Dr. Lin: What, what, in the butt?

Part I: Anal Cancer

I am going to talk about something that makes gay men very squeamish … But it’s a conversation that needs to be had. Anal cancer, the cancer that dare not rear its name, is diagnosed in over 6,000 people per year and the rate is growing. And yes, this is the very disease that claimed the life of former Charlie’s Angel, Farrah Fawcett.

You’re not a Charlie’s Angel so why should you care?

• Men who have sex with men are 20 times more likely to get anal cancer than heterosexual men.
• HIV-positive individuals have even a higher risk.
• The more sexual partners you have, the greater the risk.
• You don’t have to be a bottom to get anal cancer.
• Anal cancer is curable when caught early, but most people will seek treatment too late and there are not clear symptoms (usually bleeding or itching).

More importantly, anal cancer may be preventable.

• HPV (human papilloma virus), the same virus that causes genital warts, causes 85 percent of anal cancer and causes 80 percent of mouth and throat cancer nearly 100 percent of cervical cancers.
• So, any place where a penis can go, so too, can an HPV-related cancer.
• There are currently two FDA approved vaccines for HPV that go by trade names Gardasil (Merck) and Cervarix (Glaxo). These vaccines are now recommended for all teens to receive and everyone up to age 26.
• Anal pap smears, where they take a small swab and brush the inside of the anus for some cells, is a quick way for your doctor to check for any abnormal appearing cells.

OK, here’s the bottom line:

1. Protect yourself. No matter what your age, consider getting the HPV vaccine.
2. Get screened. Find a medical provider that is comfortable performing anal pap smears and get screened yearly particularly if you bottom and have multiple partners.
3. Get informed. You need to be comfortable talking to your doctor about this. Like many health-related issues, anal cancer seems funny until it’s not.

For more information about anal cancer, check out the Mayo Clinic website. For a gay/lesbian sensitive medical provider, check out the Gay and Lesbian Medical Association referral database.

Disclaimer: These are merely suggestions – the clinical trials / studies needed to back up these recommendations have simply not been done (and may never get done). Remember, you are your own best health advocate.