Should I be concerned?

[bluesong]

Hi to all...

I just have a quick question to see if I should be concerned or not.

I am a 36 year old male from the UK and for how long, I not sure, I have noticed a little blood on the toilet paper (it's hard to say how often but say twice a month) and especially recently it has happened quite frequently. I have recently checked the stools and found no blood mixed ( just bit of non digested tomoto skin etc) in the stool or blood in the water. I did see a little while back some mucus in the stool.

My stool is usually quite soft and it does take quite a bit of wipeing to get rid of. It is normally at the end of the wipe that I notice the bright red blood. Today it was on my very last wipe. I wiped again and some more blood (the size of a thumb mark) was on the paper. Strange thing was when I waited a few seconds and wiped again nothing!

I have had my prostrate checked recently as I had frequent urine problems etc and my doctor and a specialist both gave me the glove treatment up my back side and all seemed fine. I was also given an xray and scan for this particular problem which came back fine as well.

As far as I know none of my family have ever had any type of cancers.

Do you think I need this checked or do you think that the specialist and doctors would have found something wrong when having a problem with my prostrate symptoms.

I wasn't sure what forum to write this on and appreciate your feedback.

Thanks

[bluesong]

Ok thanks again Dr and hopefully age is on my side. As you stated and what I have since read that it is uncommon for someone of my age to get a cancer but I should go get it checked out just in case.  I am a worrier (as you can see it is late here in the UK 2:00am!) and always think of the worst case scenerio.

All the best

[Fernando Roque, MD]

Hi.  Cancers in general are not primarily diagnosed by doing blood tests, but through imaging studies (e.g. CT, MRI, endoscopy) coupled with a biopsy of any suspicious looking mass. There are some blood tests for "tumor markers" - these are substances in the blood which become elevated as a result of the presence of cancer. However, with a few exceptions (prostate specific antigen for prostate cancer; alpha fetoprotein for liver and testicular cancer) these are not specific or sensitive enough to be used as the initial test for detecting cancer.  Blood tests are not meant to be used to test for cancer in people who don't have any lumps or other symptoms. The fact that your blood tests came out normal don't necessarily indicate the presence or absence of cancer.

[bluesong]

Hi again

Thanks for the reply.
--
I forgot to mention that over the past two years I have had many different type of blood tests including various complete blood count. All my tests came back fine. Should this be a sign that I do hot have a pathology ie cancer etc? If I had cancer, would my blood test show a problem?  Would any irregulaties show if I did infact have cancer?

Please kindly reply

[Fernando Roque, MD]

Hi. Any recurrent bleeding during or shortly after defecation should be checked by a doctor.  Although it is always a possibility that the bleeding is coming from a cancer, the more common conditions at your age would be hemorrhoids or anal fissures.  These  need to be ruled out first even before considering a diagnosis of malignancy.  Hemorrhoids are dilated veins around the rectal and anal areas.  They tend to bleed when the skin covering the veins get thinned out and ruptures.  Anal fissures are breaks on the skin around the anal rim.  This can happen from frequent constipation and passage of hard dry stools, which may injure the anal rim.  Sometimes, when doing a digital rectal examination (like what was done to you when you had your prostate examined), doctors miss out on these two diagnoses because they do not bother with a visual inspection of the anal rim (they might have been too focused on the prostate examination to notice the other structures).

Anyway, the best thing to do is to have yourself examined, preferably by a gastroenterologist.  A proctosigmoidoscopy (a procedure where a flexible scope is inserted up your back side) might be needed to locate the source of the bleeding.