A nurse who survived anal cancer is one of the people shining a spotlight on a disease that is strongly linked to HPV.
The itching was particularly persistent this time around.
Michele Longabaugh had been uncomfortable for months. So, she contacted her OB-GYN hoping for a referral to someone who could treat the hemorrhoids that had been bothering her off and on for years.
However, the doctor was both baffled and alarmed by what he saw. He advised Longabaugh to see a colorectal surgeon immediately.
A biopsy confirmed the worst. Longabaugh had anal cancer.
“It wasn’t even on my radar,” the Wichita, Kansas, mother of three told Healthline.
Tests followed in quick succession, then surgery after a second tumor was found on the lower part of her spine.
Two years later, a rapidly growing malignancy showed up in one lung. More chemotherapy, more radiation.
Longabaugh eventually won the battle, though, and has become an outspoken source of information about the cancer that many people are too embarrassed to talk about.
“I figured it was a chance to educate people,” said the 56-year-old nurse.
Longabaugh maintains a blog and Twitter account. She also has been a guest on radio shows, made local TV appearances and videos for a Texas cancer treatment center, and written articles from a patient’s perspective for an oncologist who specializes in anal cancer.
“I am a voice for the silent,” Longabaugh said.
Anal cancer claimed the life of actress Farrah Fawcett in 2009.
It recently made headlines again when former “Desperate Housewives” star Marcia Cross went public about her own experience with the disease.
The frank revelations not only are drawing attention to an illness that long has been stigmatized, but to the vaccine that can reduce the risk of getting it.
Here are some
- The incidence of anal cancer is increasing, although it still ranks far behind other cancers in prevalence.
- An estimated 8,300 Americans will be diagnosed with anal cancer this year. That represents 0.5 percent of all new cancer cases.
- A person has about a 0.2 percent change of being diagnosed with anal cancer during his or her lifetime.
- About 1,280 people will die from the disease this year.
- Anal cancer typically affects older adults. The average age at diagnosis is the early 60s.
- Symptoms include bleeding from the rectum and itching, a lump or pain in the anal area, narrower than normal stool, and swelling of the lymph nodes in the groin or anal areas.
But some of these signs also can point to less serious conditions, such as hemorrhoids, small tears in the lining of the anus, and small warts in and around the anus.
Aside from the physical toll that anal cancer exacts, there’s a psychological one, too.
The disease affects a part of the body that’s considered a conversational taboo, and it’s closely linked to the sexually transmitted human papillomavirus (HPV).
When one television network took up the topic recently, the medical correspondent introduced the segment with a warning that it would be a frank discussion using words that might make some listeners uncomfortable.
“We all have one (an anus), but nobody wants to talk about it,” noted one of the show’s female hosts.
Patients with anal cancer often will tell others they have bowel or colon cancer, which is perceived as more acceptable, Longabaugh said.
Debbie Saslow, PhD, managing director of HPV/GYN cancers for the American Cancer Society, agrees.
“Our genitals… these are things we’ve been conditioned that it’s not appropriate to talk about in public, and anal cancer combines all of it — anus, sex, penetration — it’s all there,” Saslow told Healthline.
HPV, the most common sexually transmitted infection in the United States, invades the host cells of about
The virus spreads by intimate, skin-to-skin contact, usually through vaginal, anal, or oral sex.
Roughly 80 percent of those who are sexually active will contract HPV during their life. However, most don’t know they have it because it either remains dormant or gradually is eradicated by the body’s immune system.
There are more than 100 strains of HPV, a small number of which can increase the chances of developing various cancers, including tumors on the cervix and other genitalia as well as in the throat and anus.
The virus is responsible for upward of
A study published this week states that about 70 percent of throat cancers may be caused by HPV.
In fact, that study notes, the virus triggers the production of antibodies years and even decades before an actual diagnosis. That could be a useful way of identifying — and treating — individuals before they develop the disease.
But HPV isn’t the only culprit when it comes to anal cancer.
Other factors that increase the chances of malignancies include smoking, multiple sex partners, and an immune system compromised by HIV or drugs a transplant recipient takes to prevent the body from rejecting the new organ.
There’s no medical treatment that’ll clear up an HPV infection if the body doesn’t do it naturally,
Nor do doctors usually check patients for the cancers the virus can cause.
“There’s no routine screening for anal cancer,” said Dr. Sherry Ross, an OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California.
She disagrees with the federal task force that decided in 2016 there wasn’t enough evidence to warrant recommending pelvic exams for anything other than cervical cancer and two other conditions if female patients are not at risk for these diseases and have no symptoms.
Yet as long as the procedure includes a rectal exam, there’s a chance doctors can identify anal cancer, Ross told Healthline.
That’s exactly how Cross discovered her ailment.
She reportedly didn’t have any signs there was something amiss until her gynecologist probed for abnormalities during a routine checkup.
Ross is optimistic that in her lifetime she’ll see healthcare providers start regularly screening for anal cancer, at least among high-risk populations.
But in the meantime, there’s a preemptive strike available — a vaccine that provides almost ironclad protection against contracting nine strains of HPV, including the one associated with anal cancer.
The
The sooner the better to maximize the vaccine’s effectiveness, said Saslow. She explained that once someone is exposed to one or more of the HPV strains, the vaccine won’t work on those types.
The number of people getting the HPV vaccine is increasing at the rate of about 5 percent annually, she added, although there are still many more preteens getting shots for tetanus, diphtheria, and whooping cough.
But to those who didn’t get inoculated and now have symptoms of anal cancer, Longabaugh urges them to see a doctor without delay.
“This can happen to anybody,” she said. “Pay attention to what your body is telling you. Nothing is so embarrassing that it’s worth risking your life for.”