I’m ‘Dr. Butthole’ — beware this warning sign that could lead to a scary ‘silent disease’
By Tracy Swartz
That’s a bummer!
Anal cancer is on the rise, particularly among white and Hispanic women over the age of 65. The lifetime risk of developing anal cancer is around 1 in 500, according to the American Cancer Society, which predicts about 11,000 new cases and 2,000 deaths this year.
Dr. Evan Goldstein, an NYC-based anal surgeon known colloquially as Dr. Butthole and “the bottom whisperer,” cautions about a warning sign that can increase the risk of getting diagnosed with this “silent disease.”
Dr. Evan Goldstein, author of "Butt Seriously," in a white lab coat.
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Dr. Evan Goldstein, an NYC-based anal surgeon, wrote “Butt Seriously: The Definitive Guide to Anal Health, Pleasure and Everything In Between.”
Courtesy of Dr. Evan Goldstein
“Anal cancer stems from the HPV virus and, for many, from the development of anal warts,” Goldstein, founder and CEO of Bespoke Surgical and Future Method, told The Post.
About 90% of anal cancers are linked to infection with the human papillomavirus (HPV).
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HPV is a group of over 200 related viruses primarily spread through skin-to-skin contact.
The Centers for Disease Control and Prevention estimates that 85% of people will get HPV at some point.
Macro photo of skin lesion caused by human papillomavirus (HPV).
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This man has a skin lesion from human papillomavirus. Untreated skin lesions caused by HPV can potentially progress to anal cancer.
Parilov – stock.adobe.com
Certain strains of HPV are known to cause anal warts — and these benign growths can be difficult to distinguish.
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They may present as a single bump in the anal region or as a cluster that resembles cauliflower. Most are raised, but some are flat.
“Many think they are just skin tags and then find out it’s anal warts from HPV,” said Goldstein, author of “Butt Seriously: The Definitive Guide to Anal Health, Pleasure and Everything In Between.”
“They can be painful and itchy and lead to bleeding.”
Some patients don’t have any symptoms and may not know they have anal warts.
Treatment includes topical medications, cryotherapy or surgical removal.
The body’s immune system often clears HPV infections naturally, usually within a few years, but some persist.
Anal warts can be itchy and painful or not have any symptoms. Here, a man scratches his butt.
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Anal warts can be itchy and painful or not have any symptoms.
Wasan – stock.adobe.com
Chronic infections with certain high-risk types of HPV can cause changes in anal cells, potentially leading to precancerous lesions. If left untreated, they can progress to invasive anal cancer.
Symptoms of anal cancer include rectal bleeding, a lump near the anus, pain or pressure in the anal area, itching or discharge from the anus and changes in bathroom habits.
In the early stages, there may not be noticeable symptoms.
“The idea is to catch this early with early detection anal pap smears and full anoscopy (in and out visualization with a camera and high-resolution scope) with an appropriate anal practitioner,” Goldstein advised.
When found early, anal cancer is often highly treatable. Five-year survival rates after diagnosis hover around 64%.
Goldstein recommends seeing an anal specialist, especially if engaging in anal play, for internal and external evaluations and anal pap smears that can detect changes in the cells lining the anal canal. Here, a muscular man wraps a towel around his waist.
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Goldstein recommends seeing an anal specialist, especially if engaging in anal play, for internal and external evaluations and anal pap smears that can detect changes in the cells lining the anal canal.
theartofphoto – stock.adobe.com
Prevention is key. All teens should get Gardasil 9, a series of shots that can protect against certain types of HPV infections, Goldstein said.
Researchers suggest that the recent anal cancer surge in older women could be due to these women being beyond the age recommended for HPV inoculation when it became widely available in 2006.
Goldstein also recommends seeing an anal specialist, especially if engaging in anal play, for internal and external evaluations and anal pap smears that can detect changes in the cells lining the anal canal.
“The more we talk about [anal health] and standardize yearly evaluations, similar to gynecology appointments, the better all of us will be,” he said.
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