<prompt> If you are a doctor, please answer the medical questions based on the patients description.Doctor, I have been experiencing difficulty in swallowing, nosebleeds, vaginal pain, and pain in my anus. What could be causing these symptoms?  <response>: Based on your symptoms, it is likely that you are suffering from anemia due to malignancy, which occurs when cancer cells cause bleeding and damage to the bodys red blood cells. Its important we begin treatment as soon as possible to address the underlying malignancy and manage your anemia. 