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How can you tell if you’ve got anal cancer?

How can you tell if you’ve got anal cancer?

CREATED ON // Saturday, 13 February 2016 Author // Dr Brad McKay

Is anal cancer even a thing?


Ask Dr Brad: A friend of mine got anal cancer recently which I didn’t even know was a thing. The surgeon had to cut out his bum and now he does his business in a bag. Is his sex life ruined? Was it caused by his sex life? How can you tell if you've got butt cancer? 


Anal cancer is definitely a "thing". It's rare in the general population, but is much more likely to develop in men who have sex with men.

It's difficult to tell if you have anal cancer or if it's just a haemorrhoid because the symptoms are very similar: an itchy ass, bright red blood on the toilet paper, a new lump, or just feeling "uncomfortable". 

Because symptoms are often subtle and can be embarrassing, many people unfortunately leave it a long time before seeing their GP.

Anal cancer is usually caused by the virus responsible for warts, the Human Papilloma Virus (HPV). Anal sex is the perfect way to introduce HPV into your anal canal, especially when condoms aren’t used. Even skin-on-skin contact can cause HPV to set up camp where the sun don't shine.

HPV is extremely common. It's estimated that more than 80 per cent of the population have HPV infection right now and if you've ever had sex you've probably got HPV somewhere. Fortunately, most HPV infections are harmless. The wart virus sits happily in your skin and you don't even know it's there. 

There are more than 170 different types of wart virus and some members of this warty family like to cause trouble. They can cause genital warts to pop up on your penis, scrotum, groin, butt, around your anus and sometimes in your anus. It's important to see your GP for an examination and treatment as soon as you notice any genital warts. They are unsightly, highly contagious, and tend to multiply the longer you leave them. 

Some types of HPV are dangerous and cause chronic infections in the lining of the anal canal. The infection stays there for many years, causing the cells of your anal canal to mutate and eventually turn into cancer.

You look at your penis every day, but it's difficult to look inside your own ass. This means that anal cancer is often discovered at a late stage when it's hard to treat.

Treatment involves seeing a Colorectal Surgeon and having an operation to remove the cancer. The anus is completely removed and stitched up. The last part of the bowel is attached to the abdominal wall, forming a 'stoma' where poo can come out. Some guys also need chemotherapy or radiotherapy to decrease the chance of any cancer cells remaining. 

Having surgery, losing your ass and needing to use a bag certainly doesn't make people feel sexy and can cause significant self image problems. This is a total change for bottoms, as they either need to become tops or be inventive to have a successful sex life again. 

Please note that it’s not medically recommended to use the stoma for sex, but I assure you that some people have tried. The stoma is fragile and can easily tear if anything is pushed inside. It can also become infected, so it’s very much a “no-go zone” for sex.

HPV not only causes anal cancer, but also causes cervical cancer in women. Females have regular “Pap Smears” and guys may soon be having “Chap Smears” to screen for HPV changes that can lead to anal cancer.

All Australian school age kids are now given the HPV vaccination and we have started to see a decrease in cases of genital warts and cervical cancer. Hopefully over the next decade we will see a drop in the cases of anal cancer too. The vaccine works best when you're young, but can still be beneficial when you're older to protect against anal cancer, penis cancer and some throat and neck cancers. Ask your GP if it's right for you.

If you think something isn’t quite normal down there, ask your GP to check your butt. I know it might be embarrassing, but it’s what doctors are trained to do.


If you have a question for Dr Brad McKay regarding gay men’s health, including sexual matters, send a brief description of your concerns via email or use the email address: checkup [@] gaynewsnetwork [dot] com [dot] au. No attachments please.



Dr Brad McKay

Dr Brad McKay

Dr Brad McKay (MBBS, FRACGP) is an Aussie GP and host of the TV show Embarrassing Bodies Down Under. He aims to decrease stigma and increase awareness of embarrassing health issues. He is dedicated to improve gay men’s physical, sexual and mental health. He is seen regularly on Mornings (Nine Network), The Project (Ten), can be heard regularly on Tony Delroy’s Nightlife, ABC Local Radio, podcasts and at a public speaking event near you. He currently works as a GP at East Sydney Doctors in Darlinghurst, Sydney.

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