Top anal surgeon 'Dr Butthole' reveals warning sign that could lead to a scary ‘silent disease’
You work your backside off to get yourself through medical school, only to be dubbed 'Dr Butthole' and 'the bottom whisperer'.
But as Dr Evan Goldstein explains, 'only in his field' are these nicknames considered a compliment - as he's one of the finest anal surgeons in the US.
The medic, based in New York City, might be happy to lean into the humorous titles he's been honoured with, but he still takes his work extremely seriously.
Which is why he is using his platform to urge people to be wary of a warning sign which could indicate that you might be at risk of developing anal cancer.
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It's often dubbed a 'silent disease' due to the lack of noticeable symptoms which appear in the early stages - meaning a lot of people only receive a diagnosis when it has drastically advanced.
According to Dr Goldstein, the founder and CEO of Bespoke Surgical, there is one indicator of anal cancer which often appears, however, patients typically deem them as harmless.
"Anal cancer stems from the HPV virus and, for many, from the development of anal warts," the father-of-two told the New York Post.
The NHS explains that 'most' anal cancers are caused by the human papillomavirus (HPV), which you can contract via any skin-to-skin contact of the genital area, vaginal, anal or oral sex and sharing sex toys.
Although the majority of people with HPV won't go on to develop anal cancer, about 90% of cases are linked to the infection.
Some people with the virus might develop painless growths or lumps around the genitals or anus, known as warts, which are typically treated with creams, liquids or ointments, cryotherapy or sometimes surgery.
However, they can also disappear on their own within six months - and a lot of the time, people just brush them off as strange bumps or skin tags, Dr Goldstein says.
He explained the warts usually appear as a single bump in the anal region, or a cluster that resembles a cauliflower, while they can be both raised or flat to the skin.
"Many think they are just skin tags and then find out it’s anal warts from HPV," Dr Goldstein said. "They can be painful and itchy and lead to bleeding."
Still, some people don't experience any symptoms at all and therefore have no idea that they have anal warts.
The medic explained that some HPV strains can alter anal cells, potentially leading to precancerous lesions, which can develop into anal cancer if left untreated.
Anal cancer symptoms can be similar to those of piles (haemorrhoids) and anal fissures, according to the NHS, but some warning signs can be 'hard to spot'.
The main symptoms are bleeding from your bottom, itching and pain around your anus, small lumps around and inside your bottom and a discharge of mucus from your bottom.
You should also check in with your GP if you are having problems controlling when you poo (bowel incontinence) or you find yourself needing to poo often with looser, runnier poos.
Dr Goldstein said: "The idea is to catch this early with early detection anal pap smears and full anoscopy (in and out visualisation with a camera and high-resolution scope) with an appropriate anal practitioner.
"The more we talk about anal health and standardise yearly evaluations, similar to gynaecology appointments, the better all of us will be."
Discussing these intimate problems with a doctor might seem like a pain in the backside, but it could save your life.
So, if you've got anything strange going on between the cheeks, make sure you raise your concerns with your GP.
Olivia Burke