal cancers are basal cell carcinomas or malignant melanomas, which are types of skin cancer.
5. Other rare types: These include lymphomas and gastrointestinal stromal tumors (GIST).

Early Symptoms of Anal Cancer: Recognizing the Warning Signs

Identifying the early symptoms of anal cancer is crucial for timely diagnosis and treatment. However, it’s important to note that many of these symptoms can also be caused by non-cancerous conditions such as hemorrhoids or anal fissures. The most common symptoms of anal cancer include:

• Bleeding from the anus
• Anal or pelvic pain
• Anal itching
• Discharge from the anus
• A lump in or near the anus

Are there any less common symptoms to be aware of?

Yes, there are some less common symptoms that may also indicate anal cancer:

• Changes in bowel habits, such as increased gas or loss of bowel control
• Severe or complete constipation
• Swollen lymph nodes in the groin and anal region

If you experience any of these symptoms, it’s essential to consult a healthcare professional promptly for proper evaluation and diagnosis.

Causes and Risk Factors: What Increases the Likelihood of Anal Cancer?

While the exact causes of anal cancer are not fully understood, several factors have been identified that may increase an individual’s risk of developing this condition. The most significant link is to human papillomavirus (HPV), a sexually transmitted infection that more commonly causes genital and anal warts.

What are the primary risk factors for anal cancer?

Several factors can increase the risk of developing anal cancer:

• Human papillomavirus (HPV) infection
• A history of cervical or vaginal cancer
• Compromised immune system (due to HIV or medications taken after organ transplantation)
• Smoking tobacco
• Being over 50 years old
• Engaging in receptive anal intercourse
• Chronic inflammation in the anal region

It’s important to note that having one or more of these risk factors doesn’t necessarily mean you will develop anal cancer. Conversely, some people may develop anal cancer without any known risk factors.

Diagnosis of Anal Cancer: The Path to Accurate Detection

Diagnosing anal cancer involves a series of steps and tests to accurately identify the condition and rule out other potential causes of symptoms. The diagnostic process typically begins with a thorough medical history and physical examination.

What tests are used to diagnose anal cancer?

Several tests may be employed in the diagnosis of anal cancer:

1. Digital rectal examination (DRE): The doctor inserts a gloved, lubricated finger into the anus to feel for abnormal growths or lumps.
2. Anoscopy: A hollow, lighted tube is inserted into the anus to examine the anal canal and rectum.
3. Proctoscopy: Similar to anoscopy but uses a longer tube to examine the entire rectum.
4. Endoanal or endorectal ultrasound: Sound waves are used to create images of the anal canal and nearby tissues.
5. Biopsy: A small sample of tissue is removed and examined under a microscope to check for cancer cells.
6. Imaging tests: CT scans, MRI scans, or PET scans may be used to determine the extent of the cancer and whether it has spread to other parts of the body.

These tests help doctors not only confirm the presence of anal cancer but also determine its stage, which is crucial for developing an appropriate treatment plan.

Treatment Options for Anal Cancer: A Comprehensive Approach

The treatment of anal cancer typically involves a multidisciplinary approach, combining various therapies to achieve the best possible outcome. The specific treatment plan depends on several factors, including the type and stage of anal cancer, as well as the patient’s overall health and preferences.

What are the main treatment options for anal cancer?

The primary treatment options for anal cancer include:

• Surgery: This may involve local excision for early-stage cancers or more extensive procedures for advanced cases.
• Radiation therapy: High-energy rays are used to kill cancer cells and shrink tumors.
• Chemotherapy: Drugs are used to kill cancer cells throughout the body.
• Immunotherapy: This treatment helps the body’s immune system fight cancer cells.
• Targeted therapy: Specific drugs target particular abnormalities within cancer cells.

Often, a combination of these treatments is used, particularly for more advanced stages of anal cancer. For instance, a common approach is to use a combination of chemotherapy and radiation therapy, known as chemoradiation.

How effective are these treatments?

The effectiveness of treatment varies depending on the stage of cancer at diagnosis and other individual factors. However, with early detection and appropriate treatment, many cases of anal cancer have a relatively good prognosis. Five-year survival rates can be as high as 80% for localized anal cancer.

Prevention and Screening: Reducing the Risk of Anal Cancer

While it’s not always possible to prevent anal cancer, there are steps that can be taken to reduce the risk of developing this condition. Prevention strategies primarily focus on addressing known risk factors and early detection through screening.

How can the risk of anal cancer be reduced?

Several measures can help reduce the risk of developing anal cancer:

• HPV vaccination: Getting vaccinated against HPV can significantly reduce the risk of anal cancer.
• Safe sex practices: Using condoms and limiting sexual partners can reduce the risk of HPV infection.
• Quitting smoking: Tobacco use is a known risk factor for many cancers, including anal cancer.
• Regular health check-ups: Regular medical examinations can help detect any abnormalities early.
• Maintaining a healthy immune system: This includes managing conditions like HIV and following medical advice for those who have undergone organ transplants.

Is there a screening program for anal cancer?

Currently, there is no standard screening program for anal cancer in the general population. However, some high-risk groups, such as HIV-positive individuals or those with a history of cervical cancer, may benefit from regular anal Pap tests. These tests can detect precancerous changes in the cells of the anal canal, allowing for early intervention.

Living with Anal Cancer: Coping and Support

A diagnosis of anal cancer can be challenging, both physically and emotionally. Coping with the disease and its treatment requires a comprehensive approach that addresses both medical and psychological needs.

What support is available for people with anal cancer?

Various forms of support are available for individuals diagnosed with anal cancer:

• Medical support: This includes ongoing care from healthcare professionals, including oncologists, surgeons, and specialists.
• Psychological support: Counseling and therapy can help patients deal with the emotional impact of cancer diagnosis and treatment.
• Support groups: Connecting with others who have experienced anal cancer can provide valuable emotional support and practical advice.
• Palliative care: This focuses on improving quality of life and managing symptoms, regardless of the stage of cancer.
• Nutritional support: Proper nutrition is crucial during cancer treatment and recovery.
• Physical therapy: This can help manage side effects of treatment and improve overall physical function.

It’s important for patients to communicate openly with their healthcare team about their needs and concerns throughout their cancer journey.

Can people live normal lives after anal cancer treatment?

Many people who have been treated for anal cancer go on to live full and productive lives. However, the experience of cancer and its treatment can lead to significant changes. Some individuals may face ongoing challenges such as changes in bowel function, sexual difficulties, or emotional issues. Long-term follow-up care is essential to monitor for recurrence and manage any lasting effects of treatment.

With appropriate medical care, support, and lifestyle adjustments, many survivors of anal cancer are able to return to their normal activities and enjoy a good quality of life. It’s important to work closely with healthcare providers to address any ongoing issues and optimize overall health and well-being.

Anal Cancer: Early Symptoms, Causes and Treatment

What is anal cancer?

Anal cancer is a rare cancer that arises from the anus. The anus is comprised of the anal canal, a passage about 3-4 cm or 1.5 inches and the anal margin, also known as perianal skin, the opening where feces is excreted from the body. Anal cancer refers to several types of cancer that can develop in this area.

The most common symptoms of anal cancer include bleeding from the anus, itching around the anus, and anal pain. ¹ Many non-cancerous conditions have similar initial symptoms, such as anal fissure or hemorrhoids.

Anal cancer tends to spread slowly. With early treatment, in many cases, it has a relatively good prognosis. ²

This condition tends to affect older adults between the ages of 50 and 80, and is slightly more common in women than in men. ³ About 1.8 per 100,000 people in the U.S. are newly diagnosed with anal cancer per year. ⁴

Treatment depends on the type of anal cancer and stage of diagnosis, but typically involves a combination of surgery and chemotherapy. Recovery rates tend to be better in cases where the cancer is diagnosed early.

Types of anal cancer

Anal cancers are often divided into two groups, which are sometimes treated differently: ⁵⁶

• Cancers of the anal margin: These begin in the cells of the anal margin – the edge of the anus that can be partly seen as darker skin on the outside of the body. They are more common in men and have a relatively good prognosis.
• Cancers of the anal canal: These begin in the cells of the anal canal –the inner part of the anus, connecting the rectum – the final section of the intestine, that connects it to the anus – to the anal margin. They are more common in women and have a relatively worse prognosis.

There are several different types of anal cancer. These include: ⁵⁶

Carcinoma in situ

Carcinoma in situ is considered by some doctors to be the earliest form of anal cancer, and by others to be a precancerous condition, which may develop into cancer.

In carcinoma in situ, there are abnormal cells on the surface layer of the anus, which have not spread to any deeper layers.

Squamous cell carcinomas

Squamous cell carcinomas are the most common type of anal cancer, making up 80 or 90 percent of cases. It starts in the squamous cells which form the surface layer of the lining the anal margin and anal canal. This is similar to carcinoma in situ, except that these cancers have grown into the deeper cells and layers of the anal canal, and may spread.

Adenocarcinomas

Adenocarcinomas make up about 15 percent of anal cancers. These may start in glands in the anal area or in the cells that line the part of the anus near the rectum.

Skin cancers

Some anal cancers are basal cell carcinomas or malignant melanomas – two different types of skin cancer. Only a very small portion of anal cancers are skin cancers.

Other types of anal cancer

Other, very rare types of anal cancer include:

• Lymphomas
• Gastrointestinal stromal tumors (GIST)

Anal cancer symptoms

Anal cancer may present with a wide range of symptoms, or may have no symptoms at all. The most common symptoms of anal cancer include: ¹⁷

• Bleeding from the anus
• Anal or pelvic pain
• Anal itching
• Discharge from the anus
• A lump in or near the anus

Less common symptoms may include: ¹⁷

• A change in bowel habits, such as increased gas, losing control of one’s bowel, or hard or soft feces
• Severe or complete constipation
• Swollen lymph nodes in the groin and anal region

Most often these symptoms are more likely to be caused by non-cancerous conditions, such as hemorrhoids, anal fissures, or anal warts. If any of these symptoms are present, it is important to see a doctor quickly so that the cause can be found and treated appropriately.

Anal cancer causes

The causes of anal cancer are not well understood. However, certain factors are thought to increase a person’s risk of developing the condition. It is most commonly linked to human papillomavirus (HPV), a sexually transmitted infection (STI) which more commonly causes genital and anal warts.

Anal cancer risk factors

Factors that may increase the risk of developing anal cancer include: ³⁸

• Human papillomavirus (HPV)
• A history of cervical or vaginal cancer
• A lowered immune response, such as occurs with HIV or from medication taken after organ transplantation
• Smoking tobacco
• Being over 50
• Receptive anal intercourse
• Repeated inflammation in the anal region

Anal cancer is most common in people between the ages of 50 and 80, and it is slightly more common in women than in men.

Anal cancer diagnosis

Symptoms of anal cancer may be caused by a number of other conditions, including hemorrhoids, anal fissures, or anal warts. A doctor will need to rule these out in the diagnostic process.

Anal cancer tests

As the first step, a doctor will typically take the person’s medical history and perform a physical examination. In addition, a doctor may perform the following tests: ²⁹

• Digital rectal examination (DRE), which involves inserting a gloved finger into the anus to feel for lumps or other abnormalities.
• Anoscopy may be performed if the doctor feels a suspicious area during DRE. The doctor will insert into the anus a thin, flexible tube with a light and camera on the end called an anoscope, allowing them to see the inside of the anus.
• Biopsy, a procedure to remove a small amount of tissue for examination under a microscope, can make a definite diagnosis. The type of biopsy will depend on the location of the abnormal cells, but may include an excisional biopsy to remove an entire lump.
• Ultrasound, X-ray, computed tomography (CT scan), magnetic resonance imaging (MRI) or positron emission tomography (PET scan) may be used to investigate the size of the cancer.

If any of the results of these tests are positive for cancer, further investigation is done to confirm the staging of the cancer.

Anal cancer screening in people at high risk

Screening is a way of identifying apparently healthy people who may be at an increased risk of a particular condition. This is often done to help identify cancers at the earliest stages, when treatment can provide the best prognosis.

Anal cancer is not very common, so screening of the general public is not widely done. However, people who are considered to have a higher than average risk of developing anal cancer may be advised to undergo regular screening for the condition.

Screening tests for anal cancer may include: ¹⁰

• Digital rectal examinations
• Anal cytology testing, also known as an anal Pap test or smear

An anal Pap smear is very similar to a Pap smear for cervical cancer. The anal lining is swabbed to collect cells, which are then looked at under a microscope to see if any cells show pre-cancerous signs.

Those who might benefit from anal cancer screening include: ¹⁰¹¹

• People who are HIV positive
• Men who have sex with men
• Women who have had cervical cancer or vulvar cancer
• People who take immunosuppressants after receiving an organ transplant
• Occasionally, people with a history of anal warts are recommended to have screening

Anal cancer treatment

The treatment of anal cancer depends on the size of the cancer, the exact type of cancer and whether the cancer has spread. The treating doctor can give the best advice as to treatment.

Anal cancer can be treated by one or more of the following:

• Radiotherapy
• Surgery
• Chemotherapy

Often, the first step in treatment for anal cancer is a combination of radiotherapy and chemotherapy, known as combined modality therapy (CMT). Anal cancer may be curable in this way without the need for surgery.

Anal cancer chemotherapy

The general aims of chemotherapy treatment for anal cancer are to destroy any tumor tissue and increase the likelihood of recovery.

Chemotherapy can sometimes have unpleasant side effects, such as hair loss, nausea and vomiting, fatigue and pain. A doctor will be able to advise on how best to manage the side effects, should they occur.

Read more about Chemotherapy Side-Effects.

Anal cancer radiotherapy

Also known as radiation therapy, this uses X-rays to destroy cancer cells. Radiation for anal cancer can have unpleasant side-effects, such as diarrhea, skin irritation and nausea. A doctor will be able to advise on how best to manage the side-effects, should they occur.

Anal cancer surgery

Surgery is not normally the first treatment for anal cancer. If needed, the type of surgery will depend on the type and size of tumor. There are two main types of anal cancer surgery: ¹²¹³

Local resection

This removes the tumor and a small area of normal tissue around it. A local resection is commonly used for tumors on the anal margin – the skin at the end of the canal that meets the anus opening – that are small and have not spread to other tissues or to lymph nodes.

Local resection normally allows the sphincters to be saved, so that a person may continue normal bowel movements after surgery.

Abdominoperineal resection for anal cancer

Abdominoperineal resection (APR) is an operation in which the anus and rectum are removed, possibly along with some nearby groin lymph nodes. APR requires a colostomy, in which the end of the colon is diverted out through the wall of the abdomen, leading to an external bag to collect stool and other human waste.

Good to know: APR is only used if other treatments don’t work or if the cancer returns after treatment. Nowadays, APR can almost always be avoided by using chemotherapy and radiotherapy instead.

APR surgery is more likely to cause long-term complications, such as urinary incontinence and sexual dysfunction. A doctor will be able to advise on how best to manage side-effects, should they occur.

Anal cancer prognosis

Anal cancer tends to spread slowly. With early treatment, in many cases it has a relatively good prognosis and may be curable. ²

In order to determine how the cancer should be treated, such as whether potentially life-changing surgery will be required, doctors will find out the size of the cancer and whether it has spread or metastasized to nearby lymph nodes or to distant organs, in a process known as staging.

Earlier stage cancers are more likely to be curable than more advanced stages, i.e. with larger tumors, and/or cancers that have spread.

Factors associated with poorer outcomes may include: ¹⁴¹⁵

• Tumors in the anal canal rather than the anal margin
• Tumors greater than 5cm
• Tumors that invade nearby organs such as the urethra or bladder
• Lymph node involvement
• Being HIV positive

What are anal cancer survival rates?

Survival rates show what percentage of people live for a certain length of time after being diagnosed with cancer.

Survival rates are generally sorted into 5-year and 10-year time brackets. Because the statistic is based on people diagnosed over five years ago, the outlook may be better for those diagnosed today, since there are continuing improvements in treatment.

Survival rates include people who are free of disease or who experience few symptoms, as well as those who are still being treated for cancer, those who will survive for many more years and those who will not live much longer than the time bracket given.

Five-year survival rates for people with anal cancer in the U.S. are currently as follows: ³¹⁶

• Localized anal cancer: About half of all anal cancers are found early, when they are localized, meaning they have not spread beyond the anus. The five-year survival rate is about 80 percent.
• Locally advanced anal cancer: If the cancer has spread to the lymph nodes or other areas around the anus, this is known as locally advanced cancer. The five-year survival rate is about 61 percent.
• Metastatic cancer: If the cancer has spread further to other parts of the body, it is known as metastatic cancer. The five-year survival rate is about 30 percent.

The overall five-year survival rate for anal cancer is about 66 percent.

Good to know: Survival rates do not predict what will happen to someone. Treatment and responses to treatment vary greatly.

Anal cancer FAQs

Q: Anus cancer vs hemorrhoids – how can I tell the difference?
A: Hemorrhoids, also known as piles, is a very common condition involving dilated rectal veins, that typically causes no serious health problems. It can often be treated at home, without being seen by a doctor.

Some symptoms of hemorrhoids, especially bleeding from the anus, may also be caused by anal cancer, a serious condition requiring prompt treatment. Other common symptoms between the two conditions include pain, pressure, itching, mucus discharge and a lump in or around the anus. Swelling of the lymph nodes around the anus or in the groin may be a sign of anal cancer. A hard growth tends to suggest anal cancer while a squishy swelling suggests hemorrhoids. For more information on what they look and feel like, see this resource on hemorrhoids.

A person should seek help for hemorrhoid symptoms if they have heavy rectal bleeding or bleeding that is not responding to home care, or hemorrhoid symptoms accompanied by fever, weight loss, abdominal pain, or a change in bowel habits.

Q: Is anal cancer curable?
A: Anal cancer tends to spread slowly. With early treatment, in many cases it has a relatively good prognosis and may be curable. Earlier stage cancers are more likely to be curable than larger tumors and cancers that have spread.

Factors associated with poorer outcomes may include:

• Tumors in the anal canal rather than the anal margin
• Tumors greater than 5cm
• Tumors that invade nearby organs such as the urethra or bladder
• Lymph Node involvement
• Being HIV positive

Q: Is anal cancer painful?
A: A person may experience pain due to anal cancer. The severity of the pain may depend on many factors, including the stage of the cancer, the treatment plan, and the affected person’s tolerance for pain. The cancer itself may cause pain, or pain may be a side effect of anal cancer treatments. Those with advanced anal cancer are most likely to have severe pain. Medical care for anal cancer will include pain-relief. ¹⁷

Q: Anal cancer vs colon cancer – what is the difference?
A: Colon cancer, also known as colorectal cancer, occurs in the colon or large intestine, the final six-foot section of the large intestine up to the anal canal. Anal cancer refers to several types of cancer that affect the anus, which is comprised of the anal canal, a passage about 3-4 cm or 1.5 inches connected to the colon and the anal margin, also known as perianal skin, the opening where feces is excreted from the body. Colon cancer is the second most common cancer in the U.S. and third most-common cause of death from cancer, whereas anal cancer is rare and has a fairly good prognosis because it is more likely to be caught early and tends to spread slowly.

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3. URMC – University of Rochester. “Anal Cancer.” Accessed 5 July 2018.

4. Cancer Stat Facts. “Anal Cancer.” Accessed 5 July 2018.

5. Beating Bowel Cancer. “Anal Cancer – Types of Anal Cancer.” Accessed 2 July 2018.

6. American Cancer Society. “What Is Anal Cancer?” 13 November 2017. Accessed 5 July 2018.

7. Medscape eMedicine. “Anal Cancer Clinical Presentation.” 29 August 2017. Accessed 2 July 2018.

8. NCBI. “The fraction of cancer attributable to modifiable risk factors.” 23 March 2018. Accessed 20 July 2018.

9. Cancer.Net. “Anal Cancer: Diagnosis.” Accessed 5 July 2018.

10. American Cancer Society. “Can Anal Cancer Be Found Early?” 13 November 2017. Accessed 20 July 2018.

11. NCBI – NIH. “Screening for Anal Cancer in Women.” Accessed 20 July 2018.

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14. Anal Cancer Information. “Staging and Prognosis.” Accessed 20 July 2018.

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Is It Hemorrhoids or Something Worse?

Medically reviewed by Dr. Lauren R. Wilson.

• What are hemorrhoids?
• What are known causes and risk factors for hemorrhoids?
• What are the symptoms of hemorrhoids?
• When should you see your doctor?
• How are hemorrhoids diagnosed and treated?
• What is anal cancer?
• What are known causes and risk factors for anal cancer?
• What are the symptoms of anal cancer?
• Can anal cancer be caught early?
• How is anal cancer diagnosed and treated?
• What’s the takeaway?

When Charlie’s Angels star Farrah Fawcett died of anal cancer in 2009, it put a spotlight on a disease that isn’t talked about much but has early symptoms similar to everyday hemorrhoids. Understanding the risk factors and the differences between
anal cancer and hemorrhoids is critical to staying healthy. Here’s what you should know.

What are hemorrhoids?

Hemorrhoids, also called piles, are a normal part of a person’s anatomy and are part of normal bowel continence or control. What people commonly think of as hemorrhoids are actually symptomatic hemorrhoids that have become inflamed, causing bleeding, prolapse of tissue, pain and itching. These symptoms develop when the blood vessels in the rectum or anal canal become swollen. This swelling is usually the result of increased pressure from straining with bowel movements or actions that increase pressure in the perineum (the area between the anus and the genitals), such as childbirth and heavy lifting. There are two types of hemorrhoids: internal and external. Internal hemorrhoids are in the inner lining of the anus and lower rectum. External hemorrhoids are covered by the skin around the anus.

What are known causes and risk factors for hemorrhoids?

Doctors point to a variety of causes and factors for developing symptomatic hemorrhoids, including:

• Straining during a bowel movement
• Sitting on the toilet for a long period of time
• Chronic constipation or diarrhea
• A low-fiber diet
• Obesity
• Pregnancy
• Being over 50 years of age
• Lifting heavy objects
• Weakening of the tissues around the anus due to aging

What are the symptoms of hemorrhoids?

Hemorrhoid symptoms can vary depending on the type of hemorrhoids you have. For example, internal hemorrhoids inside the rectum usually can’t be seen or felt because they’re deep inside. However, you might see blood in your stool, on tissue or in the toilet bowl. You might also experience a hemorrhoid that has pushed through the anus (a prolapsed hemorrhoid), which can cause discomfort.

With external hemorrhoids, you’re most likely to experience anal itching; swelling or lumps around the anus; rectal bleeding; and pain around the anal area, especially when sitting. Some people will experience a clot in an external hemorrhoidal vessel that can be very painful.

When should you see your doctor?

We spoke with Dr. Lauren R. Wilson, a specialist in colorectal surgery and assistant professor of surgery at Dartmouth-Hitchcock Medical Center for her input.

“If you’re having any kind of issue with your bottom, go see your primary care doctor and ask them to take a look. Rectal exams used to be part of an annual physical, but a lot of doctors just don’t do them anymore. You need to be open to having an exam and ask them about it.”

How are hemorrhoids diagnosed and treated?

Your doctor can typically diagnose hemorrhoids on sight, especially if you have external hemorrhoids, or through internal examination with a finger and anoscope. They can often be easily treated by avoiding straining, increasing dietary fiber (often with a fiber supplement), and topical over-the-counter medication or home remedies, including sitting in a warm bath to help reduce swelling and inflammation. Pain relievers (acetaminophen, aspirin, ibuprofen) can also help to reduce discomfort. Symptoms usually go away within a few weeks. If you have persistent symptoms, your doctor might recommend a colonoscopy to rule out any other problems in your GI tract, and then office-based procedures or surgery.

What you need to remember is that if pain and bleeding persist, or are associated with pelvic pain and a fever, it’s time to see your doctor to rule out any other issues such as gastrointestinal diseases, infections or anal cancer, which share similar symptoms.

What is anal cancer?

Anal cancer is a rare form of cancer that occurs within the anal canal, where normal cells mutate, become abnormal and multiply, forming tumors. These tumors invade nearby tissue and can separate and spread to different parts of the body, especially to the lymph nodes, lungs and liver.

Anal cancer is rare, representing only around 0.5% of all new cancer cases reported each year, or nearly 8,600 people (as compared with 277,000 new breast cancer cases). On average, 86,000 Americans are living with anal cancer annually, and the five-year survival rate for anal cancer is approximately 70%.

What are known causes and risk factors for anal cancer?

As with most cancers, there are multiple causes and risk factors for anal cancer. One significant correlation to note is the sexually transmitted human papillomavirus (HPV), which is a common viral infection. Roughly 85% of women and 91% of men will get HPV by the time they are 45. Detected in the majority of anal cancer cases, HPV is considered a major factor in causing anal cancer (as well as cervical cancer and cancers of the vagina, vulva, penis and throat). The HPV vaccine has been effective in reducing rates of infection and reducing rates of certain types of cancer.

Other risk factors include:

• Having many sexual partners over a lifetime
• Engaging in anal sex
• A history of HPV-associated cancer, including cervical, vulvar or vaginal cancer
• Being over 50
• Being HIV-positive
• Smoking
• Taking medications that suppress the immune system (being immunocompromised)

What are the symptoms of anal cancer?

The most common first sign of anal cancer is rectal bleeding, which is why it’s a cause for concern for those with hemorrhoids. Other symptoms that are similar to hemorrhoids include pain around the rectum or anus, anal itching, and a mass or growth in the anal canal.

However, there are other symptoms of anal cancer that are distinct and should be given special attention. They include:

• A feeling of fullness around the anal area
• Abnormal discharge from the anus
• Narrow stools or changes in bowel movements
• Fecal incontinence
• Swollen lymph nodes in the groin or anal area

Can anal cancer be caught early?

Anal cancer can be caught early. “It really depends on how much someone pays attention to their symptoms,” Wilson said. “Too often people keep putting off seeing their doctor while assuming their symptoms are just hemorrhoids.”

How is anal cancer diagnosed and treated?

Most anal cancers are discovered because of patient symptoms. Your doctor might do a digital rectal exam and a pelvic exam with a Pap test, or could also recommend various types of diagnostic scopes, depending on the affected area.

Biopsies are also usually taken of any polyps or unusual growths. Once anal cancer is diagnosed, additional testing with imaging studies is performed to look for spread of the disease and establish a stage. Depending on the stage of the disease, most cases are treated with a combination of chemotherapy and radiation. However, depending on symptoms or if these treatments aren’t effective, surgery may be recommended.

What’s the takeaway?

Even while anal cancer is rare, experts including Wilson emphasize seeing your doctor at the first sign of any problems, especially bleeding. Most patients assume “it’s just hemorrhoids,” but the majority of patients presenting with symptoms in the anal or rectal area have a diagnosis other than symptomatic hemorrhoids. Sometimes it’s an infection or a tear in the lining of the anal canal called an anal fissure, and sometimes it’s cancer. With careful evaluation and testing, your doctor can make a diagnosis, recommend appropriate treatments, and get you feeling better. And if it turns out your symptoms are from cancer, early detection is key to a positive outcome.

Resources:

Anal Cancer Foundation
American Society of Colon and Rectal Surgeons — Tips for Patients

Why do lymph nodes become inflamed in the groin and what to do with them?

Let’s talk about advice from a professional.

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Inflammation of the lymph nodes in medicine is called lymphadenitis. With this disease, the lymph nodes increase, become dense and accumulate pus. A person has many lymph nodes, which are located in clusters near large veins. Due to the lymphatic vessels, the lymph circulates throughout the body, transporting toxins, bacteria and viruses to the lymph nodes for their neutralization and removal. And they can often become inflamed even for no particular reason. However, if you have inguinal lymphadenitis, then this is a sure sign of health problems.

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Men often experience pain in the groin, as different sensitive tissues and organs intersect in this area. The representatives of the stronger sex ignore going to the doctors, but it is better to find the disease at an early stage than to start the disease. In case of any ailments, it is better to immediately contact a specialist. With any rejecting symptoms.

What are the symptoms of inguinal lymphadenitis?

• Thickening and enlargement of the lymph nodes in the groin area. Outwardly similar to “bumps”.
• Reddening of the skin in the groin. It looks like mosquito bite marks, but in this case, the redness will not itch.
• Unpleasant pain that worsens during physical activity, including walking.
• High body temperature due to inflammation.

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What are the causes of inguinal lymphadenitis?

Most often, this inflammation occurs in young men, mainly associated with infections, in the elderly – associated with cancer. However, there are other reasons:

• Venereal diseases (chlamydia, trichomoniasis, gonorrhea, syphilis, HIV infection).
• Injuries (both sports and domestic).
• Past infectious diseases.
• Bacterial lesions of the body.
• Inguinal hernia.
• Taking drugs.
• Allergy.
• Inflammation of the genitourinary system (orchiepididymitis, orchitis, vesiculitis).
• Fungal growths on the lower part of the body.
• Hypothermia of the body.
• STD.
• Skin diseases (furunculosis, eczema).
• Malignant diseases of the lymphatic system (lymphogranulomatosis, Hodgkin’s lymphoma).
• Blood diseases.

Doctor of Medical Sciences Vladimir Khryshchanovich spoke in more detail about the causes of this disease.

“The inguinal region, along with the cervical and submandibular, is the most “favorite” localization of lymphadenitis. The lymph nodes located in this place collect lymph from the tissues of the perineum, genitals and lower limbs. Accordingly, the cause of their inflammation is most often sexually transmitted infections and other pathologies of the urogenital area (for example, prostatitis or urethritis). In addition, the primary focus of infection may be a purulent wound on the skin of the lower extremities, a furuncle or an anthrax. The most common causative agents of lymphadenitis are streptococci and staphylococci, that is, conditionally pathogenic microflora that lives on the surface of the skin. In a healthy person, these bacteria are not able to cause an inflammatory process. But in the presence of “entrance gates” in the form of skin abrasions, wounds, scratches and a decrease in the body’s defenses, one step remains before the development of lymphadenitis. In fact, the lymph nodes serve as a protective barrier against the spread of pathogenic microbes throughout our body. That is why lymphadenitis cannot be considered an independent disease – it is only an indicator of some kind of trouble in one or another organ, ”says the expert.

Diagnosis of inguinal lymphadenitis

Doctor’s examination

The specialist will examine the structure and mobility of the lymph nodes using palpation.

Swabs and blood

A clinical blood test will show possible diseases of the blood and lymphatic system, as well as the presence of acute inflammatory processes.

Ultrasound of the lymph node

This procedure helps to determine the structure and exact dimensions of the node.

Puncture

This procedure will help determine the structure and origin of the cells that make up the lymph node. It is the most accurate method for diagnosing the causes of lymphadenitis.

Treatment of inguinal lymphadenitis

• If the disease is at the initial stage, anti-inflammatory medical ointments and gels are prescribed. It is also recommended to take vitamins to strengthen the immune system.
• If the cause is an infection, then antibiotics are prescribed.
• If the cause is in the purulent nature of the disease, then it requires drainage of the inflamed cavity. The procedures are carried out in a special sterile room, regular treatment and dressing of the damaged area is necessary.
• If there are benign or malignant oncological formations, then the patient is prescribed chemotherapy or radiation.

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Why is the lymph node enlarged?

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