Question to a doctor
“Relationship between cancer and hemorrhoids”

Question to a doctor “Relationship between cancer and hemorrhoids”

First, it is important to rule out the possibility of the presence of cancer.

In the case of anal bleeding, the possibility of cancer must be suspected. The treatment of hemorrhoids and of cancer are different fundamentally. In the case of cancer, immediate and intensive cancer treatment must be taken. If the possibility of cancer is suspected in a patient presenting with anal bleeding and if it can be scheduled, an endoscopy will be performed on the day to check for the absence/presence of any lesion in the large intestine. Such patients are hoping that the diagnosis will be hemorrhoids, not colorectal cancer. It is the responsibility of the doctors to suspect cancer first and then rule out its possibility without hastily making a diagnosis of hemorrhoids.

Director of Okazaki Surgery, Clinic for Gastroenterology and Proctology Dr. Keisuke Okazaki

Dr. Keisuke Okazaki
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Repeated anal bleeding or abnormal fecal changes must not be left untreated.

"Anal bleeding" is the most common reason for visits to our hospital, and it is most important that patients suffering from repeated bleedings do not assume that the bleeding is from hemorrhoids and can be left untreated. This is because there may be a risk of “colorectal cancer.” Some patients visit our hospital for anal bleeding after having left it untreated for more than one year. This can be extremely dangerous. Caution must also be taken for sudden changes in the form of stools. If your stools become thinner or if you always have soft stools, such findings are also warning signs for colorectal cancer. Constipation may also be caused by colorectal cancer. If you notice any abnormalities, visit a hospital immediately. Although hemorrhoids can be cured, colorectal cancer is difficult to cure unless detected early.

Chief Director Chairman, Sapporo Ishiyama Hospital Dr. Gentaro Ishiyama

Dr. Gentaro Ishiyama
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Cancer around the anus with normal blood circulation is more likely to metastasize.

The most serious condition associated with anal bleeding and anal pain is cancer. The anal canal, which is the lower end of the digestive tract, is very richly supplied with sensory nerves. Therefore, patients may feel even a slight pain around the anus. However, since there is no nerve to transmit pain inside the area beyond the border between the intestine and anus, the patient, not feeling pain, may not notice the development of hemorrhoids (piles). The rectal and perianal regions are said to be "the second heart" with active blood circulation, and even if a small cancer develops there, cancer cells will migrate to the brain, lungs, or surrounding lymph nodes through blood and lymph vessels. When physicians examine patients complaining of "anal pain," they always check for any signs of cancer. Keep in mind that "hemorrhoids do not result in fatality but cancer does."
Other than cancer, bowel diseases such as ulcerative colitis and Crohn's disease may also cause anal bleeding or pain. If you have anal bleeding, it is recommended that you promptly visit a hospital.

Director, Sameshima Hospital Dr. Takashi Sameshima

Dr. Takashi Sameshima
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Early detected colorectal cancer can be resected by endoscopic excision.

Anal bleeding and pain are symptoms to be treated immediately. Colonoscopy revealed polyps in more than 10% (about 13%) of patients scheduled to undergo surgery for hemorrhoids at our hospital. Cancer was found in 0.4% of patients, and there is a probability that cancer is found in 4 out of 1,000 patients. According to these statistics, it is recommended that patients with anal bleeding and pain visit a hospital, not assuming that their symptoms are due to hemorrhoids. Early-stage colorectal cancer can be resected by endoscopic excision, but may progress to advanced colorectal cancer if left untreated, necessitating laparotomy. Therefore, early cancer detection is important. Rectal cancer can be detected easily by digital examination, so digital examination is very important.

Director of Matsuda Hospital Dr. Satoshi Matsuda

Dr. Satoshi Matsuda
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This article is supervised by:
Dr. Keisuke Okazaki
Dr. Gentaro Ishiyama
Dr. Takashi Sameshima
Dr. Satoshi Matsuda
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