9/22/2014

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Cancers you probably don’t care about: Anal

Cancers you probably don’t care about: Anal
Top left - Jan Van Voorst, top right - Mark Goldstein, bottom left - Cecelia Izzo, bottom right - Hyla Dobaj. All of these people were diagnosed with a cancer that draws little public interest. Dobaj was diagnosed with anal cancer in 2011.
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While women fighting breast cancer have the powerful pink ribbon on their side and men promote prostate health with fashionable facial hair, not all cancers garner the same level of public interest. Despite the horrific effects of some cancer types, few stand up to advocate for these diseases and little money is spent researching them. KOMONews.com is publishing a week-long series on some of the cancers you may not care about and all the reasons you should.

Two years ago, Hyla Dobaj of Bellevue was shocked to learn she had anal cancer, a disease she knew nearly nothing about. The only thing she had ever heard about anal cancer was Farrah Fawcett had the disease.

“I was terrified,” Dobaj said. “I didn’t know her story. All I knew is she died from it. That’s what other people were thinking, too. They thought I was going to die.”

Anal cancer is rarely discussed in the media, said Dr. Denise Galloway, a member of the Human Biology Division at Fred Hutchinson Cancer Research Center. When people do think about it, she said they’re not always compassionate. Anal cancer can be related to the human papillomavirus (HPV) and is sometimes associated with anal sex, so Galloway said people assume it is self-inflicted.

Still, nearly all sexually-active men and women in the United will be infected with HPV at some point in their lives, so many could be at risk of developing anal cancer.

“There’s the notion that you could have avoided it,” Galloway said. “It’s not always associated with anal sex. That increases the risk, but this virus can move around anywhere in the genital tract.”

Galloway said anal cancer can be difficult to prevent because there is no standard screening test like the pap smear for cervical cancer. People at high risk can request an anal pap smear or an anoscopy to check for lesions, but Galloway said these are not common.

The best prevention for anal cancer is the HPV vaccine, but even that does not guarantee you won’t get anal cancer.

Dobaj tested negative for the virus after she was diagnosed, but said some people assumed she was infected with HPV.

“I was a little uncomfortable because I felt like people might have judged me based on things I might have done, like I might have brought this on myself.”

Diagnosing anal cancer early can also be a challenge because most people don’t know the symptoms. Dojab said she experienced symptoms for months before learning she had stage-3 anal cancer. One doctor told her she had hemorrhoids, when in fact she had a growing tumor.

“I could have gone in months earlier had I known what to look for,” she said. “You just don’t know when it’s going to come and hit you - so be aware anyway.”

Because there are few anal cancer cases – about 7,000 per year in the United States – and the topic can make people uncomfortable, Galloway said few patients are speaking up to share their stories.

“We need to identify some people who are willing to talk about their battles with anal cancer and show it’s normal. To show it could be anyone.”

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