With a background in colorectal surgery and health informatics, as well as a passion for promoting prevention within the LGBTQ+ community, Dr. Elliot Aroniadis accomplished something unprecedented. At the Twin Cities Pride Event in 2023, his group, Save The Bottoms, provided on-site self-screening for anal pre-cancer and cancer. A few days later, his presentation about the success of this event at Grand Rounds impressed his professional community. This led to a collaboration with the Masonic Cancer Center, the University of Minnesota, and The Randy Shaver Research and Community Fund.

A team builder and innovator with experience in health informatics, Aroniadis understands how to leverage technology in daily life. By partnering with community influencers, Save The Bottoms effectively uses social media to reach underserved communities in Minneapolis and throughout Minnesota. Resourceful and visionary, his unique skills are enhancing awareness and prevention of anal cancer and its precursors. His team describes working with him as "fun," which is how we would characterize this interview!

Bottom Line

A candid and delightful discussion with two pioneers who are shaping the awareness of anal and colorectal cancer in the LGBTQ+ community.

What do an entrepreneur and a stand-up comic have in common? A desire to raise awareness for the LGBTQ+ community about anal and colorectal cancers. David founded Cheeky Charity following his own health scare with colorectal cancer in 2021. Daniel has been HIV positive for fourteen years and was engaged in advocacy when he was diagnosed with anal cancer.

The two began collaborating only a year ago, providing special sensitivity to mental health issues. Their approach is to educate, entertain, and inspire. With an awareness of cancer's psychological, physical, and spiritual effects, Cheeky Charity combines humor with education, creating a unique and effective strategy.

Talking about cancer at Pride events across the country, Cheeky Charity strives to keep the community healthy by addressing the risks openly. With ease of conversation that encourages people to lower their guard, they convey their message through excellent website design and honest dialogue.

Stigma is a struggle. Unapologetically irreverent, Cheeky Charity fosters an environment that promotes prevention through awareness and early detection. Their myth-busting, empowering message of support is straightforward: Love your body. Love yourself. Recognize your risk. Get screened.

Cheeky Charity https://www.cheekycharity.org/

Christian and Daniel Show https://www.youtube.com/watch?v=weUpUE7ZDGU

Today, gender care is fluid, but in 2012, in the early days of ANCHOR, it took the NY Times and a brave Boston gynecologist to shift the direction of focus of anal cancer prevention.

On the other coast, a self-described radical feminist was told that "the anus is just like the cervix," and a historical career began.

In this podcast, Drs. Beth Stier and Naomi Jay discuss how they collaborated to build consensus from a large group with diverse expertise to create the first Consensus Guidelines for Anal Cancer Screening (2024). This project is changing the course of anal cancer screening.

Looking toward the future, the next big step will involve an Implementation task force.

"No one is willing to wait another seventeen years for the changes to occur." The speakers' challenge, "Get involved. There's so much work to be done."

Anal Cancer Foundation - Passion, Determination & Love: A Conversation with Justine & Camille Almada

For Justine, Camille, and Tristian Almada anal cancer is personal. After losing their dear mother, Paulette, to Stage IV HPV-related anal cancer in 2010, the siblings set out to change the course of this disease. In her honor, they created what they wished had been available to them, The Anal Cancer Foundation. For over a decade, their work has improved awareness as they advocate for policies that help eradicate the disease and educate about the importance of early detection and HPV vaccination uptake. In this interview, the two sisters describe not only their frustration with the lack of research and treatment options when their mother was diagnosed but also their vision that provides peer support and contributes to long-overdue research. In this moving and inspiring interview Camille a nurse practitioner in oncology expresses her hopes to cast a wider to all HPV – related cancers. With the message "You are not alone," Justine discusses the victories that have changed the face and experience of anal cancer, offering hope to thrivers whose lives are made better by the Anal Cancer Foundation's gallant vision.

Camille's expressed views are her own and do not reflect those of her employer, Mount Sinai Health System.

The Anal Cancer Foundation was a strong financial support for the establishment of IANS.

IMPROVING BARRIERS TO INTIMACY – A TOOLBOX

Irena Nurkic is a specialist in continence and pelvic health physiotherapist at the Royal Perth Hospital in Western Australia. With over fifteen years of in-depth clinical expertise in management of pelvic health conditions in women, men and transgender persons, she lectures and serves as a clinical tutor at Curtin University.

In this interview Irena generously shares her passion for learning and translating science into patient care. She applies her expertise to improve and manage often ignored biological changes of post-pelvic radiation. Her approach is person-centered, supporting the patient in identifying hard-to-discuss sexual, incontinence and pelvic pain issues. She discusses her team's interdisciplinary approach and her role as a PT in guiding her clients in what to expect after treatment and in setting short and long-term personal priorities and aspirations. Her expressed expertise is filtered through her approachable, kind, and sensitive demeanor. All patients' issues and goals are different. She offers hope for often ignored post-treatment quality-of-life concerns. She validates that "bowel, bladder and sexual dysfunction post-radiation are a problem, and we have tools."

In this podcast Dr. Wong discusses how a talk he heard about HRA, high resolution anoscopy, piqued his interest in something he knew nothing about. He reasoned because he was caring for HIV patients that he should know more. He found his way to places where HRA was done and where he could be trained. His interest and dedication took him from his home in Hong Kong to Australia, to New York and San Francisco, where he learned from the experts. In a compelling interview, Dr. Wong shares the challenges and successes of his impressive professional journey. He discusses his fascination with this specialty and his commitment to bringing more trained specialists to Asia.

Dr. Mary Birdsall didn't see herself getting anal cancer, and neither did her physician colleagues. As a GYN specializing in IVF she found herself, not the expert, but the "man on the street." In this interview, she speaks frankly and passionately about her own struggle to have her symptoms taken seriously and her commitment to agitate for primary and secondary prevention. She shares of how deeply troubling the diagnosis was and how isolated she felt. "You're not the person who's supposed to get this," was her GI doctor's response. She explores the disservice this lack of awareness does to women and speaks hopefully of her dreams for the future. "I wish for anal cancer to be entirely prevented much like the trajectory for cervical cancer because we have the knowledge and the tools we just need to implement them."

Dr. Birdsall created ACSSA, Anal Cancer Support Services Aotearoa https://www.analcancer.co.nz/who-we-are to serve anal cancer and pre-cancer patients in New Zealand and Australia.

Dr. Joel Palefsky discusses his long career and trailblazing research. He discusses the cervical model which informed his research. He talks of the success of his groundbreaking ANCHOR study, a large clinical trial that found, as with the cervix, treating anal precancerous growths greatly reduces the chance of developing cancer.

As his work evolved, Palefsky's vision expanded. He saw a need to create a way for scientists and clinicians in this young field to interact and collaborate. The Anal Cancer Foundation and the Farrah Fawcett Foundation graciously stepped up to help financially, and IANS was born.

Dr. Palefsky sees ANCHOR as only the beginning of creating innovations in patient care. He expresses hopefulness that in the future the 500,000 specimens collected during the study will help define HPV types and identify which will regress and which remain persistent.

His work was not done for prestige, but his groundbreaking study has brought him that.

Dr. Palefsly ends with a reflection on his life's work, hopes and dreams.

THE ANUS HAS A PERCEPTION PROBLEM

The founders of the HPV Cancers Alliance, Lillian Kreppel and actress, Marcia Cross speak frankly about how their own experience with anal cancer became the impetus to get the word out about HPV – related cancers. One had symptoms that were dismissed, the other no symptoms. It's the difference between life and death that women ask their GYNs for a simple DARE exam. Marcia and Lillian are outspoken in this interview about their commitment to changing attitudes about an important and stigmatized body part. "It's not my area," is not an answer they are willing to accept. They talk about their commitment to do something, by educating both women and their doctors about the importance of crossing the "magic line."

BE PRESENT FOR THE PEOPLE YOU LOVE

Alana Stewart stayed at Farrah Fawcett's side supporting and advocating, through treatments and ultimately her friend's heartbreaking death. This interview with the president of the Farrah Fawcett Foundation, reflects the kindness and love present in the pages of her best-selling book, My Journey With Farrah. A Story of Life, Love and Friendship.

With warmth and frankness, Alana shares her experience as a friend and caregiver. She discusses the creation of the 2009 Emmy award-winning documentary, Farrah's Story. With humility, she recreates how she accepted the role of filmmaker. Her images brought to the public an intimate glimpse of the ugliness of cancer and the beauty of their sisterhood.

Farrah herself established The Foundation and intended to run it. Her vision was to bring research dollars to lesser known cancers and to help those in need by providing patient assistance. Alana discusses their collaboration with Stand Up To Cancer, SU2C, a program of the Entertainment Industry Foundation that raises funds for translational cancer research.

With warmth and frankness Alana discusses what her life was like before, during and now, as the journey continues. She imparts important life lessons for caregivers who live through similar stress, fear and anxiety.

With the tenderness of a person whose life has been profoundly changed, she expresses her insights. "Be grateful. Show down. Live every moment. Life is valuable."