Hemorrhoids 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

Man and woman doing stretches

A confirmed diagnosis for hemorrhoids can be treated through lifestyle changes such as increasing exercise and improving overall activity levels. Using laxatives, improving eating habits such as increasing fiber and fluid intake, and cutting back on fast food are also recommended. Immediate alleviation of discomfort can take the form of taking tepid baths and applying moist heat or ice sparingly.

Anal cancer can be treated with chemoradiation, chemotherapy alone, or surgery. Learn more about anal cancer treatment.

Resources for people with hemorrhoids

Learn more about remedies from these trusted sources:

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!