Hemorrhoids or Cancer -- How Can You Tell?
- Rectal bleeding or blood in your stool are symptoms of both hemorrhoids and some cancers.
- Lumps on the anus can also point to either cancer or hemorrhoids.
- If these symptoms are new, the only way to know what it is for sure is with the help of a doctor.
In fact, that may be a reason some colorectal and anal cancers are not caught as early as they could be. Blood in the stool and lumps on the anus can be symptoms of certain cancers. But, they can be symptoms of hemorrhoids, too.Read More
“It’s a challenge for even physicians to distinguish between cancer and hemorrhoids without doing a colonoscopy or similar diagnostic procedure because they can present with almost identical symptoms,” Dr. Peter Vu tells SurvivorNet. “And in both cases, these symptoms can come and go or get better or worse over time. At least discuss any new gastrointestinal symptom, such as a change in bowel habits, stool color, or discomfort, with your primary care physician who can then initiate a work up to help distinguish between the two and follow your symptoms closely over time.” Vu is a medical oncologist who specializes in gastrointestinal cancers.
Hemorrhoids, Colorectal Cancer, or Anal Cancer
Hemorrhoids are swollen veins on the inside or outside of your lower rectum. You can feel the ones on the outside with your fingers. These lumps can be painful and itchy. The ones on the inside may not cause any pain, but both can bleed. You might see bright red blood in the toilet or on the toilet paper.
“Most commonly, bright red blood in the stool is from hemorrhoids, but there are a number of other things both benign and malignant that it can be,” Dr. Heather Yeo tells SurvivorNet. Yeo is a surgical oncologist who specializes in colorectal cancer at Weill Cornell Medicine.
Anything that puts a lot of pressure on your anus can cause the veins to bulge and swell and lead to a hemorrhoid. Some common causes include:
- Straining during bowel movements
- Sitting on the toilet for long periods
- Chronic diarrhea or constipation
- Anal sex
- A low-fiber diet
- Routine heavy lifting
Colorectal cancer happens when cancerous cells grow in the colon or rectum. These cancers may not have any symptoms. But, they can cause rectal bleeding, which involves bright red blood. Or they can lead to blood in the stool, which can make the stool dark brown or black. Colorectal cancers can also cause other symptoms that you wouldn’t see with a hemorrhoid. They include:
- A change in bowel habits (eg. constipation, diarrhea, narrow stool) that lasts more than a few days
- A feeling that you need to have a bowel movement, even after you’ve just had one
- Abdominal cramping or pain
- Weakness or fatigue
- Unintended weight loss
Anal cancer is not the same as rectal cancer. It’s actually more like cervical cancer. That’s because the tissue that lines the anus is similar to cervical tissue, and both cancers are usually linked to human papillomavirus (HPV).
The symptoms of anal cancer can be quite similar to those of a hemorrhoid, including:
- Bleeding from the anus
- Pain in the anus
- A mass or a growth in the anus
- Itching in the area
When to See a Doctor about Symptoms Down Below
If you have a history of hemorrhoids, and your doctor has previously diagnosed them and ruled out cancer, it’s fine to hold off. As long as your hemorrhoid symptoms are the same this time around, “It’s very reasonable to just treat your hemorrhoids first without seeing a doctor,” Dr. Vu says. “But, if you’re having new symptoms and have never been evaluated for colorectal or anal cancer, then it’s important to see a doctor to help make the correct diagnosis.”
On the other hand, if you don’t have a history of hemorrhoids yourself, but you do have a family history of colorectal cancer, or you’re over 45 and haven’t yet had a colonoscopy, it’s a good idea to get checked out.
What to Do About Blood in Your Stool
Most of the time, rectal bleeding or blood in your stool is related to hemorrhoids. In fact, three in four adults have a hemorrhoid at some point. This kind of bleeding is usually bright red, comes on suddenly, and flares up again with straining.
“It is more concerning if it doesn’t go away, if it is not associated with constipation or diarrhea,” Dr. Yeo explains.
But the best way to know for sure is to bring it to your doctor’s attention. You should always discuss blood in the stool, whether it’s bright red or dark brown or black, with a medical provider,” Vu says.
When to See a Doctor for Lumps on the Anus
If you have a new lump – anywhere, in fact – that won’t go away, you should see a doctor. “Anogenital warts or anal cancer can case bumps in the anal canal. It is often hard for a patient to know the difference between these. That’s why an exam is important,” Dr. Yeo says.
Don’t be embarrassed to talk to your doctor about this. Remember, your doctor has seen it all. Dragging your feet could only raise your risk for more serious problems. “Telling your doctor sooner rather than later, so that he or she can make a diagnosis could potentially lead to the diagnosis of an early stage cancer that is still curable. If these cancers are found early they have a high chance of cure,” Dr. Vu says.
What Else You Need to Know
Many colon, rectal and anal cancers can develop without any symptoms that you would see or feel. The United States Preventive Services Task Force recommends that colorectal cancer screenings start at age 45 – or even sooner if you have a family history of colon cancer. If you fit the bill, or if you have new symptoms that include rectal bleeding or lumps on your anus, get them checked out.
“Unfortunately,” Dr. Vu says, “I’ve seen many cancer patients who have assumed their symptoms were due to hemorrhoids and this potentially delayed their diagnosis and subsequent cancer treatment.”