Sometimes a Hemorrhoid is Not Just a Hemorrhoid | Lillian Kreppel & Marcia Anne Cross

Lillian Kreppel & Marcia Anne Cross

The human papillomavirus is the most common sexually transmitted infection. In the US, 79 million people, or 1 in 4 Americans, are currently living with HPV. In fact, nearly all adults will have HPV at some point in their lifetime. Anal cancer is predominantly caused by the human papillomavirus (HPV), a virus for which over 100 strains exist. In fact, it is estimated that over 93% of anal cancer cases are caused by HPV. For most of the population, the immune system will rid the body of the virus and HPV will not progress to cancer. For other individuals, HPV can lie dormant and resurface as an HPV-related cancer decades later.

Because HPV can lie dormant for years and even decades, it is imperative that women and their doctors are educated about the warning signs that often occur as it progresses to anal cancer. The good news is that this is a cancer that can be cured if detected early, but far too often women and their doctors do not pay attention when symptoms such as bleeding and pain are present. The quick and easy “you have a hemorrhoid” without even a look from their doctor occurs all too frequently. Worse than that is the misinformed statement from doctors that “if you haven’t had anal sex then you aren’t at risk for anal cancer.” Unbelievably, women are often told after menopause that they no longer need to see their gynecologists when that is exactly the time that they are at their highest risk for developing anal cancer.

My life was saved because my gynecologist, Nancy Goldman, MD, regularly performed a digital rectal exam at my appointments as part of her routine care. A simple procedure that requires nothing but a few minutes of time and knowledge about what to be on the lookout for is the reason I am here and not a statistic. I was incredibly lucky. Why this is not a standard part of the gynecological exam is a question we have asked repeatedly with evasive or no logical answer given.

We have spoken to women whose symptoms were dismissed for months while their cancer spread to their lymph nodes and worse. Many doctors are still uncomfortable with what I now refer to as the glorious anus and prefer, perhaps unconsciously, to ignore it or have it be someone else’s domain. Patients going through anal cancer treatment find their doctors are uneducated about the side effects of their treatment. How to protect the vagina for quality of life and medical care, education about radiation stenosis, and possible sacral fractures are just a few important conversations that should take place but regularly do not. Surely we can improve this with just a little bit of education.

We must, as a culture, stop the shame and stigma felt by both patients and providers and deal with the virus and what symptoms to be on the lookout for head on. The good news is that there is no mystery about how to do this. With education and a desire to save the lives of all HPV cancer patients, this can be done. So many goals in the cancer world are still unattainable, but this one is within our reach. Let’s commit to making 2023 the year that this happens.

Lillian Kreppel is many things: she’s a Public Speaker, Entrepreneur, and Changemaker. In 2017, she added Activist to that list when she was diagnosed with an HPV-associated cancer. That diagnosis and recovery led to the launch of HPV Cancers Alliance in 2019. Alongside Co-Founders actress Marcia Cross and wellness industry executive Dan Lifton, Lillian is on a mission to de-stigmatize HPV and its associated cancers. She actively works to educate the medical community and general public about HPV, prevention, detection, and treatment guidelines for associated cancers.

Marcia Anne Cross is an American actress. She began her career on daytime soap operas such as The Edge of Night, Another World, and One Life to Live before moving to primetime television with a recurring role on Knots Landing. From 1992 to 1997, she starred as Dr. Kimberly Shaw on Melrose Place. Cross played the role of the conservative housewife Bree Van de Kamp on the ABC television series Desperate Housewives (2004–12), for which she was nominated for three Golden Globe Awards for Best Actress in a Musical or Comedy, and a Primetime Emmy for Outstanding Lead Actress in a Comedy Series. She also recurred as President Claire Haas on the ABC series Quantico. In June 2019, Marcia revealed that she had been battling anal cancer and is now in remission. Since then, she has been talking about her cancer battle to help destigmatize the disease and encourage people to treat it.