Sandra deQuant will never forget her 49th birthday: the following day, she was told she had anal cancer. "I was in a state of shock," remembers deQuant. "I didn't know what to expect and had never heard of anal cancer before."
Although rare, anal cancer is becoming more prevalent in the United States and many other developing countries. The condition develops in the tissues of the anus, which is a short tube that connects the lower part of the large intestine, known as the rectum, to the outside of the body. The anus allows the controlled disposal of body waste during bowel movements. This type of cancer, like cancer of the cervix, is caused by exposure to human papillomavirus (HPV).
Although deQuant was not considered at particular risk for anal cancer, she does have a family history of gastrointestinal cancer. Esophageal cancer claimed the life of her younger brother in 1992 and her other brother was later diagnosed with the disease.
DeQuant visited her doctor at Kaiser Permanente in South San Francisco to be tested for esophageal cancer. At the time, her only abnormal symptom was rectal bleeding, which she passed off as a hemorrhoid. However, after undergoing a sigmoidoscopy — an internal exam of the colon and rectum — deQuant's doctor noticed an abnormality at the end of her anal canal. The next day, she received a diagnosis of anal cancer.
Because of the type of deQuant's cancer a three centimeter squamous cell carcinoma her doctor advised that chemotherapy and radiation therapy, rather than surgery, were the recommended treatments, which would eliminate deQuant's need for a colostomy bag, while still offering a possible cure. Invasive anal cancer is curable in many patients, particularly when it is diagnosed early and tumors are small. DeQuant's doctor referred her to UCSF Medical Center's Helen Diller Family Comprehensive Cancer Center, where she was treated by Dr. Richard Krieg, a radiation oncologist who specializes in the treatment of gastrointestinal cancers.
"When my doctor told me that I was going to UCSF for treatment, it was a great relief," says deQuant. "I thought, Okay, I can do this. I felt very comfortable and secure going there. Everyone at UCSF was so wonderful that even if I hadn't had a positive outcome, I would still consider it a good experience."
Krieg recommended a combination of chemotherapy and radiation, the most common treatment for anal cancer, which causes tumors to completely regress in about 80 percent of cases. DeQuant underwent six weeks of daily radiation therapy and two weeks of chemotherapy.
"Sandra had the expected side effects associated with chemotherapy and radiation therapy for this disease. She also had significant shrinkage of her cancer early in her treatment course," says Krieg.
DeQuant now boasts a clean bill of health and is four years cancer free. She is also involved in anal cancer patient advocacy groups and regularly gives advice to other women fighting the disease.
"My disease has made me more outspoken," says deQuant, who believes in the value of sharing her story with others. "I learned that it doesn't matter what kind of cancer you have, you have to stay positive and believe you are going to get healthy and face it head-on."
Story written in July 2006.
Abby Sinnott is a freelance writer in San Francisco.