Often characterized by anal pain and bleeding, fissures cause severe discomfort. While they’re more prevalent in infants, they also affect adults. According to statistics, the United States reports more than 200,000 new anal fissure cases every year.
Unfortunately, some anal and colorectal cancer manifest symptoms similar to fissures, which leaves many patients wondering whether their condition is a fissure or cancer. This especially occurs in cases of chronic fissure or due to recurrences. Usually, once a person has a fissure, there’s always a probability of a recurrence.
Nonetheless, a fissure is a condition on its own, and its presence does not necessarily indicate the presence of cancer. In this article, we take a look into anal fissures vs colon cancer and anal cancer to help you understand their causes, symptoms, risk factors, treatment, and whether they’re preventable.
The Difference Between Fissure, Anal, and Colorectal Cancer
An acute anal fissure is a tear in the lining of the anal canal, mostly caused by passing hard or large stools. The anal canal is a tube at the end of the rectum usually surrounded by muscles. The fissure could form a lump or a skin tag, which is often confused with hemorrhoids (also known as piles, hemorrhoids are swollen veins that form either inside the rectum or outside the anus).
Anal cancer is a cancer type that occurs in the anal canal due to the growth of abnormal cells. According to the American Cancer Society, the exact cause of anal cancer is unknown, but most incidences are linked to HPV (human papillomavirus). Like anal fissures, anal cancer may cause anal pain and bleeding.
Colorectal cancer, known as colon cancer or rectal cancer, depending on where it starts, develops from a growth (polyp) inside the lining of the colon or rectum. The polyps form when the cells lining the colon or rectum grow out of control. However, having polyps does not necessarily mean one has cancer since some are non-cancerous.
Understanding the differences between anal cancer vs an anal fissure vs colon cancer is crucial for accurate diagnosis and treatment. While they all affect the lower digestive tract, their causes, risk factors, and symptoms differ significantly. Usually, fissures are non-cancerous. As much as they may manifest similar symptoms to anal or colorectal cancer, such as bleeding during bowel movements, they don’t cause cancer. However, having colorectal or anal cancer could trigger the formation of a fissure.
Causes of Anal Fissures
Unlike anal and colon cancers, anal fissures are not cancerous. They are small tears in the lining of the anus, often caused by:
- Physical Trauma: Such as passing large or hard stools, which can cause tearing.
- Inflammatory Bowel Disease: Conditions like Crohn’s disease can make one more susceptible to fissures.
- Childbirth: Women may experience fissures during or after childbirth.
- Straining during Bowel Movements: Chronic constipation and straining significantly contribute to the development of fissures.
Causes of Anal Cancer
Anal cancer originates from the cells lining the anal canal. Key risk factors include:
- HPV Infection: This is a major cause, especially HPV-16, which is less commonly associated with colon cancer.
- Smoking: A shared risk factor but more directly linked to anal cancer.
- Immunosuppression: Those with weakened immune systems, such as HIV/AIDS patients, are at a higher risk.
- Age and Gender: More prevalent in older adults and women.
- Sexual Behavior: Increased risk with engaging in anal intercourse, likely due to HPV transmission.
Causes of Colon Cancer
Colon cancer arises from the large intestine or colon. Causes of colon cancer may be:
- Age Factor: Risk increases after 50 years.
- Genetics: Genetic mutations and conditions like Lynch syndrome are closely linked.
- Diet and Lifestyle: A diet high in red and processed meat and low in fiber, combined with a sedentary lifestyle, increases risks.
- Personal Health History: A history of polyps or inflammatory bowel diseases is a significant risk factor.
- Alcohol and Tobacco Use: Common risk factors but more pronounced in colon cancer.
Risk Factors of Anal Fissure
In addition to the above causes, the following factors could also increase the risk of anal fissures;
- Vaginal childbirth
- Anal intercourse
- Eating a low-fiber diet
- Crohn’s disease
- Anal cancer
- Colorectal cancer
Risk Factors of Anal Cancer
On the other hand, anal cancer has the following risk factors.
- HPV infection
- Weakened immunity
- Smoking
- Anal intercourse
- History of cervical or vaginal cancer
Risk Factors of Colorectal Cancer
The exact cause of colorectal cancer is unknown. However, the following factors increase its prevalence.
- Aging
- Smoking
- Poor diet (low in fruits and vegetables)
- Alcohol consumption
- Overweight or obesity
- Lack of physical activity
- Inflammatory bowel disease (Ulcerative colitis and Crohn’s disease)
- Family history of colorectal cancer
Symptoms
While bleeding is the common one among the fissure and cancer symptoms, chronic pain during and after bowel movements is more indicative of the former. Changes in bowel habits and stool characteristics, unexplained weight loss, and persistent abdominal discomfort, on the other hand, are more aligned with the latter.
Symptoms of Anal Fissure
Among the common signs and symptoms of anal fissure is a flare-up, especially during and after a bowel movement. As a result, patients try to avoid having bowel movements, leading to chronic anal fissures and further complications such as constipation. Common symptoms include;
- Bloody stool that can be seen on toilet paper
- Stinging pain during bowel movement
- A lump or skin tag on the skin surrounding the tear
- Pain after a bowel movement (lasting for several hours)
- Visible tear in the skin around the anal margin
Symptoms of Anal Cancer
Sometimes anal cancer may fail to manifest any symptoms. But some common anal cancer symptoms may include;
- A lump at the anal opening
- Rectal bleeding
- Anal pain during bowel movement
- Rectum and anal itching
- Changes in bowel movements
- Stool incontinence
- Abnormal anal discharges
Symptoms of Colorectal Cancer
Similarly, colorectal cancer symptoms do not manifest immediately. However, when they start showing, you may experience the following;
- Rectal bleeding
- Blood in stool
- Weakness and fatigue
- Unintended weight loss
- Cramping or abdominal pain
- Change in bowel habits and movements
When Should You See a Doctor?
You should see a doctor if;
- You see blood on your stool or the toilet paper after a bowel movement, or
- Experience pain during bowel movement
After examining you, the doctor should be able to determine whether you have a fissure or other anorectal condition (fistula, hemorrhoid, etc.) or recommend further tests to rule out the possibility of either anal or colorectal cancer.
Diagnosis
Taking note of the differences between anal cancer, colon cancer, and anal fissures, it is also crucial to understand how each of these conditions is diagnosed. Distinct diagnostic approaches are key to identifying and effectively treating each.
Diagnosis of Anal Fissure
The doctor makes a diagnosis based on your symptoms, medical history, and rectal exam. In case you have a fissure, an inspection of the anal region should reveal the tear. Usually, the fissure occurs on the back or the front of the anal opening. If it appears on the side, it could indicate another underlying condition, calling for further exams. These may include;
- Anoscopy – The doctor inserts a tubular device (anoscope) through the anal opening to view the anus and the rectum.
- Colonoscopy – The doctor inserts a thin tubular device through the anus to view the inside of the colon.
- Flexible sigmoidoscopy – The doctor inserts a flexible tubular device into the rectum to view the lower part of the large intestine
Diagnosis of Anal Cancer
In the same way, the doctor may diagnose anal cancer based on your symptoms, medical history, and family history. Some of the possible exams may include anoscopy, colonoscopy, digital rectal examination, anal lining swabs, biopsy, or endoanal.
- Digital rectal examination – The doctor inserts their finger into the anus to check for lesions or lumps.
- Biopsy – The doctor collects a sample of tissue for examination in the lab.
- Anal lining swabs – The doctor performs a swab test to detect unusual formations.
- Endoanal ultrasound – The doctor evaluates the sphincter structure and the anal muscle structure using high-frequency sound waves.
Diagnosis of Colon Cancer
In the context of understanding colon cancer alongside anal cancer and anal fissures, recognizing the diagnostic procedures for colon cancer is key. Early and accurate diagnosis can significantly influence the effectiveness of the treatment.
- Digital rectal examination – The similarities of the three come down to a similar initial text, which is a digital rectal exam.
- Colonoscopy – This is the most definitive method for diagnosing colon cancer. During this procedure, a long, flexible tube equipped with a camera is inserted into the rectum to examine the entire colon. If polyps or abnormalities are found, they can be removed or biopsied during the same procedure.
- Imaging Tests – Depending on the situation, tests like CT scans, MRIs, or PET scans may be employed to get a detailed view of the colon and check for metastases.
Treatment
It’s important to recognize that anal cancer, colon cancer, and anal fissures each require unique therapeutic approaches. Tailoring treatment to the specific condition is essential for effective management and the best possible patient outcomes.
Treatment of Anal Fissure
If the diagnosis is positive, the doctor will recommend several treatments as follows;
Medication
- Taking stool softeners or laxatives
- Application of a topical anesthetic around the anus to relieve pain
- Topical application of medication around the anal canal to relax the muscles
Lifestyle Changes and Home Remedies
- Taking a higher fiber diet or supplements,
- Drinking plenty of water to soften the stool
- Taking warm 10 to 20 minutes baths (sitz bath) a few times per day
Surgical Treatment
Surgery is rarely used in acute anal fissure treatment unless for chronic fissure, in which case, it helps the sphincter muscles relax. The two surgery options include;
- Botulinum toxin (Botox) treatment – An injection administered to the anal sphincter muscle
- Lateral internal sphincterotomy – An operation on the internal sphincter muscle
Treatment of Anal Cancer
Upon a positive diagnosis, the doctor may recommend various types of treatment depending on the extent or location of the cancer. These may include;
- Surgery – Abdominoperineal resection involves removing the cancerous tissue in the anal area
- Radiation therapy – The cancer cells are killed using high-energy X-rays or radioactive material
- Chemotherapy – Drugs are administered to the patient to kill the cancer cells
Treatment of Colorectal Cancer
Is colon cancer treatable? Colorectal cancer can be treated using various options. Examples of treatments include colorectal surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy, etc.
Surgery includes laparoscopic, colostomy, and cryoablation, while radiation therapy may include external beam, stereotactic, and intraoperative. The use of medication therapy (chemotherapy, immunotherapy, and targeted therapy) is also a common cancer treatment.
Prevention
When exploring the prevention strategies for anal cancer, colon cancer, and anal fissures, it becomes evident that lifestyle choices, regular screenings, and awareness of risk factors play pivotal roles. Adopting proactive measures tailored to each condition is fundamental in reducing risks and promoting overall colorectal health.
Prevention of Anal Fissure
You can prevent anal fissures through lifestyle changes and good bowel habits, including;
- Eating a high-fiber diet and taking plenty of water to avoid strain during bowel movements
- Regular exercise
Prevention of Anal Cancer
Since the exact cause of anal cancer is unknown, it might not be possible to prevent it entirely. However, eliminating some of the risk factors can help lower its prevalence, such as;
- Taking HPV vaccines to prevent infection
- Quitting smoking
- Practicing safe intercourse
Prevention of Colorectal Cancer
On the other hand, you may not be able to prevent colorectal cancer. But you can reduce the risk factors in the following ways;
- Regular colorectal cancer screening
- Maintaining a healthy body weight
- Exercising regularly
- Eating a healthy diet
- Avoiding alcohol consumption
- Quitting smoking
Get a Diagnosis at Immunity Therapy Center
Fissures are non-cancerous, and most can be diagnosed with a simple examination of the anal area, followed by treatment. However, since they may be caused by an underlying condition sometimes, getting a thorough diagnosis is recommended. Usually, the doctor should be able to determine the proper diagnosis based on your symptoms, medical history, and family history. While most fissures can be treated without surgery, chronic fissures may require surgery to minimize recurrence and alleviate discomfort.
If you’re struggling with fissures or are afraid your symptoms could be due to a serious underlying condition such as anal or colorectal cancer, visit us at the Immunity Therapy Center. Should the diagnosis be positive, our cancer treatment program involves stimulating the immune system to destroy the cancer cells. We also use non-invasive therapies designed to aid your healing by taking advantage of the cancer cells’ weakness.
Contact us today for an appropriate diagnosis and treatment.
Written By: Dr. Pablo Orozco
Dr. Pablo Orozco is a Board Certified Medical Doctor from Universidad Autónoma de Baja California.
Dr. Orozco has been a treating physician at the Immunity Therapy Center for more than 3 years providing daily on site patient care. He works with patients on a daily basis and guides them through the treatment process. Dr. Orozco’s passion for Alternative Cancer Treatments along with his commitment to patient care is key to insure that our patients have the best experience and results possible.
Sources:
- Stewart David. “Anal fissure: Clinical manifestations, diagnosis, prevention.” UpToDate, May. 2022, https://www.uptodate.com/contents/anal-fissure-clinical-manifestations-diagnosis-prevention
- American Cancer Society Team. “What Causes Anal Cancer?” American Cancer Society, Sep. 2020, https://www.cancer.org/cancer/anal-cancer/causes-risks-prevention/what-causes.html
- Bautista Dr. “Types of Colon Polyps.” Immunity Therapy Center, Dec. 2019, https://www.immunitytherapycenter.com/blog/types-of-colon-polyps/
- American Cancer Society Team. “Colorectal Cancer Signs and Symptoms.” American Cancer Society, Jun. 2020, https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/signs-and-symptoms.html
- Memon Nazneen. “Is a Fissure a Lump? Anal Cancer Symptoms & Diagnosis.” MedicineNet, Jun. 2021, https://www.medicinenet.com/is_a_fissure_a_lump/article.htm#how_is_anal_cancer_diagnosed
- Memorial Sloan Kettering Cancer Center Team. “About Anal Fissure.” Memorial Sloan Kettering Cancer Center, Nov. 2020, https://www.mskcc.org/cancer-care/patient-education/about-anal-fissures
- Bautista Dr. “Anal Cancer.” Immunity Therapy Center, Nov. 2019, https://www.immunitytherapycenter.com/diseases-we-treat/cancer-treatment/anal-cancer/
- Bautista Dr. “How Is Cryoablation Performed?” Immunity Therapy Center, Feb. 2021, https://www.immunitytherapycenter.com/blog/how-is-cryoablation-performed/
- American Cancer Society Team. “Can Colorectal Cancer Be Prevented?” American Cancer Society, Jun. 2020, https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/prevention.html
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.