Guest guest Posted March 27, 2007 Report Share Posted March 27, 2007 I, and others I believe who read this list, attended an educational update last week, given by Dr. Palefsky, MD, the Director of the UCSF Anal Dysplasia Clinic. He distinctly said that: HIV infection in itself is not associated with High Grade dysplasia or anal cancer. But that the incidence of anal dysplasia and anal cancer is higher in MSM (men who have sex with men) due to increased prevalence of HPV in that population. Virtually 100% of MSM have HPV infection, which we know can lead to dysplasia and anal cancer, specifically HPV types 16, and 18 are associated with 70% of anal cancers. The longer men with HIV live, due to HAART, the greater the risk of developing high grade dysplasia and possibly anal cancer, due to longevity, not HIV +'ness alone. The best prevention we have so far, is early detection and treatment of high grade dysplasia. He recommends digital rectal exams at a minimum, for people who have no access to getting anal cytology from their primary doctors. Anal cytology should be a part of routine annual exams for MSM, he feels, though some smears can miss abnormal cells, especially if the celss are below the surface. Any abnormal anal cytology should be followed up with a high resolution anoscopy, and biopsy, which is something far too few providers are trained to do, currently. They have a website, and will soon be posting a list of providers nationwide who have been trained in anal cytology, high resolution anoscopy, and treatment of dysplasia. Currently only a few of the big cities (LA, NYC, Chicago, SF) have trained providers who know how to do these procedures. http://www.analcancerinfo.ucsf.edu/ > > I wish we had a list of doctors who are well trained in diagnosis and treatment of anal cancer. I have to fly to NYC from Houston to see Dr Goldstone once a year but many people cannot afford traveling. > > Contact: Enrique Rivero > _erivero@..._ (mailto:erivero@...) > 310-794-2273 > _University of California - Los Angeles_ (http://www.newsroom.ucla.edu/) > Study shows that anal cytology predicts anal precancer in HIV-positive gay men UCLA Center for Clinical AIDS Research and Education is one of only a few US centers offering an anal cytology screening service FINDINGS: HIV-positive men who have sex with men are up to 90 times more likely than the general population to develop anal cancer. Detection of precancerous changes (anal dysplasia) by anal cytology †" essentially an anal canal Pap smear †" is a relatively new procedure and one that has yet to enter standard practice. > This UCLA study demonstrated that abnormal anal cytology was highly > predictive of anal cell abnormalities that were subsequently confirmed by anal biopsy. The study was based on data from 244 patients at the UCLA CARE clinic who had anal cytology screenings between February 2002 and December 2004. > IMPACT: Abnormal anal cytology in HIV-positive men who have sex with men is highly indicative of the presence of abnormal anal cells that may be precancerous and should prompt further investigation. The UCLA CARE Center is one of a handful of clinics in the United States offering an anal dysplasia screening and management service. > AUTHORS: Ross D. Cranston, .D. Hart , A. Gornbein, Sharon L. Hirschowitz, Galen Cortina, and Ardis.A. Moe, all of UCLA. > JOURNAL: The research appears in the February issue of the International Journal of STD & AIDS. > > Regards, > > Vergel > powerusa dot org > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2007 Report Share Posted March 27, 2007 I, and others I believe who read this list, attended an educational update last week, given by Dr. Palefsky, MD, the Director of the UCSF Anal Dysplasia Clinic. He distinctly said that: HIV infection in itself is not associated with High Grade dysplasia or anal cancer. But that the incidence of anal dysplasia and anal cancer is higher in MSM (men who have sex with men) due to increased prevalence of HPV in that population. Virtually 100% of MSM have HPV infection, which we know can lead to dysplasia and anal cancer, specifically HPV types 16, and 18 are associated with 70% of anal cancers. The longer men with HIV live, due to HAART, the greater the risk of developing high grade dysplasia and possibly anal cancer, due to longevity, not HIV +'ness alone. The best prevention we have so far, is early detection and treatment of high grade dysplasia. He recommends digital rectal exams at a minimum, for people who have no access to getting anal cytology from their primary doctors. Anal cytology should be a part of routine annual exams for MSM, he feels, though some smears can miss abnormal cells, especially if the celss are below the surface. Any abnormal anal cytology should be followed up with a high resolution anoscopy, and biopsy, which is something far too few providers are trained to do, currently. They have a website, and will soon be posting a list of providers nationwide who have been trained in anal cytology, high resolution anoscopy, and treatment of dysplasia. Currently only a few of the big cities (LA, NYC, Chicago, SF) have trained providers who know how to do these procedures. http://www.analcancerinfo.ucsf.edu/ > > I wish we had a list of doctors who are well trained in diagnosis and treatment of anal cancer. I have to fly to NYC from Houston to see Dr Goldstone once a year but many people cannot afford traveling. > > Contact: Enrique Rivero > _erivero@..._ (mailto:erivero@...) > 310-794-2273 > _University of California - Los Angeles_ (http://www.newsroom.ucla.edu/) > Study shows that anal cytology predicts anal precancer in HIV-positive gay men UCLA Center for Clinical AIDS Research and Education is one of only a few US centers offering an anal cytology screening service FINDINGS: HIV-positive men who have sex with men are up to 90 times more likely than the general population to develop anal cancer. Detection of precancerous changes (anal dysplasia) by anal cytology †" essentially an anal canal Pap smear †" is a relatively new procedure and one that has yet to enter standard practice. > This UCLA study demonstrated that abnormal anal cytology was highly > predictive of anal cell abnormalities that were subsequently confirmed by anal biopsy. The study was based on data from 244 patients at the UCLA CARE clinic who had anal cytology screenings between February 2002 and December 2004. > IMPACT: Abnormal anal cytology in HIV-positive men who have sex with men is highly indicative of the presence of abnormal anal cells that may be precancerous and should prompt further investigation. The UCLA CARE Center is one of a handful of clinics in the United States offering an anal dysplasia screening and management service. > AUTHORS: Ross D. Cranston, .D. Hart , A. Gornbein, Sharon L. Hirschowitz, Galen Cortina, and Ardis.A. Moe, all of UCLA. > JOURNAL: The research appears in the February issue of the International Journal of STD & AIDS. > > Regards, > > Vergel > powerusa dot org > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2007 Report Share Posted March 28, 2007 And to further clarify 's posting to the thread- the type of annual digital exam cited, is not the one to check the prostate or for hemorrhoids; but, to ascertain if there is some 'hardness' under the surface of the rectal mucosa that might represent a cancer. I suppose one could do this oneself; but, without a standard for comparison, such as a manual breast check for lumps, it would be of dubious help. Thus, if it hasn't been done lately by your doctor, ask to drop your drawers at your next check up for the digital exam! The a-hole you save, may be your own! Healthfully & electronically yours, " Gravy Boat " Goldman yangzpa@... Project Inform Hotline Manager 415.558.8669, x215 National HIV/AIDS Treatment Hotline 800.822-7422 " I see you’re a man with ideals. I guess I better be going while you’ve still got them. " Mae West Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2007 Report Share Posted March 28, 2007 For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone: (317) 889-7906 has the proper equipment and training to do High Resolution Anoscopy and the appropriate treatment for abnormal findings due to HPV. He is very knowledgable about the disease from HPV and gay friendly. I highly recommend him. J Sherlock, M.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 28, 2007 Report Share Posted March 28, 2007 For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone: (317) 889-7906 has the proper equipment and training to do High Resolution Anoscopy and the appropriate treatment for abnormal findings due to HPV. He is very knowledgable about the disease from HPV and gay friendly. I highly recommend him. J Sherlock, M.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2007 Report Share Posted March 30, 2007 My doctor says that if you have/had anal warts that you are at higher risk for anal cancer. Has anyone information to suggest whether that is true or not? And, can anyone tell me if hemmoroids is just the inflamation of the anal sphinter muscle or is it also a prolapsed portion of the colon extruding past the anal opening? And is the latter treatable with surgery? I had a physician look at it several years ago and he wanted to refer me but I had no insurance then. But I do now and want to take care of it. Do you think they would schedule surgery for someone like me who has a CD4 count of 100 or wait until it was higher? Thank you, Lowery Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2007 Report Share Posted March 30, 2007 My doctor says that if you have/had anal warts that you are at higher risk for anal cancer. Has anyone information to suggest whether that is true or not? And, can anyone tell me if hemmoroids is just the inflamation of the anal sphinter muscle or is it also a prolapsed portion of the colon extruding past the anal opening? And is the latter treatable with surgery? I had a physician look at it several years ago and he wanted to refer me but I had no insurance then. But I do now and want to take care of it. Do you think they would schedule surgery for someone like me who has a CD4 count of 100 or wait until it was higher? Thank you, Lowery Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2007 Report Share Posted March 30, 2007 Your doctor is correct about anal warts, as they're usually caused by HPV - Human Papilloma Virus - which can cause dysplasia and cancer in the anus/rectum and the cervix in women. When they talk about HPV they're talking about venereal warts. Some specific variants of HPV are supposed to be more responsible for cancer, but I don't know those details. I do know that if you have warts it's important to control and get rid of them, and then literally " watch your ass " , and make sure you aren't developing abnormal growth there. I picked up a case in the 70's and they flared up again in the 80's when I developed HIV disease. More recently we found low-grade dysplasia, even though I haven't seen a wart in years. So I have a regular exam by a rectal surgeon, with an anuscope, or a colonoscopy if I'm due - just to keep a step ahead. I don't know much about hemorrhoids, but aren't they like varicose veins? I know people who've had surgery for them. Depends on how bad it is, I guess. BG Re:Get your butt checked My doctor says that if you have/had anal warts that you are at higher risk for anal cancer. Has anyone information to suggest whether that is true or not? And, can anyone tell me if hemmoroids is just the inflamation of the anal sphinter muscle or is it also a prolapsed portion of the colon extruding past the anal opening? And is the latter treatable with surgery? I had a physician look at it several years ago and he wanted to refer me but I had no insurance then. But I do now and want to take care of it. Do you think they would schedule surgery for someone like me who has a CD4 count of 100 or wait until it was higher? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2007 Report Share Posted March 30, 2007 Your doctor is correct about anal warts, as they're usually caused by HPV - Human Papilloma Virus - which can cause dysplasia and cancer in the anus/rectum and the cervix in women. When they talk about HPV they're talking about venereal warts. Some specific variants of HPV are supposed to be more responsible for cancer, but I don't know those details. I do know that if you have warts it's important to control and get rid of them, and then literally " watch your ass " , and make sure you aren't developing abnormal growth there. I picked up a case in the 70's and they flared up again in the 80's when I developed HIV disease. More recently we found low-grade dysplasia, even though I haven't seen a wart in years. So I have a regular exam by a rectal surgeon, with an anuscope, or a colonoscopy if I'm due - just to keep a step ahead. I don't know much about hemorrhoids, but aren't they like varicose veins? I know people who've had surgery for them. Depends on how bad it is, I guess. BG Re:Get your butt checked My doctor says that if you have/had anal warts that you are at higher risk for anal cancer. Has anyone information to suggest whether that is true or not? And, can anyone tell me if hemmoroids is just the inflamation of the anal sphinter muscle or is it also a prolapsed portion of the colon extruding past the anal opening? And is the latter treatable with surgery? I had a physician look at it several years ago and he wanted to refer me but I had no insurance then. But I do now and want to take care of it. Do you think they would schedule surgery for someone like me who has a CD4 count of 100 or wait until it was higher? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2007 Report Share Posted March 31, 2007 "My doctor says that if you have/had anal warts that you are at higher riskfor anal cancer. If you have had anal warts, you have been infected with the virus that causes most cancers of the anus, HPV. Even if you have had warts removed, the virus is probably hanging out somewhere-- and frankly, if you're a gay man who has sex, top or bottom, you are probably at risk, anyway. I think ALL HIV + gay men should consider themselves at high risk for anal cancer."And, can anyone tell me if hemmoroids is just the inflamation of the analsphinter muscle or is it also a prolapsed portion of the colon extrudingpast the anal opening? And is the latter treatable with surgery?"Hemorrhoids are actually big, dilated veins that distend around the anus and rectum, and hang down, dragging mucosal tissue with them. These extensions get irritated and inflammed. They are treatable with surgery, when they become symptomatic. They do not involve the anal sphincter muscle, itself."I had no insurance then. But I do now and want to take care of it. Do youthink they would schedule surgery for someone like me who has a CD4 count of100 or wait until it was higher?"I see no reason to wait. Talk to your doctor about it! Barrowpozbod@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2007 Report Share Posted April 3, 2007 Is there treatment for abnormal findings (dysplasia)? I was told that there's not much to be done in the rectum until there's an actual growth to deal with, as compared to the cervix, where a layer of cells can be scraped. So we continue to monitor it. (I don't show low grade dysplasia anymore after an initial positive pap smear a few years back) BG Re: Get your butt checked For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone: (317) 889-7906 has the proper equipment and training to do High Resolution Anoscopy and the appropriate treatment for abnormal findings due to HPV. He is very knowledgable about the disease from HPV and gay friendly. I highly recommend him. J Sherlock, M.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2007 Report Share Posted April 3, 2007 Good point. My doctor referred me to a rectal surgeon for a thorough annual exam, just in case her digital exam misses something. I trust a doctor more who doesn't pretend to know everything - but will help you find out. BG Get your butt checked And to further clarify 's posting to the thread- the type of annual digital exam cited, is not the one to check the prostate or for hemorrhoids; but, to ascertain if there is some 'hardness' under the surface of the rectal mucosa that might represent a cancer. I suppose one could do this oneself; but, without a standard for comparison, such as a manual breast check for lumps, it would be of dubious help. Thus, if it hasn't been done lately by your doctor, ask to drop your drawers at your next check up for the digital exam! The a-hole you save, may be your own! Healthfully & electronically yours, " Gravy Boat " Goldman yangzpa@... Project Inform Hotline Manager 415.558.8669, x215 National HIV/AIDS Treatment Hotline 800.822-7422 " I see you're a man with ideals. I guess I better be going while you've still got them. " Mae West Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2007 Report Share Posted April 3, 2007 Good point. My doctor referred me to a rectal surgeon for a thorough annual exam, just in case her digital exam misses something. I trust a doctor more who doesn't pretend to know everything - but will help you find out. BG Get your butt checked And to further clarify 's posting to the thread- the type of annual digital exam cited, is not the one to check the prostate or for hemorrhoids; but, to ascertain if there is some 'hardness' under the surface of the rectal mucosa that might represent a cancer. I suppose one could do this oneself; but, without a standard for comparison, such as a manual breast check for lumps, it would be of dubious help. Thus, if it hasn't been done lately by your doctor, ask to drop your drawers at your next check up for the digital exam! The a-hole you save, may be your own! Healthfully & electronically yours, " Gravy Boat " Goldman yangzpa@... Project Inform Hotline Manager 415.558.8669, x215 National HIV/AIDS Treatment Hotline 800.822-7422 " I see you're a man with ideals. I guess I better be going while you've still got them. " Mae West Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2007 Report Share Posted April 3, 2007 There are several treatments available. Trichloroacetic acid, Photodynamic therapy, Laser therapy, Aldara and I believe LEEP is also effective. >From: " Bill Gaul " <wgaul1@...> > " Goldman " <yangzpa@...>, " poz health " >< > >Subject: Re: Get your butt checked >Date: Tue, 3 Apr 2007 23:04:20 -0400 > >Good point. My doctor referred me to a rectal surgeon for a thorough annual >exam, just in case her digital exam misses something. I trust a doctor more >who doesn't pretend to know everything - but will help you find out. > >BG > > Get your butt checked > > >And to further clarify 's posting to the thread- the type of >annual digital exam cited, is not the one to check the prostate or >for hemorrhoids; but, to ascertain if there is some 'hardness' under >the surface of the rectal mucosa that might represent a cancer. I >suppose one could do this oneself; but, without a standard for >comparison, such as a manual breast check for lumps, it would be of >dubious help. Thus, if it hasn't been done lately by your doctor, ask >to drop your drawers at your next check up for the digital exam! The >a-hole you save, may be your own! > > >Healthfully & electronically yours, > " Gravy Boat " Goldman yangzpa@... > Project Inform Hotline Manager 415.558.8669, x215 > National HIV/AIDS Treatment Hotline 800.822-7422 > > " I see you're a man with ideals. I guess I better be going while you've >still got them. " Mae West > > > > _________________________________________________________________ Don’t waste time standing in line—try shopping online. Visit Sympatico / MSN Shopping today! http://shopping.sympatico.msn.ca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2007 Report Share Posted April 3, 2007 There are several treatments available. Trichloroacetic acid, Photodynamic therapy, Laser therapy, Aldara and I believe LEEP is also effective. >From: " Bill Gaul " <wgaul1@...> > " Goldman " <yangzpa@...>, " poz health " >< > >Subject: Re: Get your butt checked >Date: Tue, 3 Apr 2007 23:04:20 -0400 > >Good point. My doctor referred me to a rectal surgeon for a thorough annual >exam, just in case her digital exam misses something. I trust a doctor more >who doesn't pretend to know everything - but will help you find out. > >BG > > Get your butt checked > > >And to further clarify 's posting to the thread- the type of >annual digital exam cited, is not the one to check the prostate or >for hemorrhoids; but, to ascertain if there is some 'hardness' under >the surface of the rectal mucosa that might represent a cancer. I >suppose one could do this oneself; but, without a standard for >comparison, such as a manual breast check for lumps, it would be of >dubious help. Thus, if it hasn't been done lately by your doctor, ask >to drop your drawers at your next check up for the digital exam! The >a-hole you save, may be your own! > > >Healthfully & electronically yours, > " Gravy Boat " Goldman yangzpa@... > Project Inform Hotline Manager 415.558.8669, x215 > National HIV/AIDS Treatment Hotline 800.822-7422 > > " I see you're a man with ideals. I guess I better be going while you've >still got them. " Mae West > > > > _________________________________________________________________ Don’t waste time standing in line—try shopping online. Visit Sympatico / MSN Shopping today! http://shopping.sympatico.msn.ca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 My Doctor prescribes Aldara (imiquimod) cream for patients with anal dysplasia with great success. They place a small bead of Aldara once a day at the rectal opening, not inside, twice a week for a two or three week period. Six months after this treatment, he re-schedules an anoscopy to assess the effectiveness of this treatment. http://www.rxlist.com/cgi/generic/imiquimod.htm Aldara causes immune cells it touches to produce interferon-alpha. Interferon-alpha puts cells into a viral protective mode. If these cells sense they are being invaded by a virus they kill themselves, stopping the HPV viral infection dead in its tracks. Since there is a very high turn-over (replacement rate) in tissue in the rectum and intestines, within a two week period you have a high probability of greatly controlling the HPV infection since you are preventing it from taking over new host cells. The FDA approved indication for this drug is treatment of (1.) superficial basal cell carcinomas, and (2.) external warts in the genital or rectal area. Even though these warts are caused by HPV, the same virus which causes the dysplasia,the drug is not specifically approved for treatment of dysplasia. So if your Doctor is a Stiffly Stifferson, expect to experience some resistance on this therapy, unless you can figure out a way to pull the stick out of his or her butt. >> Is there treatment for abnormal findings (dysplasia)? I was told that > there's not much to be done in the rectum until there's an actual growth to > deal with, as compared to the cervix, where a layer of cells can be scraped. > So we continue to monitor it. (I don't show low grade dysplasia anymore > after an initial positive pap smear a few years back)> > BG> > > Re: Get your butt checked> > > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone:> (317) 889-7906 has the proper equipment and training to do High> Resolution Anoscopy and the appropriate treatment for abnormal findings> due to HPV.> > He is very knowledgable about the disease from HPV and gay friendly. I> highly recommend him.> > J Sherlock, M.D.> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 " My Doctor prescribes Aldara (imiquimod) cream for patients with anal dysplasia with great success. " Would this only be for external dysplasia? Since it's only being applied outside or is it absorbed? Seems to me it's the internal dysplasia that more problamatic, difficult to diagnose and more painful to treat. I've just recovered from two internal surgeries to remove anal cancer and, wow, that was an experience. Cancer all gone tho (!!) On a side note none of the doctors in my area nor the local ASO do rectal screenings, we have to beg to get screened in LA, a two hour drive, one way. One would think that in Palm Springs there would be more assistance with our large HIV community. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 " My Doctor prescribes Aldara (imiquimod) cream for patients with anal dysplasia with great success. " Would this only be for external dysplasia? Since it's only being applied outside or is it absorbed? Seems to me it's the internal dysplasia that more problamatic, difficult to diagnose and more painful to treat. I've just recovered from two internal surgeries to remove anal cancer and, wow, that was an experience. Cancer all gone tho (!!) On a side note none of the doctors in my area nor the local ASO do rectal screenings, we have to beg to get screened in LA, a two hour drive, one way. One would think that in Palm Springs there would be more assistance with our large HIV community. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 " My Doctor prescribes Aldara (imiquimod) cream for patients with anal dysplasia with great success. " Would this only be for external dysplasia? Since it's only being applied outside or is it absorbed? Seems to me it's the internal dysplasia that more problamatic, difficult to diagnose and more painful to treat. I've just recovered from two internal surgeries to remove anal cancer and, wow, that was an experience. Cancer all gone tho (!!) On a side note none of the doctors in my area nor the local ASO do rectal screenings, we have to beg to get screened in LA, a two hour drive, one way. One would think that in Palm Springs there would be more assistance with our large HIV community. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 Accordiing to Dr. Palefsky, of the UCSF Anal Dysplasia Clinic: http://www.analcancerinfo.ucsf.edu/ Aldara is not effective against HIGH grade dysplasia, but may be effective in treating anal warts and low grade dysplasic, neither of which are associated with the types of HPV that cause anal cancer. Also, in addition to the treatments mentioned in a previous post, the one that the UCSF team is having most success with, and least side effect profile, is Infra-red Coagulation Therapy. > > > > Is there treatment for abnormal findings (dysplasia)? I was told that > > there's not much to be done in the rectum until there's an actual > growth to > > deal with, as compared to the cervix, where a layer of cells can be > scraped. > > So we continue to monitor it. (I don't show low grade dysplasia > anymore > > after an initial positive pap smear a few years back) > > > > BG > > > > > > Re: Get your butt checked > > > > > > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone: > > (317) 889-7906 has the proper equipment and training to do High > > Resolution Anoscopy and the appropriate treatment for abnormal > findings > > due to HPV. > > > > He is very knowledgable about the disease from HPV and gay friendly. I > > highly recommend him. > > > > J Sherlock, M.D. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 Aldara is one of many treatments to use. My Doctor too uses Infra-red Coagulation to remove high grade dysplasia and Aldara to treat low grade dysplasia. Some patients who do not respond to Aldara are later treated with Infra-red Coagulation. And patients treated with Infra-red Coagulation, after they are healed, are often then treated with Aldara to control a recurrence. > > >> > > Is there treatment for abnormal findings (dysplasia)? I was told that> > > there's not much to be done in the rectum until there's an actual> > growth to> > > deal with, as compared to the cervix, where a layer of cells can be> > scraped.> > > So we continue to monitor it. (I don't show low grade dysplasia> > anymore> > > after an initial positive pap smear a few years back)> > >> > > BG> > >> > >> > > Re: Get your butt checked> > >> > >> > > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone:> > > (317) 889-7906 has the proper equipment and training to do High> > > Resolution Anoscopy and the appropriate treatment for abnormal> > findings> > > due to HPV.> > >> > > He is very knowledgable about the disease from HPV and gay friendly. I> > > highly recommend him.> > >> > > J Sherlock, M.D.> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 Aldara is one of many treatments to use. My Doctor too uses Infra-red Coagulation to remove high grade dysplasia and Aldara to treat low grade dysplasia. Some patients who do not respond to Aldara are later treated with Infra-red Coagulation. And patients treated with Infra-red Coagulation, after they are healed, are often then treated with Aldara to control a recurrence. > > >> > > Is there treatment for abnormal findings (dysplasia)? I was told that> > > there's not much to be done in the rectum until there's an actual> > growth to> > > deal with, as compared to the cervix, where a layer of cells can be> > scraped.> > > So we continue to monitor it. (I don't show low grade dysplasia> > anymore> > > after an initial positive pap smear a few years back)> > >> > > BG> > >> > >> > > Re: Get your butt checked> > >> > >> > > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone:> > > (317) 889-7906 has the proper equipment and training to do High> > > Resolution Anoscopy and the appropriate treatment for abnormal> > findings> > > due to HPV.> > >> > > He is very knowledgable about the disease from HPV and gay friendly. I> > > highly recommend him.> > >> > > J Sherlock, M.D.> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 Aldara is one of many treatments to use. My Doctor too uses Infra-red Coagulation to remove high grade dysplasia and Aldara to treat low grade dysplasia. Some patients who do not respond to Aldara are later treated with Infra-red Coagulation. And patients treated with Infra-red Coagulation, after they are healed, are often then treated with Aldara to control a recurrence. > > >> > > Is there treatment for abnormal findings (dysplasia)? I was told that> > > there's not much to be done in the rectum until there's an actual> > growth to> > > deal with, as compared to the cervix, where a layer of cells can be> > scraped.> > > So we continue to monitor it. (I don't show low grade dysplasia> > anymore> > > after an initial positive pap smear a few years back)> > >> > > BG> > >> > >> > > Re: Get your butt checked> > >> > >> > > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone:> > > (317) 889-7906 has the proper equipment and training to do High> > > Resolution Anoscopy and the appropriate treatment for abnormal> > findings> > > due to HPV.> > >> > > He is very knowledgable about the disease from HPV and gay friendly. I> > > highly recommend him.> > >> > > J Sherlock, M.D.> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 The HPV dysplasia is internal, but the effect of Aldara spreads because the activated immune cells embedded in the tissue slowly affected migrate. In addition, a small amount of Aldara spread into the anal cavity when a pea-size lump of Aldara is applied to the anal opening. If you were to apply the Aldara internally, the effects would be too strong. Even as it is, the treatment sometimes needs to be skipped if the area its applied to becomes too red and irritated. When used for its FDA indicated use, Aldara is often applied over a large area of skin, say the scalp of a bald person with basal cell carcinoma. In these situations, some patients experience a reaction on another part of their body, such as their legs or face. In addition, when used over a large area of skin people often experience the same side-effects as if they had injected interferon-alpha as this is what Aldara causes immune and other cells to release. If you read patient experiences with this, you will see the range of reactions and results including really horrible reactions. But you'll also discover that the extreme reactions occur in patients who faithfuly follow their Doctor's instructions for daily application to a large area of skin, and do not discontinue the treatment when problems begin to occur. Sort of like an HIV+ person who is in a wheelchair today because he continued to take d4T (stavudine) for seven years after he developed severe neuropathy - just like his clueless Doctor said. Very sad, very stupid. http://www.askapatient.com/viewrating.asp?drug=20723 & name=ALDARA These problems do not seem to occur when a small pea-sized lump is applied to the anal opening at night, although localized redness is common. Once again, if this becomes too severe you need to skip a treatment. >> "My Doctor prescribes Aldara (imiquimod) cream for patients with anal > dysplasia with great success."> > Would this only be for external dysplasia? Since it's only being > applied outside or is it absorbed? Seems to me it's the internal > dysplasia that more problamatic, difficult to diagnose and more painful > to treat. I've just recovered from two internal surgeries to remove > anal cancer and, wow, that was an experience. Cancer all gone tho (!!)> > On a side note none of the doctors in my area nor the local ASO do > rectal screenings, we have to beg to get screened in LA, a two hour > drive, one way. One would think that in Palm Springs there would be > more assistance with our large HIV community. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2007 Report Share Posted April 4, 2007 Anal warts are caused by different strains of HPV than the strains that causes dysplasia and cancer. However, anyone with anal warts should still get checked for dysplasia, because it is likely that they are also infected with the strains that cause dysplasia and cancer. Where there is smoke, there is probably fire. Bill Gaul <wgaul1@...> wrote: Anal warts are NOT associated with the HPV that causes cancer? Where did Imiss this before?Reading the link below, I get conflicting recommendations. Maybe this quote sums it up?"It is common, especially in people who are immune-compromised, to have ongoing HPV and to develop HSIL within a few years of developing LSIL or warts."This is really news to me!BG Re: Get your butt checked> >> >> > For those close to Indianapolis, Dr. R Barry Melbert, M.D. Phone:> > (317) 889-7906 has the proper equipment and training to do High> > Resolution Anoscopy and the appropriate treatment for abnormal> findings> > due to HPV.> >> > He is very knowledgable about the disease from HPV and gay friendly. I> > highly recommend him.> >> > J Sherlock, M.D.> >> Quote Link to comment Share on other sites More sharing options...
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