The FDA approved retifanlimab-dlwr (brand name Zynyz) with carboplatin and paclitaxel – a type of chemotherapy – for the first-line or initial and preferred treatment of adult anal cancer patients with inoperable locally recurrent – cancer that returns near its origin – or metastatic squamous cell carcinoma of the anal canal (SCAC) which is anal cancer that’s spread beyond the anus.
The FDA says progression-free survival—the time in which the cancer does not worsen—improved from roughly seven months to “9.3 months” during clinical trials.
“Desperate Housewives” star Marcia Cross, 63, and fellow cancer survivor Lillian Kreppel co-founded the HPV Cancers Alliance, advocates for destigmatizing anal cancer, pushing for advancements in treatment, and promoting the human papillomavirus (HPV) vaccine.
The HPV vaccine creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers.
The human papillomavirus, or HPV, is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex, according to the National Cancer Institute. It can cause a handful of cancers, including cervical and throat cancers.
For the first time, a medicine has been approved for anal cancer for the roughly ten thousand people diagnosed with it every year, including famous people like “Desperate Housewives” star Marcia Cross, 63, and her fellow HPV Cancers Alliance co-founder Lillian Kreppel.WESTWOOD, CALIFORNIA – SEPTEMBER 21: Actress Marcia Cross speaks onstage during the Concert for America at Royce Hall, UCLA, on September 21, 2019, in Westwood, California. (Photo by Scott Dudelson/Getty Images) The Food and Drug Administration (FDA) approved retifanlimab-dlwr (brand name Zynyz) with “carboplatin and paclitaxel” which is a chemotherapy combination, according to the National Cancer Institute. The treatment is used for the first-line or initial and preferred treatment for adult anal cancer patients with inoperable locally recurrent – cancer that returns near its origin – or metastatic squamous cell carcinoma of the anal canal (SCAC), which is anal cancer that’s spread beyond the anus.
The FDA says progression-free survival—the time in which the cancer does not worsen—improved from roughly seven months to “9.3 months” during clinical trials.
Anal cancer is a rare tumor that’s most often linked to human papillomavirus (HPV), according to the National Institutes of Health.
Although the new treatment offers immense hope for thousands of patients and their families battling anal cancer each year, progress has moved slowly, making this moment more remarkable.
Actress Marcia Cross often advocates for advancements in cancer treatments and does not shy away from the stigma often associated with an anal cancer diagnosis.
“I know there are people who are ashamed. You have cancer! You have to then also feel ashamed? Like you did something bad, you know because it took up residence in your anus? I mean, come on, really. There’s enough on your plate,” Cross previously told CBS News about her diagnosis.
“Even for me, it took a while…You just have to get used to it,” Cross added.
Cross was diagnosed with anal cancer In November 2017, following a routine check-up at the gynecologist. Her doctor felt something unusual during a digital rectal exam, so Cross was directed to a clinic to get it checked out. After two biopsies and one colonoscopy, Cross’ cancer diagnosis was confirmed.
Marcia Cross acted as ‘Desperate Housewives’ character Bree Van De Kamp
The National Cancer Institute says, “Most anal cancers are related to human papillomavirus (HPV) infection.” Common signs include bleeding from the anus or a lump near the anus.
Cross has been public about her cancer fight and admitted chemotherapy was challenging, but the cancer warrior fought through it.
“I will say that when I had my first chemo treatment, I thought I was doing great. And then, out of nowhere, I felt this sting on my lip; it was excruciating. It was from the chemo,” Cross told Coping magazine.
Cross told SurvivorNet in a previous interview her cancer diagnosis was HPV-related.
“I didn’t have any symptoms. Never had an irregular pap smear. I had never heard of HPV until my husband. We both probably carried it for most of our lives. I think there’s just a vast lack of knowledge about HPV and how it’s spread, how we carry it, what happens to it when you have it,” Cross said.
Lillian Keppel Turned Her Anal Cancer Diagnosis Into Purpose
Lillian Keppel was diagnosed with anal cancer in September 2017. She first thought she was dealing with a nagging hemorrhoid that wouldn’t go away. However, her persistent symptoms, which included itching and bleeding, caused her doctor to perform a digital rectal exam. During the exam, he felt something that “wasn’t normal,” Keppel said to SurvivorNet.
Further tests revealed stage 2 anal cancer.
“There is a stigma because people are embarrassed about where it is,” Keppel said.
She says she got the cancer through the human papillomavirus (HPV).
“There’s a lot of ignorance and a lot of misconceptions about it,” Keppel added.
Now, after being declared “cancer-free,” she’s become a staunch advocate for patients battling the disease and helping diminish the stigma surrounding it.
HPV’s Cancer Link
HPV infection is linked to multiple cancers, and most sexually active people will get the disease at some point in their lives.
Although nearly all cases of cervical cancer are indeed caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers, such as oral cancer and cancers of the vagina, penis, anus, and throat.
WATCH: Why the HPV Vaccine is so Important in Preventing Cancer
Overall, HPV is believed to be the cause of 90% of anal and cervical cancers, approximately 70% of vaginal and vulvar cancers, and 60% of penile cancers.
“There are no screening guidelines to screen for throat cancer, unlike cervical cancer with pap smears,” saysDr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center, previously told SurvivorNet. “There are no standard tests to determine if you harbor the virus.”
On the plus side, HPV-related throat cancers are generally very responsive to a combination of radiation and chemotherapy treatments, according to Dr. Geiger.
“The cure rates for people who have HPV-related disease are a lot higher than those who have tobacco-related throat cancer,” she said.
Protecting Against HPV
Nearly 80 million Americans have HPV today, according to the Centers for Disease Control and Prevention. It impacts men and women and won’t cause problems for most people.
However, in a small percentage of cases, it can lead to cancer.
The HPV vaccine is recommended to protect against HPV and, therefore, HPV-related cancers.
Gardasil 9 is an HPV vaccine that offers protection against “nine HPV types: the two low-risk HPV types that cause most genital warts, plus seven high-risk HPV types that cause most HPV-related cancer,” according to the National Cancer Institute.
The vaccine creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers. Once children are vaccinated, they cannot be infected with that strain. For parents, the HPV vaccine enables them to protect their children from developing cancer in the future.
“The key with the vaccine is that you receive it before you have sexual encounters,” says Dr. Geiger. “So that’s why these vaccines are approved for young children ages 9, 10, 11 years old, up to age 26.”
According to the CDC, the HPV vaccine is recommended for all male and female preteens 11 to 12 years old, given in two doses between six and 12 months.
The series of shots can also start as young as 9.
The CDC also notes that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine.
Additionally, people with weakened immune systems or teens and young adults between 15 and 26 who started the series should get three doses instead of two.
Although adults up to 45 can still receive the vaccine, it’s not recommended for everyone older than 26. Still, a person older than 26 could choose to get vaccinated after talking to their doctor about possible benefits, even despite it being less effective in this age range, as more people have already been exposed to HPV by this point.
WATCH: Should children get the HPV Vaccine?
Vaccine hesitancy can impede people from getting the vaccine. The concern may come from parents who may feel the vaccine paves the way for early sexual activity. For this reason, some health practitioners educate the public differently about the vaccine.
“I think rebranding the vaccine as a cancer vaccine, rather than an STD vaccine, is critically important,” saysDr. Ted Teknos, a head and neck cancer surgeon and scientific director of University Hospital’s Seidman Cancer Center.
Dr. Teknos believes concerted efforts to “change the mindset around the vaccine” can make a difference.
Questions for Your Doctor
Suppose you are concerned about your cancer risk related to the human papillomavirus or whether HPV caused the cancer you have. In that case, you can use one of the conversation starters below when talking with your doctor:
I am unsure if I received the HPV vaccine when I was younger. What can I do to know for sure?
If I experience symptoms that could be because of HPV, what tests can I undergo to know for sure?
