Many people confuse anal cancer with colorectal cancer. Although these two cancers share a few of the same symptoms, they start in different areas of the large intestine. Anal cancer is rare and more likely to affect women than men. About 25 percent of people diagnosed with anal cancer never experience any symptoms, while others experience a variety. In some cases, symptoms do not appear until the cancer has spread.

Risk Factors for Anal Cancer

Before evaluating symptoms, doctors usually assess risk factors associated with anal cancer. People who have a human papillomavirus infection (HPV) or genital warts are at a higher risk, though the majority of people with HPV never develop anal cancer. The risk increases for people who are over 50 and those who smoke. Other risk factors include:

  • Multiple sexual partners
  • Engagement in anal sex (receptive anal sex )
  • A history of cervical, vulvar, or vaginal cancer
  • Immunosuppressive drugs
  • HIV, an illness that suppresses the immune system

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The Most Common Symptom: Bleeding

Minor anal bleeding is an early sign of anal cancer, reported by almost a half of individuals with the disease. Hemorrhoids are a common problem and may cause rectal bleeding. In most cases, the bleeding clears up without the need for treatment. However, a physician should evaluate rectal bleeding that lasts longer than two to three weeks, especially if the individual is also experiencing weight loss or anal leakage. Even if the symptom is not caused by cancer, other serious conditions can cause it, such as Crohn's disease and ischemic colitis.

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Persistent Rectal Itching

Anal itching or pruritus ani is common. Hemorrhoids or simply washing too much can cause the problem. Psoriasis and contact dermatitis also cause this symptom, as can diabetes and thyroid disease, yeast infections, and sexually transmitted infections. However, if the itching is persistent or becomes severe, or if the individual experiences anal leakage, it could be a symptom of anal cancer.

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Changes in Bowel Movements

The color, consistency, and frequency of an individual's bowel movements are clues to their overall health. These factors can indicate issues with the liver, an obstruction in the bowels, or they can be symptoms of other conditions, including cancer. An increased number of bowel movements is an early symptom of anal cancer. Those who experience strained bowel movements, or notice that their stools are narrower than normal should consult a medical professional. Dark or red blood in the stool can be a symptom of anal cancer, as well. Fecal incontinence, bloating, and recurring diarrhea require further evaluation.

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Abnormal Discharge

Abnormal discharge encompasses any substance other than stool that comes out of the rectum. The individual may first notice it in their underwear or their stool. They may also feel a strong urge to have bowel movements but only pass a small amount of stool or mucus. Although this symptom can indicate irritable bowel syndrome, a sexually transmitted infection, and many other issues, it can also be a sign of anal cancer. In most cases, the discharge looks like mucus or pus and may be intermittent or continuous.

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Anal Pain

Anal pain may be due to hemorrhoids or a fissure, a small rip, in the lining of the anal canal. Abscesses, infections, and skin conditions can cause anal pain, as can anal cancer. If bleeding and changes in bowel movements accompany the pain, there could be a tumor or mass in the anus. If the pain is recurring or never goes away, consult a physician.

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Mass or Growth in the Anal Opening

Any lump or swelling in the anal area may indicate a growth that requires further medical evaluation. Small growths called polyps can develop in the rectal area, but they rarely turn cancerous. Anal cancer forms when healthy cells mutate and become abnormal ones. Cancerous cells continue to grow abnormally and form a tumor near the anus. Anal cancer rarely spreads to other parts of the body; if it does, the liver, bones, and lungs are the most common sites.

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Swollen Lymph Glands

Lymph nodes are glands that store white blood cells. When the body experiences an infection, illness, or even stress, the lymph nodes swell as they create more cells to fight the problem. Swollen inguinal lymph nodes on either side of the groin may be a symptom of a variety of infections, as well as anal and other cancers. Swollen, hard, or immovable nodes that seem to be increasing in size can indicate cancer.

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Pressure Around the Anus

Prolonged rectal pressure that increases in intensity requires evaluation by a medical professional. The individual may feel as though they still need to void the bowels, even after a successful bowel movement. A mass in the rectum can lead to this sensation of incomplete emptying or tenesmus. If the tumor is large, it may cause a complete or partial rectal obstruction, which leads to constipation and cramping that becomes progressively worse.

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Rectal cancer can cause bleeding, which can lead to a depletion of red blood cells. If a patient complains of fatigue, a physician will likely perform a CBC (complete blood count) blood analysis to measure the white blood cells, red blood cells, and platelets in the body. A diagnosis of anemia means the body is not producing enough healthy red blood cells to carry adequate oxygen to the tissues in the body. This can result in weakness, chest pains or shortness of breath, and lightheadedness or dizziness.

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