When a patient with anal cancer presents with pain and bleeding, it is important to recognise these as potential side effects or complications of their cancer treatment NICE NG151. Patients who have undergone surgery for colorectal cancer, which can include procedures affecting the anal region, should be informed about possible physical changes such as anal discharge or bleeding NICE NG151. Pain is also a known short-term, long-term, permanent, or late side effect of treatments for colorectal cancer NICE NG151.
Patients should be advised on how, when, and where to seek help if these side effects become problematic NICE NG151. If the pain or bleeding is related to bowel dysfunction, primary care can offer initial treatments such as dietary management, laxatives, anti-bulking agents, anti-diarrhoeal agents, or anti-spasmodic agents NICE NG151. However, if these treatments are not successful, advice should be sought from secondary care NICE NG151.