Anal cancer for pozzums... it ain't just for queers

[Miss Philicia]

Whenever this topic comes up on this forum it seems there's this perception among our non-gay male members that it's something that doesn't concern them (hell, half of the gay men here ignore the issue... but let's leave that for another day shall we?)

Anywho, you may want to read this:

Increased risk of anal cancer for all groups with HIV

[Rev. Moon]

It is an important topic to which all pozzies need to pay attention. 

I must note however that this report doesn't mention whether these HIV positive patients were on ARVs or not.  It only states that "a higher baseline CD4 cell count was protective against the development of the cancer".  This would be an important variable to consider (and it might be something to take into account when considering the idea of starting meds before CD4 levels drop below certain thresholds).

[mikeyb39]

Yeah i dicussed this with my doc the other day since i had a wart years ago  he is going to do an anal pap smear on next visit    pap smear sounds so lady like   i wonder if i will be able to put my legs in those stirrups

[LM]

Interesting. Since I also had to deal with warts, it's something I can't ignore. But it's good to know about having high CD4s help to prevent it, or to reduce the risk. It's something to consider for starting treatment.

[buginme2]

Yeah i dicussed this with my doc the other day since i had a wart years ago  he is going to do an anal pap smear on next visit    pap smear sounds so lady like   i wonder if i will be able to put my legs in those stirrups

Hehe I can only imagine.  I am kind of dumbfounded at how there isn't a universal (or even US) standard on how to deal with this.  The HIV clinic I go to stopped doing anal pap smears and now everyone that is HIV positive has to be seen at the "anal dysplasia clinic" and have a high resolution anoscopy done every year (mine is in March). 

It seems like this isn't the standard though, some places don't even do the pap smear. 

[skeebo1969]

   On a similar note, last night after our Italian feast at one of the local restaurants here in Boston,  I gave birth in the bathroom without the use of stirrups.  I tried to get my wife to come look at my pride and joy but she said to flush it.  I hate it when she won't show interest in these matters.

 But,  I'm sure one of the local retention ponds used for drinking water appreciated it as much as I did.
   

[Jeff G]

Hehe I can only imagine.  I am kind of dumbfounded at how there isn't a universal (or even US) standard on how to deal with this.  The HIV clinic I go to stopped doing anal pap smears and now everyone that is HIV positive has to be seen at the "anal dysplasia clinic" and have a high resolution anoscopy done every year (mine is in March). 

It seems like this isn't the standard though, some places don't even do the pap smear.

You would think a high res . anoscopy would be the norm by now since there is so much data to support it . I went for a routine exam at UAB where I was under the impression I was to have that procedure done but the docs at UAB insist there is no evidence that a high res . scope leads to early detection or diagnostics . I didn't argue with them but I was thinking its an excuse not to invest in the equipment more than any thing else , its a shame a great hospital like UAB doesn't offer this test in my view . They did a regular old ass scope thing or what ever its called instead .   

[tednlou2]

My colorectal doc said while cervical dysplasia very often turns into cervical cancer, he said this isn't the case with anal.  He said a lot of anal damage could be done by attempting to remove them, when they are unlikely to turn into cancer.  I've heard this argument before.  We should still look I think.  He acted like removing anomalies often causes bad anal tissue damage.  However, I've heard some here say it was no big deal, I think.  I keep seeing these studies, but docs seem to not know what to do. 

Skeebs, I often want my partner or roommate to come look when I've given birth to a big one.  There is this feeling of pride that I made that.   

[buginme2]

My colorectal doc said while cervical dysplasia very often turns into cervical cancer, he said this isn't the case with anal.  He said a lot of anal damage could be done by attempting to remove them, when they are unlikely to turn into cancer.  I've heard this argument before.  We should still look I think.  He acted like removing anomalies often causes bad anal tissue damage.  However, I've heard some here say it was no big deal, I think.  I keep seeing these studies, but docs seem to not know what to do. 

So what's his solution? Wait until it does become cancer and then remove it?   

I found a small article from when the clinic I go to started their anal dysplasia clinic. In it it says complications from removing the abnormalities was low (non existent). 

http://www.springerlink.com/content/501337m654847151/fulltext.pdf

[wolfter]

No national anal-cancer screening guidelines exist for PLWHA. However, most HIV specialists recommend that PLWHA--particularly gay or bisexual men and people with a history of genital warts and/or an abnormal cervical Pap smear--get screened for anal dysplasia yearly because they may not otherwise have signs.

I rec'd lots of conflicting information on this subject and it was tough to navigate and make an informed decision.  High grade dyplastic masses should usually be removed as they're more likely to develop into cancer.  Where as low grade masses can be monitored before deciding if they should be removed. 

Personally, I'll always have them promptly removed.  My last one was quite large and required invasive procedures which was one of the worst recoveries I've ever experienced in all my years fighting HIV. 

Wolfie

[LM]

So, I have a question. The doctor who zapped my warts said he usually had his patients take the HPV vaccine because it reduced recurrence and the risk of cancer. Regardless of this actually happening, is it safe for us pozzies to take it?

[OneTampa]

This is one area my doctor has not consistently addressed.

I will bring it up on my next visit.

[wolfter]

So, I have a question. The doctor who zapped my warts said he usually had his patients take the HPV vaccine because it reduced recurrence and the risk of cancer. Regardless of this actually happening, is it safe for us pozzies to take it?

I didn't have time to research the exact numbers, but I believe there about 40 strains of HPV.  The vaccine will work against any of the strains that you aren't already infected with.  It does nothing to prevent reoccurence of those you already have. 

Wolfie

[Hellraiser]

I didn't have time to research the exact numbers, but I believe there about 40 strains of HPV.  The vaccine will work against any of the strains that you aren't already infected with.

I dunno if this is just poorly worded or if you misunderstand how gardasil works.  Gardasil protects against 4 strains of HPV, specifically the 4 responsible for most cases of Cervical cancer.  If you are not yet infected with any of these 4 strains then it will vaccinate you against infection by them.

[spacebarsux]

Gardasil protects against 4 strains of HPV, specifically the 4 responsible for most cases of Cervical cancer.  If you are not yet infected with any of these 4 strains then it will vaccinate you against infection by them.

Are they the same strains responsible for Anal Cancer ?

[Hellraiser]

Are they the same strains responsible for Anal Cancer ?

I would imagine so, but I don't know for certain.

[wolfter]

Trey, I'm aware of how vaccines work.  Not sure what I worded that was confusing.  Of the 40 or so types, the vaccine works against the 4 that are responsible for warts and anal cancer.

HPV vaccines will not treat or get rid of existing HPV infections. Also, HPV vaccines do not treat or cure health problems (like cancer or warts) caused by an HPV infection that occurred before vaccination.

Wolfie

[Matty the Damned]

Are they the same strains responsible for Anal Cancer ?

HPV-16 and HPV-18 are the strains most commonly associated with anal cancer.

MtD

[elf]

I will be getting Gardasil. It's expensive, but it's worth it.
Even if your HPV positive, there are some advantages, if you develop a cancer, it will be less malignant.

[wolfter]

I will be getting Gardasil. It's expensive, but it's worth it.
Even if your HPV positive, there are some advantages, if you develop a cancer, it will be less malignant.

What is a less malignant cancer?  Can you site the research so we can read it?

Thanks
Wolfie

[Miss Philicia]

Yes, elf we shall need a link for that claim. And I hope it's better than a study of 12 people where the wording says "may help" and which was conducted in Moldova.

[Jeff G]

What is a less malignant cancer?  Can you site the research so we can read it?

Thanks
Wolfie

Its probably one of those cancers that a cancer sniffing dog would think , I don't know , I could go ether way on this one . 

[Matty the Damned]

I think elf means that in people who have been vaccinated and who subsequently develop anal cancer, the course of the disease is less aggressive than in those who have not been vaccinated.

I'm not suggesting this is what happens but it seems to be a reasonable conclusion given that other vaccinations tend to ameliorate the course of diseases.

MtD

[buginme2]

I'm on my phone so this link might not work.  There is an article on Aidsmap thats titled "Guardasil protelcts agaist recurrence of precancerous anal lesions..."

http://mobile.aidsmap.com/page/2234343/

[Matty the Damned]

I'm on my phone so this link might not work.  There is an article on Aidsmap thats titled "Guardasil protelcts agaist recurrence of precancerous anal lesions..."

http://mobile.aidsmap.com/page/2234343/

Some persuasive evidence which justifies Elf's decision to be vaccinated.

Assholes.

MtD

[Miss Philicia]

I'm on my phone so this link might not work.  There is an article on Aidsmap thats titled "Guardasil protelcts agaist recurrence of precancerous anal lesions..."

http://mobile.aidsmap.com/page/2234343/

So basically even with that considered one would still need to get an annual anoscopy amirite? It all seems quite marginal.

[buginme2]

So basically even with that considered one would still need to get an annual anoscopy amirite? It all seems quite marginal.

Absolutely, plus that article says the benefit seems to wear off after a couple years.  The vaccine might help, but you still need an annual looksy.

[wolfter]

Thanks Bug.  Even the authors can't positively state what the results indicate. 

However, they add: “Whereas [Gardasil] appears effect in preventing recurrent disease, it is not effective at preventing all recurrence.” They believe that this disease could have been associated with non-high-risk strains of virus, or have reoccurred because “viral integration into the host genome had already occurred and the vaccine is not effective after integration.”
 
The authors believe their findings are potentially of public health significance. “If our results are confirmed by a randomized, placebo-controlled trial, then indications for vaccination and the age of the target population should be expanded.”

Wolfie

[Miss Philicia]

Absolutely, plus that article says the benefit seems to wear off after a couple years.  The vaccine might help, but you still need an annual looksy.

So that begs the question of it even being at all cost-effective. Plus, of course, I'd wager that 95% of HIV positive patients haven't had a single look-see up their butthole as it stands.

[Matty the Damned]

So that begs the question of it even being at all cost-effective. Plus, of course, I'd wager that 95% of HIV positive patients haven't had a single look-see up their butthole as it stands.

Thanks Bug.  Even the authors can't positively state what the results indicate. 

However, they add: “Whereas [Gardasil] appears effect in preventing recurrent disease, it is not effective at preventing all recurrence.” They believe that this disease could have been associated with non-high-risk strains of virus, or have reoccurred because “viral integration into the host genome had already occurred and the vaccine is not effective after integration.”
 
The authors believe their findings are potentially of public health significance. “If our results are confirmed by a randomized, placebo-controlled trial, then indications for vaccination and the age of the target population should be expanded.”

Wolfie

Really? All this because Elf thinks he might benefit from having gardasil?

I say all power to him.

No disrespect, but I think we all know that half of the continental US has seen up both of your bungholes.

MtD

[anniebc]

Its probably one of those cancers that a cancer sniffing dog would think , I don't know , I could go ether way on this one .

OK that's it, I'm coming over to sort you out my boy, I'm tired of mopping up coffee off my screen and keyboards..not to mention the stuff coming down my bloody nose that's making me choke..

Aroha
Jan

[Jeff G]

OK that's it, I'm coming over to sort you out my boy, I'm tired of mopping up coffee off my screen and keyboards..not to mention the stuff coming down my bloody nose that's making me choke..

Aroha
Jan

I'm just relieved that somebody knows I'm kidding and not actually this stupid . I'm ready to take my punishment like a man now  .

[anniebc]

LOL @ Jg...silly bugger...

Aroha
Jan

[LM]

Well, my only worry was if the vaccine was safe for us. If there are possible benefits, I'll take it when I can.

[jacken]

Ever since I had my anal pap smear, I have been under the care of doc. First biopsy found high grade dysplasia. I had IRC procedure. Anoscopy is no fun at all.