My name is Philip Philip, I am a Professor of Medical Oncology. I specialize in gastrointestinal malignancies, and I have been treating anal cancer for the past three decades. For patients who have symptoms in the anal area, if the symptoms include pain, this is talking about beyond an anal discomfort that comes and goes, and has been there for a while. This is beyond saying that there is some bleeding, which is really known to be associated with hemorrhoids. So anything that has pain which is getting worse, bleeding getting worse, any difficulty in opening the bowels and getting worse—all these things really have to be looked at immediately by a doctor.

Make sure that the doctor really examines you. Anything beyond a discomfort, approaching pain, or increasing pain should be taken very seriously. During my career of three decades, I still see sometimes patients who have their symptoms either ignored, or the patient didn't follow up on the symptoms. Anything that persists and gets worse has to be investigated. Patients have to use their resources of communicating with the team effectively, and they shouldn't be any reluctance in doing that. We don't really get upset if a patient calls us two or three times a week, we get upset if they don't call us, and then three weeks later they are in worse shape. So that's important.