Tuesday, May 19, 2009

Peter, what's the scoop on anal cancer?

[Peter Pointers is here 4 YOU, as a service to LifeLube readers - whatever question you may have regarding sexual health, physical health, mental/emotional and spiritual health - ask him. He will find the answers you are looking 4. Below is a recent Q&A you may be interested to read.]

Question: I was concerned, after seeing and hearing about Farrah Fawcett , and reading about the christian right against gay marriage due in part that gay men average life span is shorter than a hetero one, and seeing that anal cancer is 17 times higher in gay men than straight, whats the scoop. Been in monogamous relationship most of my life and been a bottom. just really scared about these facts.

Answer: Thank you for your question. I am always pleased to hear from people who are actively involved in educating themselves about their health. Being health-minded and proactive about maintaining our well-being is something the gay and bisexual community actually does very well.

Definitely, some of the information we come across in mainstream media can be a little scary; especially when the focus is on how sick one population is compared to another. You may be surprised to hear that this type of reporting gives a misperception as to the truth of the matter. Often times in reporting on health issues, there is a focus on negatives or “health disparities.” Read more about why that isn’t always the best viewpoint (especially when discussing gay health) here.

In regards to the “christian right” evidence for shorter gay men’s lifespans, you can read more about that research from a different perspective here.

Now, to the meat of your question: anal cancer and gay men. In gathering information about this topic, I spoke with Dr. Ross Cranston, from the University of Pittsburgh Medical Center, who has worked in the field of anal dysplasia (pre-cancer) for a number of years, and Matt Sharp, the Director of Treatment and Prevention Advocacy for Project Inform out of San Francisco, CA, and a long-time health educator for men who have sex with men (MSM). Both men have presented on or worked in the fields of gay men and anal health.

Human Papillomavirus (HPV) is a virus that infects the skin and can lead to genital warts, anal warts, and some types of cancers (including penile and anal cancers). Dr. Cranston informed me, “As a gay man, you are rightly concerned about developing anal cancer. Receptive anal intercourse is a major risk factor for infection with HPV that can lead to the development of pre-cancerous cells and ultimately anal cancer.” According to Cranston, HIV-positive gay men are at highest risk, with HIV-negative gay men at approximately half this (which is still much higher than the general population). Sharp adds, “But infection with HPV does not mean you will get anal cancer.” According to Sharp, “about the same proportion of men with HPV disease develop anal cancer as women with cervical cancer.” Only certain types or “strains” of HPV are linked to cancers, and often times strains that cause warts are not the same strains associated with cancers.

Being in a monogamous relationship does not rule out risk. “However, knowing this information is good for us to be able to maintain our health” Sharp assured me. Cranston continued, “There is no HPV test approved for men, so the only test that may be available is an anal Pap test that will show the effects of having HPV infection - abnormal anal cells.” While anal Pap testing remains controversial as a national screening tool - having one will allow your healthcare provider both to detect any abnormal anal cells that are present and to discuss symptoms, signs, and risk of anal cancer with you. In the absence of a Pap test or referral structure, continue to be aware of any new anal symptom such as new pain, bleeding or a 'lump', and have a clinician examine you if it does not resolve in 1-2 weeks. (Many anal conditions have these symptoms, are not serious, and will get better during this time frame - early anal cancer will not.)

As with other cancers, early detection is crucial and anal cancer is no different. Anal cancer is a slow progressing disease and can be treated effectively if detected early - giving patients and doctors time to take care of it - if an anal pap smear is performed.

There are unfortunately relatively few clinics available that can diagnose and effectively treat pre-cancerous areas, such as the one run by Dr. Ross Cranston at the University of Pittsburgh (tel. 877 788 7228). There is a great clinic right here in Chicago called Dyer GI Clinics of Illinois – Dr. Julia Dyer comes highly recommended. Their website is www.dyerclinics.com. They have more information that specifically speaks about the anal pap procedure. Doing a little research into available resources could help you in preventing anal cancer as someone who has anal sex with other men. Your pal, Peter Pointers, would be happy to assist you in that search, as well.

More information about anal pap smears. Here also. (This article mentions the Gardasil vaccine for HPV. Currently it’s only approved for use in girls and young women, but you could speak with your doctor to see if they thought it would be an option for you.)

Be Well,
Peter Pointers
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