On 21 March is the worldwide Anal Cancer Awareness Day. For us, too, this is an occasion not to sweep the topic under the carpet, but to contribute to raising awareness.
Anal cancer is a rare disease that is caused by the human papillomavirus in more than 80% of all cases. Transmission takes place during sex, so passive gays are particularly at risk. In general, however, the risk is increased in all people who have regular anal sex.
The good news is that HP viruses cause warts and other benign skin changes much more often. The bad news, on the other hand, is that patients with HIV or chronic diseases including suppression of the immune system develop anal cancer more quickly.
Prevention instead of reaction – detect anal cancer early with a test
When you have sex with your lover, you don’t think about issues like anal cancer, because his butt is just too tempting. But you still need to pay attention to your bottom, even outside the bed. In fact, it is possible to become aware of anal cancer in time, which significantly increases the chances of a cure. Unlike bowel cancer, your doctor can easily see anal cancer if you are examined accordingly. Palpation of the rectum can reveal ulcers and lumps, so that further examinations can be carried out.
How quickly an existing anal tumour is found also depends on the type of cancer. The deeper the tumour, the fewer symptoms it causes. However, people with a high risk of developing the disease should not wait for symptoms. Screening can detect anal cancer even when it is still completely asymptomatic. This is one of the reasons why days like Anal Cancer Awareness Day exist! They draw attention to the fact that this rare type of cancer also claims victims again and again!
Screening makes sense? When you should be screened regularly
There is no universal screening recommendation, which makes anal cancer different from other cancers. For women, for example, a mammogram is done every two years from the age of 50. However, anal cancer can be detected in the course of classic colon cancer screening. It can be done either by stool examination (occult blood) or colonoscopy (every 10 years).
If you have an increased risk of developing anal cancer, it is worthwhile to have regular screening. In the United States of America, the following groups of people, among others, are counted as “high-risk patients”:
- People at increased risk of developing AIN (intraepithelial anal neoplasia).
- Bisexual and homosexual men who actively sleep with other men
- HIV-positive people
- Patients who have to take immunosuppressants because of a disease
- Women who have already had an HPV-triggered tumour (vulva cancer, uterine cancer)
If you belong to one of these groups, screening may make sense for you. Although it is not yet clear how great the benefit really is, the anal “PAP test” can reliably detect uncontrolled cell growth. If there are any abnormalities, there is then the possibility of further examinations to detect and treat anal cancer in time.
What symptoms can indicate anal cancer?
Please remember that symptoms do not necessarily indicate a tumour. On the other hand, anal cancer can also be completely symptom-free. Days like Anal Cancer Awareness Day were created to make people more aware of their own symptoms.
If you have any of the following symptoms, it does not necessarily mean that you have cancer. However, it would be advisable to see a doctor to rule out any potential danger by means of a pap test and anoscopy.
Leading symptoms (which may or may not occur) are:
- Palpable lump at the anal opening
- Pain during defecation or persistent urge to defecate
- Loss of stool during flatulence or in everyday life without the possibility of control
- Itching in the rectal area
- Pencil stool (very thin stool)
- Bleeding when going to the toilet or outside
- Unusual discharge from the anus
These symptoms do not only indicate anal cancer. They could also be caused by anal warts, haemorrhoids or fissures. To be able to differentiate, your doctor will carry out screening examinations. This way he or she can be sure that it is not anal cancer, but a comparably harmless problem.
At the doctor’s: What happens when symptoms are present?
If you experience symptoms, it is important to visit a doctor who will perform a rectal examination. This involves the doctor asking about your medical history, using a glove and Vaseline to feel for any tumours near the outlet, and potentially conducting further examinations. These steps are crucial for identifying any potential issues and obtaining accurate results.
- Anoscopy: During an anoscopy, the doctor can visualise the inside of your anus. He inserts the rigid instrument into your rectum and illuminates you from the inside. If there are polyp-like structures, they can be removed directly during the examination (painlessly) and examined in the pathology department.
- Proctosigmoidoscopy: This examination is a little more in-depth because the examination instrument can penetrate as far as the sigmoid (loop of intestine in the left lower abdomen). You will have to empty your bowels beforehand so that the doctor has an optimal view of your insides.
- Endoscopy: Endoscopies are also done if you are suspected of having bowel cancer, which can have similar symptoms to anal cancer. Endoscopes are not rigid, but flexible. There is a camera at the end, so the doctor can look at your entire bowel on the monitor. He can take tissue samples and remove polyps painlessly.
- Biopsy: In all examinations, your doctor can (and will) take a piece of tissue if he finds a change. This sample is analysed and examined in the pathology laboratory. Under the microscope, it can now be determined whether there are malignant cell changes.
Take cancer screening seriously: Don’t forget the prostate!
We only let water, soap and our lover touch our ass, don’t we? Now and then, however, a doc should also get a chance to get involved. Prevention is an important topic, especially due to the higher risk of anal cancer among gays. But another hotspot of our body is important, the prostate. It is the number one pleasure giver for gays, but unfortunately also a centre for cancer. It strikes many men in Germany every year, but the chances of recovery are good if it is detected in time.
The simplest screening option is the PSA test. It does not hurt and only requires a little blood. The prostate-specific antigen can be detected in the blood if there is a change in the prostate. Although a positive result is not a definite diagnosis, it does prompt further follow-up tests.
You don’t want to go through all this alone? Then make your friends or lover aware of Anal Cancer Awareness Day and prevention options. Sometimes you are less alone together, and it feels good to be able to talk to others!
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