Anal cancer: Fighting the stigma

When Desperate Housewives actress Marcia Cross revealed recently that she had anal cancer, she said she was doing so to battle the shame associated with the disease.

“I know that there are people who are ashamed,” she said. “You have cancer. Should you then also feel ashamed like you did something bad because it took up residence in your anus?”

Cross’ sentiments are certainly understandable to Haisar E. Dao, M.D., FACS, assistant professor of surgery and a specialist in colon and rectal surgery.

“There’s a lot of stigma surrounding talking about anal or rectal issues,” Dr. Dao said. “People tend to put it on the back burner and wait way too long. Or blame it on more benign causes, like hemorrhoids. It might be (hemorrhoids) and probably is in a majority of patients, but that diagnosis should be made by a medical professional and not by the patient thinking there’s nothing going on.”

Although rare, Dr. Dao said anal cancer is becoming more common.

“About two people in a thousand will get anal cancer. So compared to other cancers, it’s rare, but not rare enough that we don’t see it,” he said. He added that he and other specialists at UT Health Physicians practice see about 10 to 15 cases of anal cancer a year.

As with any cancer, he said, people should be aware of changes in their body and possible symptoms.

“Like the majority of cancers, most people don’t feel anything until it’s too late,” he said. “But with this particular cancer, symptoms that don’t go away should trigger an office visit. Persistent bleeding, for example. Feeling a mass or a lump in the anal area should be regarded as an alarm sign. Those are the most common things, as well as a persistent itching or discharge around the anal area.”

Anal cancer is curable, Dr. Dao said, particularly if caught early.

“With the majority of anal cancers, patients are going to be treated with chemo and radiation at the same time, and that’s curative,” he said. “We limit surgeries for very early cancers…. Those are rare.”

While anal cancer is not preventable, Dr. Dao said, “We know there are certain things that make someone more prone to getting this cancer. A patient who has HIV is more prone to get it. A patient who has multiple sexual partners.”

There is a connection between human papillomavirus (HPV) and anal cancer, so getting the HPV vaccine is important, he said.

Most of all, Dr. Dao said, if you see signs or symptoms of anal cancer, talk to your doctor. It might be awkward, but it could be a life-saving conversation.

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