Worried about anal or rectal cancer.

I'm 32! 

Hi Ana,

Boy, am I familiar with the awful dance of knowing something's wrong but trying to take all the 'good news' and stop worrying. Anal cancer is certainly uncommon in women of your age, but that doesn't mean never.

I'm far too much of a layman to even think of diagnosing you, but I do encourage you to keep looking. I spent over two years going from doctor to doctor, exam to exam, trying to deal with the pain and hearing 'You look fine' over and over again. I'm not even positive I HAD cancer when it started. I almost gave up and just resigned myself to ongoing pain that was taking a toll on my daily life.

Cancer is never a relief, but a definitive diagnosis and treatment plan were weirdly comforting after all the subtle eye-rolls and suggestions that I was a drama queen. 

I can't rule anything out for you, just encourage you to keep looking. The doctors in the US aren't necessarily better at diagnosing anal cancer either, and we have our weird addiction to enriching insurance companies to handle as well. 

This is a good forum for questions and support, and I'm glad you've found us.

Hugs

Suz

Thanks a lot for taking the time to answer my message.

I understand what you just said. But, what I’m supposed to do then? I mean, what else can I do? Because maybe it’s true that it’s a simple fisure that’s taking very persistent in time. But how can I do? Which other tests can I take? What did you do and why did they do not found out it was cancer earlier? 

Regards! 

Hello Ana

I am so sorry that you have these ongoing worries.  Depending on where you are in Spain if you are near a big city you are more likely to find a major hospital that carries out training and research.   I don't know if your funds stretch to a private consultation but that is what a forum member on here (I think you have already asked her some questions) did when she thought the doctors examining her weren't taking her seriously.  In her case she was greatly reassured.  I also think that a private consultation in Spain doesn't cost anywhere near what is charged here in the UK or in the States.

Your doctors do seem to be taking your concerns seriously though, which is encouraging, and you have had many of the procedures that would detect anything untoward.  I think you need to make your doctors aware of just how worried you are about this unexplained bleeding and pain - I think anyone would be concerned.  Please come back when you know more about your results.

Irene x

HI Ana,

I'm sorry to frustrate you and totally understand it. I'll answer what I can, which isn't much.

I think the first thing you can do is to keep a journal of your symptoms and what you do to ameliorate them. (We always think we'll remember but we don't.) Figure out what types of foods make things worse, what pain meds help, what activities worsen the symptoms, anything at all that might help. 

I don't know what other tests to ask for. It's a maddening contradiction that all of the tests (for me, anoscopies in particular) irritate our poor abused anuses and make them bleed and hurt. 

I went in for what I thought was a hemorrhoid, but was told was actually just a skin tag and easy to remove. But they wanted to do a colonoscopy first, then Covid came and I let it go. But it kept bothering me, pain and sheer annoyance, so I went to another gastroenterologist who said I didn't need a colonoscopy and referred me to a surgeon, after assuring me that the pain would be minimal. The surgeon reinforced all of that, but added that if he noticed a potentially bothersome hemorrhoid while he was there he'd remove it. 

That's exactly what happened, only since it was a hemorrhoidectomy it was HORRIBLY painful. I went back to him weeping a week later, ice pack stuffed betwen my buttcheeks, and he was horrid. Gaslighted and mocked and yelled at me. I left his office still weeping, but in fury. 

The pain abated a little but never went away, so I found yet another gastroenterologist office, but my appointment was with a nurse practitioner, during Covid still, who was very pregnant and very disinterested. She told me-without ever examining me- that the surgeon had probably nicked some nerves in my anus and that I'd probably be in pain for the rest of my life, but that nothing could be done until I got a colonoscopy.

So I got one. The doctor who did it was so kind and sympathetic that I almost wept with relief, commiserating with me on the bumpy journey to this point, and promising to take good care of me.

The colonoscopy showed nothing. My follow up was with the same disinterested NP who said 'See you in 20 years.'

I finally found, through a friend, the gastroenterologist/surgeon who found the cancer. I was unable to take the anoscope, so got the exam and biopsy under anesthesia. That's when I finally go the diagnosis. I was T2N0 so it was very early, and I can't be sure it was even there for the jerk surgeon to find, if he had bothered to look.

So my very long and sordid tale leaves me nothing to suggest to you but not to give up. It's not a diagnosis of anal cancer you're seeking, after all, but simply an answer to what's causing you pain. It takes a doctor who has the skill, curiousity and lack of ego to keep looking. 

I sure hope your search doesn't take as long as mine. I'm rooting for you!

Suz