Symptoms of anal cancer

The symptoms of anal cancer include bleeding from the back passage (rectum), pain and feeling like there is a lump in or around your anus .

You should see your GP if you have any symptoms that may be due to anal cancer.

What are the symptoms of anal cancer?

Bleeding is the most common symptom of anal cancer. Other common symptoms are anal pain and feeling like there is a lump in your anus.

There are a number of less common symptoms such as itching and changes to bowel habits . If the cancer has spread to the lymph nodes in the groin, they may be swollen. But some people do not have any symptoms to start with.

All the symptoms of anal cancer can be caused by other conditions such as piles (haemorrhoids) or an infection. But it is still important to see your GP.

Bleeding

You might notice this as blood:

• mixed in with your poo
• streaks on the outside of your poo
• on the tissue when you wipe
• in the toilet water after you have had a poo – this can make the water pink 

Bleeding is a common symptom of non cancerous (benign) conditions such as piles or a small tear in your anus. This is called an anal fissure. Bleeding can also be caused by medicines that thin your blood.

You should see your GP if you have blood in your poo and have any other symptoms. This includes tiredness or unexpected weight loss. Or if you have bleeding for more than 3 weeks with no other symptoms.

If your poo is very red or you have very loose poo (diarrhoea) with blood, you should see your GP urgently or call NHS 111. If the bleeding won’t stop or there is lots of blood you should call 999 or go to A&E.

Pain

You might have pain in or around your anus. Or you might get pain when you have a poo.

Pain can be a symptom of haemorrhoids. These are much more common than anal cancer.

Sensation of a lump

You might feel the sensation of a lump in or around your anus.

Other symptoms

Other symptoms of anal cancer can include:

• a sore that doesn't heal
• itching around your anus
• passing mucus
• changes to your bowel habits
• an abnormal connection between your anus or rectum and a nearby part of your body (fistula)
• swollen groin lymph nodes

A sore (ulcer) that does not heal

This can develop in or around your anus. It might feel painful and may bleed.

Severe itching

This can affect the skin around the anus. Itching of the skin is also called pruritis.

Passing mucus

You might pass a substance called mucus from your anus. Mucus is produced by the mucous membranes in the body. These are the moist tissues that line the inside of body openings including the anus. Mucus makes the tissues slippery to reduce damage from friction when you have a poo.

You might pass mucus with your poo or find it in your underwear.

Bowel changes

You may have changes that can include:

• difficulty controlling your bowels (faecal incontinence)
• needing to have a poo urgently
• thin poos

You may also feel like you need to have a poo even if you have just been. Or feel like you haven’t emptied your bowel completely.

A fistula

A fistula means an abnormal path between two body areas. Passing wind or poo from the vagina can be a symptom of a fistula connecting the anus or rectum to the vagina.

Swollen lymph nodes

These can feel like lumps under the skin in your groin. Lymph nodes commonly swell if you have an infection but they usually go back to normal over a short time. If you have anal cancer, swollen groin lymph nodes may be a sign that cancer cells have spread to them.