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Deadly Enemy #2:
Anal/Colorectal Cancer is the 2nd leading cause of cancer deaths in the
United States.
Cancer is the number one killer for both men and women (according to the Department of Health)and it comes in many shapes
and sizes killing 135,000+ people each year. Cancer does not discriminate.
In 2006, there will be 4,660 new cases of anal cancer in the U.S. and about 660 deaths, according to ACS statistics.
- Anal cancer occurs more often in men than in women.
- Anal cancer occurs more often in black men over 50, but can occur at any age and in any race.
- In the general population anal cancer is fairly rare; about one in 100,000 people.
- In men who have sex with men, the incidence climbs to about 35 in 100,000.
- MSM who are HIV positive are twice as likely to get anal cancer than MSM who are HIV negative.
- While anal cancer affects the anus and nearby anatomy, it is actually a type of skin cancer.
- Anal cancer can be successfully treated if discovered early.
How is Anal Cancer Diagnosed?
The key to early diagnosis is regular exams by your doctor. Using these diagnostic
techniques, your doctor can diagnose your cancer early, improving your chance for a good outcome. The diagnostic techniques
include:
- Anal PAP Smear - taking a sample of cells from around the anus and looking at them under a microscope to identify cellular changes consistant
with anal cancer.
- Directly observing the anus and surrounding tissues using an anoscope - a scope inserted into the anus that allows direct
visualization of the area.
- A manual rectal exam - the physician inserts a gloved finger into the anus in order to feel any abnormal tumors that may
be present.
- Biopsy - surgically removing bits of suspect tissue and examining it under the microscope for evidence of cancerous
cells.
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Screenings:
Some polyps and/or anal or colorectal cancer may not be just detected from a
colonoscopy alone. If you have anal or rectal cancer, sometimes only a sigmoidoscopy is the only type of screening that
can detect it (as it did in my mother with her tumor. The colonoscopy led the doctors to believe that it was hemoroids
that was causing her pain-so get a 2nd opinion!)
Doctors may find anal cancer early with a rectal exam. During this test the doctor
inserts a gloved finger into the anus to feel for lumps or growths.
The Procedure
The anal PAP screening is very simple, painless, and quick.
Simply put, the physician uses a Dacron swab and collects cell samples from the anal canal by swabbing all surfaces of the
anus and rectum. These cell samples are sent to a lab where technicians prep the samples and look at them under a microscope.
In a few days, the physician will have the results and will discuss them with you.
But how often do you need an anal PAP? Sue Goldie, MD, MPH, the author of a anal
PAP study at the Harvard School of Public Health found that screening gay and bisexual men every three years would identify
many cases of anal cancer early -- when they can be treated successfully.
What if the test finds an abnormality? Initially, the cells in the anal canal develop
abnormal, pre-malignant changes called intraepithelial (the superficial layer of the anal canal) neoplasms. These changes
gradually worsen and become an invasive cancer. If abnormal changes are noted, further investigation and possible surgical
excision by a laser may be necessary. Or, there are currently three methods of non-surgical treatment:
- Imiquimod: This is a topical agent that has limited effect because it so
easily gets rubbed off.
- Therapeutic vaccines: These may work, but one needs to have a strong immune
system for vaccines to work well.
- Onxy-015: This is a recombinant adenovirus that is about to enter clinical
trial phase. It has the ability to kill cells infected with HPV.
Needless
to say, it is obvious that regular anal PAP screenings are an important part of staying healthy while living with HIV. While
this test is gaining popularity, it may not be available in all areas. Consult your physician and tell him you want this screening.
If he is unable to provide the screening, ask him to refer you to someone who performs the procedure. It could very well save
your life.
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Common Myths:
- Colonoscopies/Sigmoidoscopies hurt. Wrong. Most of the time
they put you out whether you request it or not with a "twilight anestesia". Most times, and you can request this, they
put you out to where you don't feel or remember a thing. You just wake up midly sore in your anus. (On a personal note:
I just had one at the age of 30...I don't remember a thing)
- I don't need a screening until the
age of 50. Wrong. You can get a screening any time at any age. Most often times if you have no symptoms, or no family history of anal or colorectal cancer, the average age is 50.
If you have a family history of this cancer, you need to get screened at 40. If someone in your immediate family has
cancer, the age to get screened is 5 years less than the person's age in your immediate family when they were diagnosed.
For example, if your mother was first diagnosed with colon cancer at age 40, you need to get screened, AND EVERYONE ELSE
in your family, at age 35...or sooner if you are experiencing the symptoms.
Anal/Colorectal Cancer is the same thing. WRONG! There are
several types of cancer "down there".
- Colon cancer mainly is located in the upper colon to the sigmoid colon (lower
colon).
- Colorectal Cancer is located in the area between your upper and lower colon.
- Rectal Cancer is located in your lower colon, or 'sigmoid' colon.
- Anorectal cancer is located in between your sigmoid colon and anal cavity.
- Anal Cancer is located in your anal cavity. This area is only about a 1
1/2 inches in length and once the growth occurs, can grow out of your anus.
People...its all about: LOCATION, LOCATION, LOCATION!!!!
Too often times people think that there is one set of Colon Cancer. That
is why Anal Cancer is not heard of much. There is such a small margin for it to occur.
*See our HOME page for illustration*
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