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Gay Cancer -- Again

Unusually high rates of anal cancer found
in gay men and gay men with HIV

Winter, 1999




And, unlike some other diseases, anal cancer does not seem to improve with better HAART therapy. In one study, 28 men with anal cancer, low CD4 counts, and high viral loads, were given HAART therapy and saw good results virologically. But, only 1 of the 28 experienced a regression of lesions or cancer. This indicates that HAART may have little impact on anal cancer.

Like cervical cancer, anal cancer is caused by a virus, the human papilloma virus (HPV). Initially, the cervix or anal canal develops abnormal, pre-malignant changes called intraepithelial (the superficial layer of the anal canal) neoplasms. These changes gradually worsen and become an invasive cancer. Screening tests are available to look for early changes, a pap smear for women and a similar pap smear of the anal canal for men. This can be preformed easily with a Dacron swab.

If abnormal changes are noted, further investigation and possible surgical excision by a laser may be necessary. Or, there are currently three methods of non-surgical treatment:

  1. Imiquimod.
  2. This is a topical agent that has limited effect because it so easily gets rubbed off.

  3. Therapeutic vaccines.
  4. These may work, but one needs to have a strong immune system for vaccines to work well.

  5. Onxy-015.
  6. This is a recombinant adenovirus that is about to enter clinical trial phase. It has the ability to kill cells infected with HPV.

Because of this data it is very important for all men who have sex with men to add anal screens to their health check-ups.

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