Cancer of anal canal or rectum:

Classically it has been taught that these cancers are more common in the West than in India. This can lead to a false sense of security and a delay in diagnosis. Many times cancers are found in cases who are seeking treatment for “piles”.
It is mandatory for the surgeon to consider the possibility of a cancer in patients even if obvious hemorrhoids are seen.
It is common to perform a “sigmoidoscopy” test where about 25 cms of the colon above the anal verge is examined to exclude a tumor.This test is advisable whenever the patient is around 40 years or older. Surgeons should maintain a high index of suspicion towards this serious condition where delay in diagnosis often leads to poor outcome inspite of treatment.