January 26, 2025 • 19 mins
You may know Dr Mary Birdsall as the fertility queen of New Zealand with her work helping kiwi couples realise their dream of starting a family. But Mary recently went on her own terrifying health journey with her battle with anal cancer.
This experience has helped Mary gain a deeper understanding of what some her own patients have been through, and she's not entirely impressed by the standard of healthcare in New Zealand.
In this episode, Toni and Mary chat about how she discovered she had cancer, the treatment and recovery process, and why Mary thinks it's so important to discuss anal cancer.
You can find Mary's Anal Cancer Support Services here
Or listen to her podcast Anal Cancer all you wanted to know but were afraid to ask
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
We need to Talk Conversations on Wellness with co cfm's
Tony Street.
Speaker 2 (00:06):
Hello, welcome to we need to talk now. You might
know doctor Mary Burdsill as the Fertility Queen of New Zealand.
Via Fertility Associates, Mary has helped countless couples realize their
dream of having a child, even when the odds have
been stacked against them. I'm one of those people. Mary
was the expert I turned to when I first explored
surrogacy as an option to have my son Lockey, six
(00:28):
years ago. But fertility is not the reason Mary is
chatting with me today. Mary has had her own personal
health problems. She was diagnosed with anal cancer in twenty
twenty one and quickly found there was no support group,
no pink ribbons, when all she wanted was to connect
with someone who had walked this journey before her. Being
(00:48):
a doctor herself, she found that anal cancer is a
preventable cancer, but the knowledge and tools are not being
used here in Alterior. Mary, It's lovely to see you again,
Thank you, Tony. Sorry it's under such awful circumstances. I
had no idea that this had been going on for you.
How is your health. Sitting here today, I am good.
Speaker 3 (01:09):
I've just had my three year check so I'm now
out of the woods, so I am good. Thank you
very much.
Speaker 2 (01:16):
How did this come about? How did you know that
you had anal cancer?
Speaker 3 (01:20):
Well? I was perfectly fit and well, working seven hours
a week, being busy, and I had a bit of
bleeding when I went to the loo and I thought, oh,
I've got hemorrhoids. My father had hemorrhoids at fifty nine.
I went, yeah, just got hemorrhoids. So I discussed it
with my husband. He's a GP, and it was during
(01:41):
COVID and we thought we'd bypass GPS because they weren't
really seeing patients. So I did a really dumb doctor
thing and I just booked myself in to have a
colonoscopy because I kind of thought, I want the drugs.
I want to be asleep. I don't want to know
anyone's looking at my bottom. Yep. So I I went
to see a colleague because being in medicine, you know everyone,
(02:03):
and I said, look, I think I've got hemorrhoids, but
I just don't want to know. I don't have anything
more serious, and give me lots of drugs. So I
woke up after the beautiful drugs and he said, yeah,
you've got a couple of hemorrhoids. You know, basically, get
over yourself and get on with life.
Speaker 2 (02:19):
Yeah, and that was just from a cholonoscopy.
Speaker 3 (02:21):
Yes, yep. The next four months I had a lot
more bleeding, I had some discomfort, and I thought, wow,
I'm going to have to do something about these hemorrhoids.
So I booked myself in to see a chlorectal surgeon
and he said, these aren't hemorrhoids, Mary, you have anal cancer.
And my world kind of stopped.
Speaker 2 (02:39):
Oh, I bet it did. So did you think by
having the cholonoscopy that that was enough to be.
Speaker 3 (02:44):
Checked one hundred percent? And in fact, when I showed
the cholorectal surgeon the images that had been given from
my colonoscopy, he said, oh, yeah, you can see the
cancer quite clearly on the images. So that was challenging
because I had seen me in the doctors as patients
over my career, and I always felt that when I
(03:05):
was seeing someone special like a doctor or you, and
I would really up my game and try really hard.
So it was really challenging to have my cancer completely misdiagnosed?
Speaker 2 (03:18):
Yeah, and why do you think that? What?
Speaker 3 (03:20):
I think that he didn't think about it. I think
he might have been a bit burnt out, was on
remote control. And when I contacted him about it, he said, oh, wow,
that's never happened to me before. And I thought, that's
an incredibly inadequate response, because this isn't actually about you,
This is now about me. And then he said, but
(03:42):
you're not the sort of person who gets anal cancer,
And in fact, that is entirely incorrect, because the most
common person to get aint or cancer is a sixty
year old woman, and so I was absolutely the typical person.
That was kind of disappointing.
Speaker 2 (04:02):
And what happened from that point? Where were you in
terms of how serious the cancer was?
Speaker 3 (04:07):
Yeah, it was pretty serious. It was five centimeters, so
quite a decent size cancer. I think the fortunate thing
about being a doctor at that point is is things
happened really quickly, and so I launched quite quickly into treatment,
and that, fortunately for me, was starting within two weeks
of being diagnosed.
Speaker 2 (04:26):
What was the treatment.
Speaker 3 (04:27):
The treatment's a combination of chemotherapy and radiotherapy, and it
was pretty harsh. You know, I've famously said I wouldn't
put my dog through this, and it was also really
difficult to be offered a treatment that's fifty years old.
You kind of think we should be better than this.
Why are we still putting people through this? And the
(04:51):
rather trite responses that I would get, Oh, it works
quite well. And what quite well means that seventy percent
a peace people are cured by this. But where I
went from being what I thought was completely well to
someone telling me that I had a thirty percent chance
that I would be dead. That didn't feel great to me.
Speaker 2 (05:11):
You had no other choice, I'm guessing no.
Speaker 3 (05:13):
And it is effective treatment and clearly it has worked
for me.
Speaker 2 (05:17):
Do you have any idea how you contracted a cancer?
Speaker 3 (05:21):
So anal cancer is almost all due to HPV, So
it's exactly the same as cervical cancer. And HPV is
something that we just are ignoring, you know, even though
we think we're vaccinating our young people.
Speaker 2 (05:38):
That's the one where girls around twelve thirteen is that
the girls and boys and always get the vaccine.
Speaker 3 (05:43):
Yeah, in New Zealand, currently we're vaccinating less than half
of our kids, and yet HPV causes eight percent of
all cancers in women. So it's the single biggest cause
of cancers in the world and it is utterly preventable
these cancers with the use of the vaccine, and we're
(06:05):
just not talking about it.
Speaker 2 (06:06):
So you obviously hadn't had that vaccine.
Speaker 3 (06:09):
No, And the difficulty is you need to have the
vaccine before you become sexually active. So that's because that's
how we all acquire HPV. So there's about thirty years
of people who will never have had the vaccine. So
there's a lot more of these cancers to come. And
in fact, anal cancer is increasing by two percent each
(06:31):
year just because of these nasty HPV viruses that were around.
Speaker 2 (06:36):
There will be people listening to this right now in
the same situation as you. I didn't get that vaccine.
In fact, I'm one of those people absolutely that came
in after my time. Yeah, what do we do to
try and prevent this?
Speaker 3 (06:49):
Well, now you should be having your regular cervical screening
and that's now done in a much better way where
they're actually looking for a So the big thing is
to have your regular screens for HPV and if you
found that you do have HPV, say to the person, Hey,
(07:10):
I want to be checked for anal cancer, and I
think what should now be part of a routine guyiny
exam is actually having a rectal exam at the same time.
And that's people don't do that and they need to
be doing it.
Speaker 2 (07:24):
So you can have HPV and not have anal cancer, right.
Speaker 3 (07:28):
Yes, absolutely, But if you do have HPV, particularly HPV
sixteen and eighteen, because there are a whole lot of
different subtypes, these are the ones that mostly cause anal cancer,
along with other cancers like header neck cancers, penal cancer,
VOLVL cancer, vaginal cancer, and of course cervical cancer.
Speaker 2 (07:49):
Yeah. I know people will be listening to this thinking, oh,
I don't know if I want to wreck them exam.
Can you put their minds at ease?
Speaker 3 (07:54):
Yeah, it's two minutes, you know, But I think just
doing this job, getting your swabs done is really important.
And the other pe message I want to really get
out there is if you're having any sort of bleeding,
go and get checked and say to someone do you
think I might have anal cancer? And don't be fobbed
off because I think sometimes doctors aren't keen to examine
(08:17):
bottoms sometimes we're not keen to show our bottoms to doctors,
and I think we all just need to get over this.
It's just another part of our body.
Speaker 2 (08:25):
I think the scary thing for me about your story
is you had blood in your stool, and I think,
I mean, I would be alarmed by that, But then
you did take the correct step to go and get
it checked and then it was fine. And that's everyone's
worst nightmare. You go and think you've done the correct
process and that still doesn't lead you anywhere.
Speaker 3 (08:41):
Yeah, and my story is the story of fifty percent
of people with anal cancer. I think the doctors need
to up their game. And as a doctor, I'm a
lot to say that.
Speaker 2 (08:52):
How do you get that message through to GPS.
Speaker 3 (08:54):
I think you just do things like this. You just
are brave enough to get out there and tell your story.
Speaker 1 (09:03):
You're listening to We need to talk with Tony Street.
Speaker 2 (09:06):
I know that doctors would be looking for, say, lumps
in the breast, because breast cancer has had so much publicity.
We talked about pink ribbon. Is it because not as
many people get this type of cancer?
Speaker 3 (09:17):
Yeah, it is quite rare, So it's one hundred people
a year in New Zealand get anal cancer, so it
is pretty uncommon. There are some people who are really
at risk of AIN or cancer and they're the people
that we should be actively targeting for screening.
Speaker 2 (09:33):
Who are those people.
Speaker 3 (09:34):
They're people with HIV, people who have things wrong with
their immune system, so people who are on immino suppressing drugs,
maybe have had SLA, you know, lupus, people who have
had solid organ transplants, women who have had cevical cancer,
vulv or cancer. So these are the groups. They're at
(09:56):
really high risk. And in Australia they're just about to
roll out testing for these people, so they're actually going
to be screened for AIN or cancer, which will be
fabulous because you can actually detect AAN or cancer before
it becomes AIN or cancer and then prevent people going
(10:17):
through the horrible treatment that you need to do. So
you can detect it much like we detect people with
abnormal cells in their serve ACX.
Speaker 2 (10:25):
So how would that screening process work.
Speaker 3 (10:27):
Yeah, so you take this population that are at a particular
high risk and you do either a smear on their
butts yep or a swab just like we do in vaginas,
and then the people who show up that they have
some abnormal cells, they would go through and have essentially
a colposcopy of their anus. So that's like looking at
(10:49):
your anus with a microscope and if you can see
these abnormal cells, you biopsye them and remove them before
they become ain or cancer. So this screening is about
to be rolled out in Australia. But the frustrating thing
in New Zealand is we are nowhere close to doing
(11:09):
any of this and what we don't even have is
any reasonable number of clinicians that are trained in looking
at your anus. So there's a real gap in our
in our medical system.
Speaker 2 (11:20):
And I know that when you got diagnosed, you almost
didn't know where to turn. And I feel like if
a doctor doesn't know where to turn for support and information,
then the rest of us are screwed. Right.
Speaker 3 (11:33):
Look, it was really hard. It was so socially isolating,
and all I wanted to do was connect with someone
who had been through this treatment and how to get
through it. So when I was through all of it,
and about a year or two down the line, then
I started a support group. And what that looks like
is I've put together a lovely website that's called anal
(11:56):
Cancer Support Services at ROER and it's got good informative,
good quality information. And we've also run a peer to
peer support program, so if you've got an or cancer,
you can connect with us and we'll match you with
someone who's been through the process to be kind of
your support buddy through the process. And I've got a
Facebook group. It's a very elite club. You need to
(12:19):
have had anal cancer to be part of this little club.
Speaker 2 (12:21):
So we don't want to be part of that club,
but good to know it's there.
Speaker 3 (12:25):
Yeah. So, and I've also made a podcast series and
I'm really super excited about my podcast.
Speaker 2 (12:31):
Here tell us what that's called.
Speaker 3 (12:32):
It's called anal Cancer All you wanted to Know but
we're afraid to ask. Spotify and Apple and it's just
eight episodes of everything you want to know about anal cancer.
And it's the sort of thing that I would have
would have wanted to have had when I was diagnosed.
And I'm super excited to have got that up.
Speaker 2 (12:52):
Yeah, well done you for doing that one thing that
would have made all of this much harder for you.
You were just telling me before we started chatting that
you're husband was also diagnosed with cancer at the same time.
Speaker 3 (13:03):
Yeah, that was pretty surreal. You know, it's hard enough
having one of you go through cancer, let alone the
two of you, And it was a really tough time.
In fact, we talk about our anos orobolis. You know
how the Queen had her bad year, so we had
we had a tough year. But yeah, we've got through
it and we're great. But you know, it was challenging
(13:25):
times and it really tests your relationship, I think, because
you know, generally you want to support your partner fully
and it's hard when you both need that support.
Speaker 2 (13:36):
Yeah, and you'd both be dealing with it in different ways.
Speaker 3 (13:39):
I guess, very different ways. My husband is my opposite.
Let's say opposites attract, and so it was. It was
a tough time. I had a fabulous psychologist. I would
highly recommend that to anybody going through cancer. Treatment and
friends and family really important. But the tough thing about
anal cancer is many of us don't want to say
(14:00):
we've got anal cancer. There's this awful stigma that it's
supposed to be associated with having anal sex, so people
are incredibly embarrassed about it.
Speaker 2 (14:10):
But that's not necessarily the case.
Speaker 3 (14:12):
Absolutely not. And I think as women, you can't help
wear this virus lands. And there's this really lovely study
that's come out of Tasmania that shows that if you're
a woman and you're a front to back wiper, after
you've been to the loop and we're all taught to
(14:32):
wipe that way so we don't get UTIs, you're much
more likely to get anal cancer than if you're a
back to front wiper because you just spread the virus around.
So you can't help with this virus lands.
Speaker 2 (14:46):
Are you saying that we've all been wiping role? Should
we change your heabits? I'm shook.
Speaker 3 (14:53):
Look maybe we all need to become dabbers. I don't know.
Speaker 2 (14:56):
Wow, that is something to process right now. I need
to bring that up on radio.
Speaker 3 (15:01):
I think we're talking about that one I've spoken about before. Wow.
Speaker 2 (15:05):
Yeah, that there could be a whole podcast on it. Sown.
I think as a doctor you would have seen many,
many patients particularly who would have come through fertility associates,
and some of them would have gone through chemotherapy. Do
you have a different or deeper understanding now of what
your patients went through? Given you've been through that grueling treatment.
Speaker 3 (15:25):
Yeah, one hundred percent. I think that it just teaches
you how hard it is to be a patient and
how incredibly vulnerable you are, and how people with the
best intentions in the world often don't treat you as
you would want to be treated. And I was, without
(15:46):
a doubt, the worst pression in the world.
Speaker 2 (15:49):
But you know, you kind of had motivation to be
after being misdiagnosed. I mean, that's a lot to process
in itself.
Speaker 3 (15:56):
I was pretty angry. Yeah, but even like I've recently
had an MRI, because you have, you know, these regular images,
and it just brought home how difficult it is to
be a patient again because things like you say, oh,
when will you get your result? Because you're desperate to
get the result, and they go on three to five
working days, but it needs to be seen by your
(16:17):
specialist first. It drives me crazy. This gives me the result.
It just gives me the result. The information belongs to me.
It does not need to be vetted by someone else.
I am an adult. It's just that the experience of
being a patient I find incredibly difficult.
Speaker 2 (16:33):
And it's interesting because I feel like we have come
quite far in that respect, you know, from when I
was a kid and you had no access to your
lab results at least Now we have sites like your
Health three six five where you have access to some
of them and the patient notes like that's one good thing, right.
Speaker 3 (16:50):
It is better, But things like patients aren't necessarily c
seed on all their own letters, so there's all this
doctor talk that doesn't involve the most important person. I
found at times I was asked to undress in places
where my privacy wasn't respected. I just found it a
(17:11):
really challenging process, and I think we can. Even though
I absolutely think we have got better, I think there's
a long long way to go before we treat patients
as I think they need to be treated.
Speaker 2 (17:25):
What's the answer then, to this, what's the answer?
Speaker 3 (17:27):
I think every doctor needs to go through radiation. Yes,
I think we just need to put ourselves in the
patient's seat. The answer is to include patients in all decisions,
in all communication, and just be kinder people.
Speaker 2 (17:44):
How do you get this message out? I mean, I
know you're putting it out now, that's that's part of it.
But how do you make sure so that New Zealand
the health professionals can all be sort of lifted up
to where you think it needs to be.
Speaker 3 (17:57):
I'm not sure. Yeah. I talk about it all the time.
As I was having my MRI this week, I was
grilling the poor radiographer about why the communication process was
so poor. So I just talk about it all the time.
Speaker 2 (18:11):
And for people that might be concerned that they too
could have a misdiagnosis, what is your message to people
when they're going in to get their tests.
Speaker 3 (18:22):
If you're worried and you're not getting the care that
you think you need, seek a second opinion. And I
couldn't say that strongly enough. I think that you know
if something's not right, so go back and ask and
ask again.
Speaker 2 (18:36):
I think I can say this to you. It shocked
me that as a doctor you had blood in your
stool you kind of didn't take it seriously.
Speaker 3 (18:43):
Yeah, And I was stupid, And part of that was
my unwillingness to show my bottom to someone, which you know,
as a kind of coologist just frankly dumb yep, and
me having this explanation in my head to what it
was and you kind of downplay, and my thinking I
didn't need to bother my GP during COVID. You know,
(19:05):
I think you know, and they weren't really keen to
see people face to face. So I think that's all stupid.
You know, your anus is just another part of your body.
We've all got one. We couldn't live without it. We
just need to just treat it like any other part
of our body and go and get checked.
Speaker 2 (19:22):
Do you think anal cancer stats are going to decrease
in New Zealand or are we on the way up.
Speaker 3 (19:27):
We're on the way up, and so that's why I'm
keen to get this message out. Go and get checked,
and please, as a doctor, please check people's anus is properly.
Speaker 1 (19:37):
We need to talk with COASTFMS Tony Street. If you
enjoyed the podcast, click to share with family or friends.
To get in touch, email, we need to talk at
Coast online, dot co dot MZ
We need to Talk Conversations on Wellness with co cfm's
Tony Street.
Speaker 2 (00:06):
Hello, welcome to we need to talk now. You might
know doctor Mary Burdsill as the Fertility Queen of New Zealand.
Via Fertility Associates, Mary has helped countless couples realize their
dream of having a child, even when the odds have
been stacked against them. I'm one of those people. Mary
was the expert I turned to when I first explored
surrogacy as an option to have my son Lockey, six
(00:28):
years ago. But fertility is not the reason Mary is
chatting with me today. Mary has had her own personal
health problems. She was diagnosed with anal cancer in twenty
twenty one and quickly found there was no support group,
no pink ribbons, when all she wanted was to connect
with someone who had walked this journey before her. Being
(00:48):
a doctor herself, she found that anal cancer is a
preventable cancer, but the knowledge and tools are not being
used here in Alterior. Mary, It's lovely to see you again,
Thank you, Tony. Sorry it's under such awful circumstances. I
had no idea that this had been going on for you.
How is your health. Sitting here today, I am good.
Speaker 3 (01:09):
I've just had my three year check so I'm now
out of the woods, so I am good. Thank you
very much.
Speaker 2 (01:16):
How did this come about? How did you know that
you had anal cancer?
Speaker 3 (01:20):
Well? I was perfectly fit and well, working seven hours
a week, being busy, and I had a bit of
bleeding when I went to the loo and I thought, oh,
I've got hemorrhoids. My father had hemorrhoids at fifty nine.
I went, yeah, just got hemorrhoids. So I discussed it
with my husband. He's a GP, and it was during
(01:41):
COVID and we thought we'd bypass GPS because they weren't
really seeing patients. So I did a really dumb doctor
thing and I just booked myself in to have a
colonoscopy because I kind of thought, I want the drugs.
I want to be asleep. I don't want to know
anyone's looking at my bottom. Yep. So I I went
to see a colleague because being in medicine, you know everyone,
(02:03):
and I said, look, I think I've got hemorrhoids, but
I just don't want to know. I don't have anything
more serious, and give me lots of drugs. So I
woke up after the beautiful drugs and he said, yeah,
you've got a couple of hemorrhoids. You know, basically, get
over yourself and get on with life.
Speaker 2 (02:19):
Yeah, and that was just from a cholonoscopy.
Speaker 3 (02:21):
Yes, yep. The next four months I had a lot
more bleeding, I had some discomfort, and I thought, wow,
I'm going to have to do something about these hemorrhoids.
So I booked myself in to see a chlorectal surgeon
and he said, these aren't hemorrhoids, Mary, you have anal cancer.
And my world kind of stopped.
Speaker 2 (02:39):
Oh, I bet it did. So did you think by
having the cholonoscopy that that was enough to be.
Speaker 3 (02:44):
Checked one hundred percent? And in fact, when I showed
the cholorectal surgeon the images that had been given from
my colonoscopy, he said, oh, yeah, you can see the
cancer quite clearly on the images. So that was challenging
because I had seen me in the doctors as patients
over my career, and I always felt that when I
(03:05):
was seeing someone special like a doctor or you, and
I would really up my game and try really hard.
So it was really challenging to have my cancer completely misdiagnosed?
Speaker 2 (03:18):
Yeah, and why do you think that? What?
Speaker 3 (03:20):
I think that he didn't think about it. I think
he might have been a bit burnt out, was on
remote control. And when I contacted him about it, he said, oh, wow,
that's never happened to me before. And I thought, that's
an incredibly inadequate response, because this isn't actually about you,
This is now about me. And then he said, but
(03:42):
you're not the sort of person who gets anal cancer,
And in fact, that is entirely incorrect, because the most
common person to get aint or cancer is a sixty
year old woman, and so I was absolutely the typical person.
That was kind of disappointing.
Speaker 2 (04:02):
And what happened from that point? Where were you in
terms of how serious the cancer was?
Speaker 3 (04:07):
Yeah, it was pretty serious. It was five centimeters, so
quite a decent size cancer. I think the fortunate thing
about being a doctor at that point is is things
happened really quickly, and so I launched quite quickly into treatment,
and that, fortunately for me, was starting within two weeks
of being diagnosed.
Speaker 2 (04:26):
What was the treatment.
Speaker 3 (04:27):
The treatment's a combination of chemotherapy and radiotherapy, and it
was pretty harsh. You know, I've famously said I wouldn't
put my dog through this, and it was also really
difficult to be offered a treatment that's fifty years old.
You kind of think we should be better than this.
Why are we still putting people through this? And the
(04:51):
rather trite responses that I would get, Oh, it works
quite well. And what quite well means that seventy percent
a peace people are cured by this. But where I
went from being what I thought was completely well to
someone telling me that I had a thirty percent chance
that I would be dead. That didn't feel great to me.
Speaker 2 (05:11):
You had no other choice, I'm guessing no.
Speaker 3 (05:13):
And it is effective treatment and clearly it has worked
for me.
Speaker 2 (05:17):
Do you have any idea how you contracted a cancer?
Speaker 3 (05:21):
So anal cancer is almost all due to HPV, So
it's exactly the same as cervical cancer. And HPV is
something that we just are ignoring, you know, even though
we think we're vaccinating our young people.
Speaker 2 (05:38):
That's the one where girls around twelve thirteen is that
the girls and boys and always get the vaccine.
Speaker 3 (05:43):
Yeah, in New Zealand, currently we're vaccinating less than half
of our kids, and yet HPV causes eight percent of
all cancers in women. So it's the single biggest cause
of cancers in the world and it is utterly preventable
these cancers with the use of the vaccine, and we're
(06:05):
just not talking about it.
Speaker 2 (06:06):
So you obviously hadn't had that vaccine.
Speaker 3 (06:09):
No, And the difficulty is you need to have the
vaccine before you become sexually active. So that's because that's
how we all acquire HPV. So there's about thirty years
of people who will never have had the vaccine. So
there's a lot more of these cancers to come. And
in fact, anal cancer is increasing by two percent each
(06:31):
year just because of these nasty HPV viruses that were around.
Speaker 2 (06:36):
There will be people listening to this right now in
the same situation as you. I didn't get that vaccine.
In fact, I'm one of those people absolutely that came
in after my time. Yeah, what do we do to
try and prevent this?
Speaker 3 (06:49):
Well, now you should be having your regular cervical screening
and that's now done in a much better way where
they're actually looking for a So the big thing is
to have your regular screens for HPV and if you
found that you do have HPV, say to the person, Hey,
(07:10):
I want to be checked for anal cancer, and I
think what should now be part of a routine guyiny
exam is actually having a rectal exam at the same time.
And that's people don't do that and they need to
be doing it.
Speaker 2 (07:24):
So you can have HPV and not have anal cancer, right.
Speaker 3 (07:28):
Yes, absolutely, But if you do have HPV, particularly HPV
sixteen and eighteen, because there are a whole lot of
different subtypes, these are the ones that mostly cause anal cancer,
along with other cancers like header neck cancers, penal cancer,
VOLVL cancer, vaginal cancer, and of course cervical cancer.
Speaker 2 (07:49):
Yeah. I know people will be listening to this thinking, oh,
I don't know if I want to wreck them exam.
Can you put their minds at ease?
Speaker 3 (07:54):
Yeah, it's two minutes, you know, But I think just
doing this job, getting your swabs done is really important.
And the other pe message I want to really get
out there is if you're having any sort of bleeding,
go and get checked and say to someone do you
think I might have anal cancer? And don't be fobbed
off because I think sometimes doctors aren't keen to examine
(08:17):
bottoms sometimes we're not keen to show our bottoms to doctors,
and I think we all just need to get over this.
It's just another part of our body.
Speaker 2 (08:25):
I think the scary thing for me about your story
is you had blood in your stool, and I think,
I mean, I would be alarmed by that, But then
you did take the correct step to go and get
it checked and then it was fine. And that's everyone's
worst nightmare. You go and think you've done the correct
process and that still doesn't lead you anywhere.
Speaker 3 (08:41):
Yeah, and my story is the story of fifty percent
of people with anal cancer. I think the doctors need
to up their game. And as a doctor, I'm a
lot to say that.
Speaker 2 (08:52):
How do you get that message through to GPS.
Speaker 3 (08:54):
I think you just do things like this. You just
are brave enough to get out there and tell your story.
Speaker 1 (09:03):
You're listening to We need to talk with Tony Street.
Speaker 2 (09:06):
I know that doctors would be looking for, say, lumps
in the breast, because breast cancer has had so much publicity.
We talked about pink ribbon. Is it because not as
many people get this type of cancer?
Speaker 3 (09:17):
Yeah, it is quite rare, So it's one hundred people
a year in New Zealand get anal cancer, so it
is pretty uncommon. There are some people who are really
at risk of AIN or cancer and they're the people
that we should be actively targeting for screening.
Speaker 2 (09:33):
Who are those people.
Speaker 3 (09:34):
They're people with HIV, people who have things wrong with
their immune system, so people who are on immino suppressing drugs,
maybe have had SLA, you know, lupus, people who have
had solid organ transplants, women who have had cevical cancer,
vulv or cancer. So these are the groups. They're at
(09:56):
really high risk. And in Australia they're just about to
roll out testing for these people, so they're actually going
to be screened for AIN or cancer, which will be
fabulous because you can actually detect AAN or cancer before
it becomes AIN or cancer and then prevent people going
(10:17):
through the horrible treatment that you need to do. So
you can detect it much like we detect people with
abnormal cells in their serve ACX.
Speaker 2 (10:25):
So how would that screening process work.
Speaker 3 (10:27):
Yeah, so you take this population that are at a particular
high risk and you do either a smear on their
butts yep or a swab just like we do in vaginas,
and then the people who show up that they have
some abnormal cells, they would go through and have essentially
a colposcopy of their anus. So that's like looking at
(10:49):
your anus with a microscope and if you can see
these abnormal cells, you biopsye them and remove them before
they become ain or cancer. So this screening is about
to be rolled out in Australia. But the frustrating thing
in New Zealand is we are nowhere close to doing
(11:09):
any of this and what we don't even have is
any reasonable number of clinicians that are trained in looking
at your anus. So there's a real gap in our
in our medical system.
Speaker 2 (11:20):
And I know that when you got diagnosed, you almost
didn't know where to turn. And I feel like if
a doctor doesn't know where to turn for support and information,
then the rest of us are screwed. Right.
Speaker 3 (11:33):
Look, it was really hard. It was so socially isolating,
and all I wanted to do was connect with someone
who had been through this treatment and how to get
through it. So when I was through all of it,
and about a year or two down the line, then
I started a support group. And what that looks like
is I've put together a lovely website that's called anal
(11:56):
Cancer Support Services at ROER and it's got good informative,
good quality information. And we've also run a peer to
peer support program, so if you've got an or cancer,
you can connect with us and we'll match you with
someone who's been through the process to be kind of
your support buddy through the process. And I've got a
Facebook group. It's a very elite club. You need to
(12:19):
have had anal cancer to be part of this little club.
Speaker 2 (12:21):
So we don't want to be part of that club,
but good to know it's there.
Speaker 3 (12:25):
Yeah. So, and I've also made a podcast series and
I'm really super excited about my podcast.
Speaker 2 (12:31):
Here tell us what that's called.
Speaker 3 (12:32):
It's called anal Cancer All you wanted to Know but
we're afraid to ask. Spotify and Apple and it's just
eight episodes of everything you want to know about anal cancer.
And it's the sort of thing that I would have
would have wanted to have had when I was diagnosed.
And I'm super excited to have got that up.
Speaker 2 (12:52):
Yeah, well done you for doing that one thing that
would have made all of this much harder for you.
You were just telling me before we started chatting that
you're husband was also diagnosed with cancer at the same time.
Speaker 3 (13:03):
Yeah, that was pretty surreal. You know, it's hard enough
having one of you go through cancer, let alone the
two of you, And it was a really tough time.
In fact, we talk about our anos orobolis. You know
how the Queen had her bad year, so we had
we had a tough year. But yeah, we've got through
it and we're great. But you know, it was challenging
(13:25):
times and it really tests your relationship, I think, because
you know, generally you want to support your partner fully
and it's hard when you both need that support.
Speaker 2 (13:36):
Yeah, and you'd both be dealing with it in different ways.
Speaker 3 (13:39):
I guess, very different ways. My husband is my opposite.
Let's say opposites attract, and so it was. It was
a tough time. I had a fabulous psychologist. I would
highly recommend that to anybody going through cancer. Treatment and
friends and family really important. But the tough thing about
anal cancer is many of us don't want to say
(14:00):
we've got anal cancer. There's this awful stigma that it's
supposed to be associated with having anal sex, so people
are incredibly embarrassed about it.
Speaker 2 (14:10):
But that's not necessarily the case.
Speaker 3 (14:12):
Absolutely not. And I think as women, you can't help
wear this virus lands. And there's this really lovely study
that's come out of Tasmania that shows that if you're
a woman and you're a front to back wiper, after
you've been to the loop and we're all taught to
(14:32):
wipe that way so we don't get UTIs, you're much
more likely to get anal cancer than if you're a
back to front wiper because you just spread the virus around.
So you can't help with this virus lands.
Speaker 2 (14:46):
Are you saying that we've all been wiping role? Should
we change your heabits? I'm shook.
Speaker 3 (14:53):
Look maybe we all need to become dabbers. I don't know.
Speaker 2 (14:56):
Wow, that is something to process right now. I need
to bring that up on radio.
Speaker 3 (15:01):
I think we're talking about that one I've spoken about before. Wow.
Speaker 2 (15:05):
Yeah, that there could be a whole podcast on it. Sown.
I think as a doctor you would have seen many,
many patients particularly who would have come through fertility associates,
and some of them would have gone through chemotherapy. Do
you have a different or deeper understanding now of what
your patients went through? Given you've been through that grueling treatment.
Speaker 3 (15:25):
Yeah, one hundred percent. I think that it just teaches
you how hard it is to be a patient and
how incredibly vulnerable you are, and how people with the
best intentions in the world often don't treat you as
you would want to be treated. And I was, without
(15:46):
a doubt, the worst pression in the world.
Speaker 2 (15:49):
But you know, you kind of had motivation to be
after being misdiagnosed. I mean, that's a lot to process
in itself.
Speaker 3 (15:56):
I was pretty angry. Yeah, but even like I've recently
had an MRI, because you have, you know, these regular images,
and it just brought home how difficult it is to
be a patient again because things like you say, oh,
when will you get your result? Because you're desperate to
get the result, and they go on three to five
working days, but it needs to be seen by your
(16:17):
specialist first. It drives me crazy. This gives me the result.
It just gives me the result. The information belongs to me.
It does not need to be vetted by someone else.
I am an adult. It's just that the experience of
being a patient I find incredibly difficult.
Speaker 2 (16:33):
And it's interesting because I feel like we have come
quite far in that respect, you know, from when I
was a kid and you had no access to your
lab results at least Now we have sites like your
Health three six five where you have access to some
of them and the patient notes like that's one good thing, right.
Speaker 3 (16:50):
It is better, But things like patients aren't necessarily c
seed on all their own letters, so there's all this
doctor talk that doesn't involve the most important person. I
found at times I was asked to undress in places
where my privacy wasn't respected. I just found it a
(17:11):
really challenging process, and I think we can. Even though
I absolutely think we have got better, I think there's
a long long way to go before we treat patients
as I think they need to be treated.
Speaker 2 (17:25):
What's the answer then, to this, what's the answer?
Speaker 3 (17:27):
I think every doctor needs to go through radiation. Yes,
I think we just need to put ourselves in the
patient's seat. The answer is to include patients in all decisions,
in all communication, and just be kinder people.
Speaker 2 (17:44):
How do you get this message out? I mean, I
know you're putting it out now, that's that's part of it.
But how do you make sure so that New Zealand
the health professionals can all be sort of lifted up
to where you think it needs to be.
Speaker 3 (17:57):
I'm not sure. Yeah. I talk about it all the time.
As I was having my MRI this week, I was
grilling the poor radiographer about why the communication process was
so poor. So I just talk about it all the time.
Speaker 2 (18:11):
And for people that might be concerned that they too
could have a misdiagnosis, what is your message to people
when they're going in to get their tests.
Speaker 3 (18:22):
If you're worried and you're not getting the care that
you think you need, seek a second opinion. And I
couldn't say that strongly enough. I think that you know
if something's not right, so go back and ask and
ask again.
Speaker 2 (18:36):
I think I can say this to you. It shocked
me that as a doctor you had blood in your
stool you kind of didn't take it seriously.
Speaker 3 (18:43):
Yeah, And I was stupid, And part of that was
my unwillingness to show my bottom to someone, which you know,
as a kind of coologist just frankly dumb yep, and
me having this explanation in my head to what it
was and you kind of downplay, and my thinking I
didn't need to bother my GP during COVID. You know,
(19:05):
I think you know, and they weren't really keen to
see people face to face. So I think that's all stupid.
You know, your anus is just another part of your body.
We've all got one. We couldn't live without it. We
just need to just treat it like any other part
of our body and go and get checked.
Speaker 2 (19:22):
Do you think anal cancer stats are going to decrease
in New Zealand or are we on the way up.
Speaker 3 (19:27):
We're on the way up, and so that's why I'm
keen to get this message out. Go and get checked,
and please, as a doctor, please check people's anus is properly.
Speaker 1 (19:37):
We need to talk with COASTFMS Tony Street. If you
enjoyed the podcast, click to share with family or friends.
To get in touch, email, we need to talk at
Coast online, dot co dot MZ
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