Haemorrhoids (also spelt hemorrhoids, or called piles) can sometimes be mistaken for anal cancer. They have similar symptoms and broadly affect a similar part of the body. However, they are very different conditions, with different causes, risk factors and treatments.
Because symptoms overlap, anal cancer may occasionally be mistaken for haemorrhoids at first. This can delay further investigation and treatment.
If you notice bleeding, pain, a lump, discharge, or any other persistent change around the anus, it is important to speak to a GP or healthcare professional.
Key differences between anal cancer and haemorrhoids
Bleeding is one of the more common symptoms linked with both conditions. If bleeding continues, it is important to speak to a GP.
With haemorrhoids, the blood is usually bright red. With anal cancer, bleeding may be bright red or darker in colour, and may occur alongside other symptoms.
People with anal cancer may have either diarrhoea or constipation, increased straining or narrow stools. Haemorrhoids are more often linked with straining or constipation.
The other sign is a lump near the anus, which is similar to haemorrhoids. Lymph node swelling and abnormal discharge from the anus are commonly seen with anal cancer, and are not seen with haemorrhoids.
Finally, a firm growth within or surrounding the anus may be more indicative of anal cancer. A more “squishy” or rubbery, veiny growth would more likely suggest haemorrhoids.
Symptoms of haemorrhoids
The symptoms of haemorrhoids usually depend on what type it is.
External haemorrhoids develop under the skin around your anus. Symptoms might include:
- itching or irritation around your anus
- pain or discomfort
- swelling around the anus
- bleeding
Internal haemorrhoids develop inside the rectum, and are hard to see or feel. They also rarely cause any discomfort. Straining when passing stool can cause:
- painless bleeding during bowel movements.
- A haemorrhoid to push through the anal opening. This is known as a prolapsed or protruding haemorrhoid, which can lead to pain and irritation.
Thrombosed haemorrhoids happen when blood collects in an external haemorrhoid and forms a clot known as a thrombus. This can result in:
- severe pain
- swelling
- inflammation
- a hard lump near the anus
Symptoms of anal cancer
It’s important for people who have anal cancer symptoms to be assessed by a GP or referred for further investigation. In some cases, anal cancer causes no symptoms in its early stages.
Some of the possible symptoms of anal cancer include:
- anal or rectal discharge, such as pus, mucus or bleeding.
- rectal, anal, or surrounding area pain, itching, pressure or a full feeling. These symptoms may be constant or exacerbated by bowel movements or sex.
- change in bowel frequency, size or difficulty. Stools may become narrower, you may experience increased straining, or you may use the bathroom more often.
- a lump or hard area near the anus or swollen lymph nodes in the groin, pelvis, or anal area.
Learn more about the symptoms of anal cancer.
Causes and risk factors of haemorrhoids
The risk of haemorrhoids usually increases with age. A haemorrhoid is formed when a vein in the rectum becomes irritated and inflamed. As it grows larger, bowel movements rub against it, causing more irritation and pain.
Increased pressure in the lower rectum causes haemorrhoids to form due to any of the following:
- straining during bowel movements
- chronic diarrhoea or constipation
- remaining seated on the toilet for long periods of time
- obesity
- pregnancy
- a low-fibre diet
- regular heavy lifting and associated straining
Causes and risk factors for anal cancer
Anal cancer and anal precancer have several causes and risk factors. These can include:
- infection with human papillomavirus (HPV)
- a history of anal warts or HPV-related conditions
- smoking
- immunosuppression
- older age
Learn more about the causes of anal cancer.
How haemorrhoids and anal cancer are treated
Haemorrhoids treatment
Haemorrhoids can often be relieved by some of the following home treatments
You can often relieve the mild pain, swelling and inflammation of haemorrhoids with home treatments including:
- Taking regular warm baths or sitz baths
- Drinking lots of fluid and eating plenty of fibre to keep stools soft
- Gently wiping your bottom with damp toilet paper
- Using an ice pack wrapped in a towel or a dishcloth on the affected area
- Taking over the counter pain relief such as paracetamol or ibuprofen
A pharmacist or GP may also recommend creams, ointments or suppositories.
If symptoms are more sever or do not improve, hospital treatment may be needed although this does not always prevent haemorrhoids from returning.
Common non-surgical hospital treatments include:
- rubber band ligation: a band is placed around your haemorrhoids to make them drop off
- sclerotherapy: a liquid is injected into the haemorrhoids to make them shrink
- electrotherapy: a gentle electric current is applied to the haemorrhoids to shrink them
- infrared coagulation: an infrared light is used to cut the blood supply to the haemorrhoids to shrink them
If these treatments don’t work, you may need surgery to remove your haemorrhoids.
Surgical treatments include:
- haemorrhoidectomy: to remove the haemorrhoids
- hemorrhoidal artery ligation: which cuts off the blood supply to the haemorrhoids to make them shrink
- stapled haemorrhoidopexy: haemorrhoids are stapled back inside the anus
Anal Cancer Treatment
Treatment for anal cancer depends on the size of the tumour, its stage and type.
Treatment options for anal cancer include:
- Chemotherapy, usually involving the drugs mitomycin-C and either 5-fluorouracil (5-FU) or capecitabine.
- Radiotherapy, directed at the cancer to shrink tumours and kill cancer cells.
- Surgery, although uncommon, may be used for early-stage anal cancer when the tumour is extremely small and localised.
For stages 1 to 3, the standard treatment is radiotherapy together with chemotherapy, often called chemoradiotherapy. This approach is sometimes referred to as the Nigro protocol.
Learn more about anal cancer treatment.
Are there different risk factors between anal cancer vs haemorrhoids?
Risk factors for anal cancer include HPV infection, a history of anal warts, smoking, weakened immune system, and certain sexual behaviours. Risk factors for haemorrhoids include chronic constipation or diarrhoea, straining during bowel movements, obesity, pregnancy, and prolonged sitting.
Is there a difference in the way anal cancer and haemorrhoids look?
Anal cancer may present with lumps or growths near the anus that are firm, irregular in shape, and may bleed. Haemorrhoids typically present with soft, swollen blood vessels around the anus, which may protrude during bowel movements.
How are anal cancer and haemorrhoids diagnosed?
Anal cancer is typically diagnosed through a combination of physical examination, imaging tests (such as MRI or CT scans), and biopsy of suspicious areas. Haemorrhoids are usually diagnosed based on a physical examination of the anal area and medical history. In some cases, further diagnostic tests such as anoscopy or sigmoidoscopy may be performed.
Can anal cancer and haemorrhoids cause similar pain or discomfort?
Both anal cancer and haemorrhoids can cause pain or discomfort in the anal area, but the nature and severity of the pain may differ. Anal cancer pain may be more persistent and severe, while haemorrhoid pain is often milder and related to bowel movements.
Can haemorrhoids be a sign of cancer?
Haemorrhoids themselves are not typically a sign of cancer. Haemorrhoids are swollen veins in the lowest part of your rectum and anus. They are a common condition and can be caused by various factors such as straining during bowel movements, chronic constipation or diarrhoea, sitting for long periods of time on the toilet, or pregnancy.
However, some symptoms of haemorrhoids can overlap with symptoms of more serious conditions, including anal or colorectal cancer. These symptoms may include rectal bleeding, pain, itching, or swelling around the anus.
It’s essential to differentiate between haemorrhoids and more serious conditions like colorectal cancer. If you experience persistent symptoms such as bleeding from the rectum, changes in bowel habits, unexplained weight loss, or persistent abdominal discomfort, it’s crucial to see a healthcare professional for proper evaluation and diagnosis.
How We Help Anal Cancer Patients
We aim to provide anal cancer patients (thrivers) with comprehensive resources and information. Learn more about anal cancer prevention, screening and anal precancer, treatment and managing the side effects of treatment.
We also work to support patients (thrivers) and carers through our unique peer-to-peer support programme. This pairs patients and carers with trained volunteers who have experienced anal cancer treatment and recovery. Register for the thrivers P2P programme or the caregivers P2P programme.
Hemorrhoids (also spelt haemorrhoids, or called piles) can sometimes be confused for anal cancer. They have similar symptoms and broadly affect a similar part of the body. However, there are important differences, both in how they form and how they affect patients.
Anal cancer is frequently misdiagnosed as hemorrhoids and this can lead to a delay in adequate treatment and care.
If you are experiencing anything unusual in your anal area, it’s important to get it checked out with a provider who listens to your concerns.
Key differences between anal cancer and hemorrhoids
One of the most apparent signs of anal cancer is bleeding. It may not start out as frequent bleeding but it’s important to see a doctor if it continues for some time.
A sign of anal cancer is that the bleeding may be either dark or bright red colored. Bleeding occurs with hemorrhoids too, but tends to be bright red only. People with anal cancer may have either diarrhea or constipation, while someone with hemorrhoids generally has a history of chronic constipation.
The other sign is a lump near the anus, which is similar to hemorrhoids. Lymph node swelling and abnormal discharge from the anus are commonly seen with anal cancer, and are not seen with hemorrhoids.
Finally, a hard growth within or surrounding the anus may be more indicative of anal cancer. A more “squishy” or rubbery, veiny growth would more likely suggest hemorrhoids.
Symptoms of hemorrhoids
The symptoms of hemorrhoids usually depend on what type it is.
External hemorrhoids are found under the skin around your anus. Symptoms might include:
- itching or irritation around your anus
- pain or discomfort in the anal area
- swelling around the anus
- bleeding
Internal hemorrhoids are inside the rectum, and are hard to see or feel. They also rarely cause any discomfort. Straining when passing stool can cause:
- bleeding without pain during bowel movements.
- the hemorrhoid to push through the anal opening. This is known as a prolapsed or protruding hemorrhoid, which can lead to pain and irritation.
Thrombosed hemorrhoids, when blood gathers in an external hemorrhoid and forms a clot known as a thrombus. This can result in:
- severe pain and swelling
- inflammation
- a hard lump near the anus
Symptoms of anal cancer
It’s important for people who have anal cancer symptoms to be examined by their healthcare provider or referred to a specialist. Although these symptoms may indicate the presence of anal cancer, some individuals with anal cancer may be asymptomatic. This can happen when the disease is in its early stages.
Some of the main symptoms of anal cancer include:
- anal or rectal discharge, such as pus, mucus or bleeding.
- rectal, anal, or surrounding area pain, itching, pressure or a full feeling. These symptoms may be constant or exacerbated by bowel movements or sex.
- change in bowel frequency, size or difficulty. Stools may become more narrow, you may experience increased straining, or you may use the bathroom more often.
- a lump or hard area near the anus or swollen lymph nodes in the groin, pelvis, or anal area.
Learn more about the symptoms of anal cancer.
Causes and risk factors of hemorrhoids
The risk of hemorrhoids usually increases with age. A hemorrhoid is formed when a vein in the rectum becomes irritated and inflamed. As it grows larger, bowel movements rub against it, causing more irritation and pain.
Increased pressure in the lower rectum causes hemorrhoids to form due to any of the following:
- straining during bowel movements
- chronic diarrhea or constipation
- remaining seated on the toilet for long periods of time
- obesity
- pregnancy
- a low-fiber diet
- regular heavy lifting and associated straining
Causes and risk factors of anal cancer
Anal cancer and precancer have several causes and risk factors. These can include:
- having a history of human papillomavirus (HPV) and related conditions.
- smoking
- immunosuppression
- older age
Learn more about the causes of anal cancer.
How anal cancer is treated vs how hemorrhoids are treated
Hemorroids treatment
Hemorrhoids can often be relieved by some of the following home treatments
You can often relieve the mild pain, swelling and inflammation of hemorrhoids with home treatments including:
- Taking regular warm baths or sitz baths
- Drinking lots of fluid and eating plenty of fibre to keep stools soft
- Wiping your bottom with damp toilet paper
- Using an ice pack wrapped in a towel or a dishcloth on the affected area
- Using over the counter pain relievers such as aspirin, acetaminophen, paracetamol or ibuprofen
You can also speak to your medical professional about topical treatments such as creams or suppositories that can be purchased without a prescription.
Should the hemorrhoids worsen, you may require hospital treatment, although this does not always prevent hemorrhoids from returning.
Common non-surgical hospital treatments include:
- rubber band ligation: a band is placed around your hemorrhoids to make them drop off
- sclerotherapy: a liquid is injected into the hemorrhoids to make them shrink
- electrotherapy: a gentle electric current is applied to the hemorrhoids to shrink them
- infrared coagulation: an infrared light is used to cut the blood supply to the hemorrhoids to shrink them
If these treatments don’t work, you may need surgery to remove your hemerrhoids.
Surgical treatments include:
- haemorrhoidectomy: to cut out the hemorrhoids
- hamorrhoidal artery ligation: stitches cut the blood supply to your hemorrhoids to make them shrink
- stapled hamorrhoidopexy: hemorrhoids are stapled back inside your anus
Treatment for anal cancer
The treatment for anal cancer is dependent on the size of the tumor, its stage and type. Treatment options for anal cancer include:
- Chemotherapy: usually involving the drugs mitomycin-C and 5-fluorouracil (5-FU).
- Radiation: directed towards the cancer location to shrink tumors and kill anal cancer cells.
- Surgery: although uncommon this can be used for early-stage anal cancer when the tumor is extremely small and localized
For stages I – III, the standard protocol is radiation and chemotherapy, used in conjunction with one another (often called ‘chemoradiation’). This is known collectively as the Nigro Protocol.
Learn more about anal cancer treatment.
Are there different risk factors between anal cancer and hemorrhoids?
Risk factors for anal cancer include HPV infection, a history of anal warts, smoking, weakened immune system, and certain sexual behaviors. Risk factors for hemorrhoids include chronic constipation or diarrhea, straining during bowel movements, obesity, pregnancy, and a sedentary lifestyle.
Is there a difference in the way anal cancer and hemorrhoids look?
Anal cancer may present with lumps or growths near the anus that are firm, irregular in shape, and may bleed. Hemorrhoids typically present with soft, swollen blood vessels around the anus, which may protrude during bowel movements.
How are anal cancer and hemorrhoids diagnosed?
Anal cancer is typically diagnosed through a combination of physical examination, imaging tests (such as MRI or CT scans), and biopsy of suspicious areas. Hemorrhoids are usually diagnosed based on a physical examination of the anal area and medical history. In some cases, further diagnostic tests such as anoscopy or sigmoidoscopy may be performed.
Can anal cancer and hemorrhoids cause similar pain or discomfort?
Both anal cancer and hemorrhoids can cause pain or discomfort in the anal area, but the nature and severity of the pain may differ. Anal cancer pain may be more persistent and severe, while hemorrhoid pain is often milder and related to bowel movements.
Can hemorrhoids be a sign of cancer?
Hemorrhoids themselves are not typically a sign of cancer. Hemorrhoids are swollen veins in the lowest part of your rectum and anus. They are a common condition and can be caused by various factors such as straining during bowel movements, chronic constipation or diarrhea, sitting for long periods of time on the toilet, or pregnancy.
However, some symptoms of hemorrhoids can overlap with symptoms of more serious conditions, including anal or colorectal cancer. These symptoms may include rectal bleeding, pain, itching, or swelling around the anus.
It’s essential to differentiate between hemorrhoids and more serious conditions like colorectal cancer. If you experience persistent symptoms such as bleeding from the rectum, changes in bowel habits, unexplained weight loss, or persistent abdominal discomfort, it’s crucial to see a healthcare professional for proper evaluation and diagnosis.
Resources for people with hemorrhoids
Learn more about remedies from these trusted sources:
- Harvard Health: Hemorrhoids and What to Do About Them
- Healthline: Hemorrhoids Home Remedies and OTC Treatment
- Mayo Clinic: Hemorrhoids
- UCSF Health: Hemorrhoids Patient Education
- Piles (Haemorrhoids)
How we help anal cancer patients
We aim to provide anal cancer thrivers (our word for patients) with comprehensive resources and information. Learn more about anal cancer prevention, screening and anal precancer, treatment, and managing the side effects of chemo and radiation.
We also work to support thrivers and caregivers with our unique peer-to-peer support program. This pairs thrivers and caregivers with trained volunteers who have experienced anal cancer treatment and recovery. Learn more about the program and register to connect with a peer, or to volunteer!
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