Our Summary

This research looked at the increasing occurrence of a type of cancer called squamous cell carcinoma in the anal region, especially in Kentucky. They found that this type of cancer is often identified unexpectedly during the removal of hemorrhoids.

They examined data from the Kentucky Cancer Registry from 2007 to 2016 and found 722 cases of this type of anal cancer. Of these, 3.05% were found in patients who had hemorrhoids removed.

The researchers noticed that the characteristics of the patients and the treatments they received were similar, whether the cancer was found in hemorrhoids or not. The most common treatment was a combination of chemotherapy and radiation. The rates of the disease remaining, coming back, and survival were also similar in both groups. However, the disease was more commonly found in its early stages (Stage I) in the hemorrhoid group.

The researchers concluded that some patients might be receiving more treatment than necessary because of inaccurate labeling of hemorrhoid samples. They suggest that each hemorrhoid sample should be submitted separately to avoid this.

FAQs

  1. What type of cancer was the focus of this research?
  2. How did the researchers find a connection between hemorrhoid removal and this type of cancer?
  3. What did the researchers suggest to avoid over-treatment of patients due to inaccurate labeling of hemorrhoid samples?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to make sure to follow post-operative care instructions carefully, including taking prescribed pain medication, eating a high-fiber diet, staying hydrated, and avoiding straining during bowel movements. It is also important to follow up with your doctor for any concerns or symptoms that may arise after the surgery.

Suitable For

Patients who are typically recommended for hemorrhoidectomy are those who have severe or persistent symptoms of hemorrhoids that do not improve with conservative treatments such as dietary changes, topical creams, and sitz baths. These symptoms may include pain, bleeding, itching, and prolapse. Additionally, patients with large, external hemorrhoids or those with thrombosed hemorrhoids (blood clots within the hemorrhoid) may also be recommended for surgery.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if a hemorrhoidectomy is the best course of action for their individual case.

Timeline

Before a hemorrhoidectomy, a patient may experience symptoms such as itching, pain, swelling, and bleeding in the anal region. They may also have tried conservative treatments such as over-the-counter creams, sitz baths, and dietary changes without success.

After a hemorrhoidectomy, the patient will undergo surgery to remove the hemorrhoids. The recovery process typically involves pain and discomfort in the anal region, as well as possible bleeding and difficulty with bowel movements. Patients are usually advised to follow a special diet, avoid straining during bowel movements, and take pain medication as needed. It may take several weeks for the patient to fully recover from the surgery.

In some cases, as mentioned in the research findings, anal cancer may be unexpectedly found during the removal of hemorrhoids. This can lead to additional treatments such as chemotherapy and radiation, depending on the stage of the cancer. Patients may also need to undergo regular follow-up appointments to monitor their condition and ensure the cancer does not return.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a hemorrhoidectomy?
  2. What is the likelihood of developing squamous cell carcinoma in the anal region after having a hemorrhoidectomy?
  3. How often should I have follow-up screenings for anal cancer after a hemorrhoidectomy?
  4. Are there any specific symptoms I should watch out for that could indicate the presence of anal cancer?
  5. How can I ensure accurate labeling of any tissue samples taken during the hemorrhoidectomy procedure?
  6. Are there any alternative treatments or procedures that could reduce the risk of developing anal cancer after a hemorrhoidectomy?
  7. How common is it for anal cancer to be found unexpectedly during a hemorrhoidectomy procedure?
  8. What steps can I take to reduce my risk of developing anal cancer in the future?
  9. Is there a specific specialist I should see for monitoring and managing my risk of anal cancer after a hemorrhoidectomy?
  10. Are there any lifestyle changes I should consider making to reduce my risk of developing anal cancer after a hemorrhoidectomy?

Reference

Authors: O’Brien SJ, Ellis CT, McDowell J, Galandiuk S, Polk HC Jr. Journal: Surgery. 2021 Mar;169(3):610-616. doi: 10.1016/j.surg.2020.08.026. Epub 2020 Sep 29. PMID: 33004218