New Anal Cancer Test from British Researchers

[edfu]

This is is amazing, and very welcome, news.  It would be too much to expect our vaunted--but homophobic--U.S. medical research system and its funders (mostly our wonderful government) to have come up with this.  Watch:  It will be now be an immense struggle to have the test approved for use here by the F.D.A., let alone approved for coverage by our insurance companies. 

http://www.edgeboston.com/index.php?ch=news&sc=&sc2=news&sc3=&id=82951

P.S.  A big shout-out and thank you is due England's Peter Tatchell, who pressed for years to see this happen.  In so many ways he is perhaps one of the greatest and most important international gay leaders of our time. 

[J.R.E.]

Great news, and also a good article. Thanks for posting this.


Ray

[Ann]

'Bout time!

Edfu, I hope you're wrong about this getting approval in the States, but yeah, I hear you.

And yes, thank goodness for Mr Tatchell. He deserves a knighthood for services to both the gay and hiv positive communities.

Arise, Sir Peter!

Ann


edited because I just now realised I spelled Mr Tatchell's name wrong. Colour me embarrassed!

[dixieman]

Thank you for sharing this very important medical advancement information with everyone... John

[StrongGuy]

Good news indeed. Thanks for posting.

[mecch]

Any specifics on which countries actually offer this testing, now?
"The MRC news release explains that the new screening procedure looks for MCMs, or "minichromosome maintenance proteins," naturally-occurring proteins that appear in tissues where cancerous and pre-cancerous cells are present."
thanks

[allopathicholistic]

Hi Ed. Thank you. I bet England will permit any man to get this test regardless of a man's age. Here in New York City there seems to be some sort of rule about men under 55 yrs of age can not get tested under Medicaid or some nonsense. (Someone please give me the precise rules if you know. Thanks) That said, I smell an American rat (a health insurance industry rat).  I remember a super rude colo rectal specialist in my hospital  blurted out to me  in an **EXTREMELY** rude tone   : "You're not over 50, you don't need a colonoscopy." What a prick!! Our meeting wasn't even 10 seconds old when he said that to me. To top it off he even ran my Medicaid card through a machine (a billing machine I assume) after providing virtually NO CARE. What a  travesty of statefunded health care.  He rushed me out before I could ask serious health questions. The other rude question he barked was "Why would you even think you have HPV?" I was flabbergasted. I mean, I think it's semi-obvious I'm a gay man . I should have cited the study and said the rate is 37 out of 100,000 gay men get anal cancer and for poz gay men the risk is double.   And yes, from the starting gate I told this prick doctor about me being poz. The bottom line was this doctor's attitude toward me was atrocious and methinks was a bigtime HOMOPHOBE.

[edfu]

I don't know what the Medicaid rules are, but you should know that there is extreme controversy in the U.S. medical establishment about the effectiveness of anal pap tests in diagnosing potential anal cancer. As I have posted elsewhere on this site, my own ID doctor--a prominent HIV specialist in NYC, and gay himself--told me anal pap tests were useless, and the labs couldn't or wouldn't do them.  When he discovered anal warts during an annual digital prostate exam a year ago, he referred me to a proctologist associated with St. Vincent's Hospital--prominent for its AIDS care from the very beginning of the epidemic--and he told me the same thing.  (I have been celibate for over 20 years and never suffered from anal warts during my active sexual period.)   I referred both of them to the research done by Dr. Joel Palefsky in San Francisco and Dr. Stephen Goldstone in NYC--to no avail.  The proctologist did peform an anoscopy, a "miniature" version of a colonoscopy, and did discover internal warts as well as external warts.  He removed all of them but still would not consider a pap test.  He wanted me to come back for further anoscopies, which I did, and I was clear.

When I went on Medicare--I am now 66--I had him perform a colonoscopy, which I had never had done.  He discovered two more internal benign warts.  (Medicare will cover a colonoscopy every two years in a high-risk situation, which anal warts warrant.  Otherwise, it covers a colonoscopy only every ten years[!].)  However, the colonoscopy itself does not guarantee that I have no potential anal-cancer lesions. 

Anal warts are the primary sign of HPV infection.  HPV infection is a primary indicator of potential anal cancer.  As you are perfectly aware--and the doctors are not--gay and HIV are further potential signifiers of anal cancer.  The colorectal specialist you saw should at least have examined you for anal warts. 

Bottom line:  It is obvious that this situation regarding anal cancer, HIV, and a pap test--or any kind of test--is one that we must organize and fight for.  It is exactly analogous to the early years of the epidemic, when we had to organize and fight for the recognition of Bactrim as a prophylactic for PCP pneumonia.  As an old-timer at this, I can tell you that that simple remedy was not automatic and required a great deal of activism.  (You may not remember that, initially, the only prophylaxis for PCP was aerosolized Pentamidine, which did not work very well at all.)   

This horrific situation demands immediate attention.  But from whom?   

More on this controversy:

http://www.poz.com/articles/aids_anal_pap_401_14727.shtml

[AndyArrow]

Semi good news

AIDS Associated Malignancies Clinical Trials Consortium & National Cancer Institute are conducting clinical trials to develop methods to detect anal and genital human papillomavirus infection in HIV-positive patients.

The trials are being done on patients who have already been diagnosed with anal cancer.  Different methods of diagnosing are being tested including anal ctyology (anal pap smear).

And now the bad news -- the trials are expected to last until May 2012 and most likely the big insurance companies will still want further testing before covering screenings.