Typically, a person cannot identify anal cancer by sight. However, in some cases, small, hard lumps may develop just inside and outside the anus, so it may be beneficial to learn about what anal cancer may look like.

The American Cancer Society (ACS) estimates there will be approximately 9,760 new cases of anal cancer in the United States in 2023. They also say this particular disease is rarer than other colon or rectum cancers.

Often, a person cannot see anal cancer. However, in some cases, they may have hard, fleshy lumps just inside or outside the anus.

This article examines what anal cancer looks like, with pictures and a comparison with external hemorrhoids. Finally, it explores the symptoms of anal cancer, other reasons for lumps around the anus, and when to consult a doctor.

A person may not be able to identify anal cancer externally.

However, the ACS states that an individual may develop a lump or mass that can appear around and inside the opening of the anus. The United Kingdom’s National Health Service (NHS) notes that these lumps are often small.

People may also develop a painful sore around the anus that does not heal.

Other associated symptoms

The National Cancer Institute states individuals may also experience the following symptoms as a result of these lumps:

  • bleeding from the anus or rectum
  • pain or pressure in the anus
  • itching
  • discharge

Additional possible symptoms of anal cancer include:

  • changes in bowel movements, including:
    • needing to open the bowels more often or less frequently
    • straining more regularly
  • narrowing of stool
  • loss of bowel control or incontinence
  • swollen lymph nodes in the anus or groin area
  • a feeling of needing to open the bowels

However, approximately 20% of individuals with anal cancer do not experience any symptoms.

Learn more about rectal cancer symptoms.

In some cases, a person may mistake hemorrhoids for anal cancer, particularly external hemorrhoids. These often occur when there is too much pressure on the veins around the anus.

There are two different types of hemorrhoids:

  • External: These form under the skin around the anus. A person with external hemorrhoids may have one or more lumps that feel itchy. They may also be painful, particularly when sitting. However, external hemorrhoid symptoms should disappear within a few days.
  • Internal: These are lumps that form just inside the anus. They may cause bleeding from the rectum and a prolapse. Internal hemorrhoids can also prolapse. When this happens, the hemorrhoid falls through the anal opening, causing pain and discomfort.

The table below outlines some key differences between hemorrhoids and lumps relating to anal cancer:

External hemorrhoidsAnal cancer
Causeswollen and inflamed veins due to excess pressurecells that grow out of control that may cause lumps
Symptoms• lumps that can be hard or soft
• bright red blood after passing stool
• itching
• pain
• mucus in the underwear or on the toilet paper after passing stool
• the sensation that a person still needs to empty their bowels even after pooping
• lumps that can be hard
• rectal bleeding
• itching
• pain
• atypical discharge from the anus
• bowel incontinence
• swollen lymph nodes in the groin or anal areas
• narrowing of the stool

Find out more about the difference between external hemorrhoids and anal cancer.

Lumps on or around the anus are not always cancer. Below are some possible other causes of lumps on or around the anus.

Polyps

This is a benign growth that may form in the anus. They are often small, bumpy, and mushroom shaped. Symptoms include blood in the stool, mucus, stomach pain, and a change in bowel habits.

Polyps affect approximately 20–30% of American adults.

Anal warts

These are growths that form just outside the anus or in the lower anal canal. The cause of anal warts is a virus known as the human papillomavirus. Anal warts often require surgical or topical treatment.

Individuals who have or have had anal warts are more likely to develop anal cancer.

Skin tags

Skin tags look similar to hemorrhoids and warts. They are small, skin-colored, and usually soft. These lumps are benign, but doctors can remove them if a person wishes.

Anal fissures

These are small tears in the anal lining. Initially, an anal fissure does not cause lumps. However, if the fissure spreads downward, it can result in a lump.

People may also notice bright red blood on the toilet paper after wiping.

A person should contact a doctor if they develop lumps around the anus area, particularly if rectal bleeding or changes in bowel habits also accompany them.

People should also contact a doctor if they experience any other symptoms of anal cancer.

Some individuals with anal cancer may not develop any symptoms. However, occasionally, individuals may be able to feel lumps just inside or outside the anus.

These lumps may also cause rectal bleeding, pain or pressure in the anus, itching, and discharge.

If a person experiences symptoms of anal cancer, they should consult a doctor.