Megan Hensgen thought she had hemorrhoids. A few years ago, the Menomonie Falls mother of two was suffering from symptoms such as bleeding, itching and burning from her anus. She saw her primary care physician, Dr. Anna Caban Cardona, who soon connected Megan to Dr. Kirk Ludwig, a colorectal surgeon and faculty member at the Medical College of Wisconsin.
After Dr. Ludwig examined her, he told Megan that he was almost certain that she had anal cancer. Her biopsy confirmed the diagnosis of stage II squamous cell carcinoma, which affects the lining of the anus. It is the most common type of anal cancer.
“People need to know that this disease can be cured if caught early,” Megan said. “They need to know what to look out for and where to go for help. It changed everything for me – there’s no reason not to talk about this.”
Most anal cancers are caused by the human papillomavirus (HPV), most commonly associated with cervical cancer. HPV can cause cancers of the mouth and oral cavity, as well as cancers of the vulva, vagina, penis, and anus. The HPV vaccine is designed to prevent her from getting HPV infection and can prevent these cancers.
“My father often said we needed to come up with a vaccine to cure cancer,” said James Thomas, MD, MD, a medical oncologist and MCW faculty member. “HPV vaccination can stop cancer before it starts.”
Treatment plan from anal cancer expert
Experts from the Froedtert & MCW Colorectal Cancer Program and other experts within the Froedtert & MCW Cancer Network worked together as a multidisciplinary team to develop Megan’s treatment plan.
Her case will be presented at weekly disease-specific cancer conferences, where experts from all disciplines review the details of a patient’s case and discuss which treatments will provide the best results.
Megan’s personal plan included targeted radiation therapy followed by chemotherapy. Surgery is not recommended for most anal cancers because it can be extensive and can leave patients with a permanent ostomy.
Dr. Beth Erickson, a radiation oncologist and MCW faculty member, was part of Megan’s care team.
“Treatment is intensive,” Dr. Erickson says. “That’s why you want to be treated with a doctor who has experience with the latest anal cancer treatments and who can manage the side effects.”
Megan experienced some side effects during her treatment, including cracked skin and pain from the radiation therapy. Dr. Erickson’s nurses have developed a routine to keep your skin healing and comfortable. Radiation also caused early menopause. Megan’s gynecologist prescribed hormone therapy to combat these symptoms. She was also given medication to reduce nausea and fatigue caused by chemotherapy.
The payoff was worth it. Megan is considered cured. She will be closely monitored by colorectal cancer specialists at Freedert & MCW using image scans and anoscopy, an in-office technique that uses a thin tube with a camera to view the lining of the anus and rectum. .
Good results for anal and colorectal cancer
Froedtert and MCW’s colorectal cancer experts are committed to helping more cancer patients achieve positive outcomes.
“We treat a large number of patients with anal cancer and other colorectal cancers, so we know what works and what doesn’t,” Dr. Ludwig said. “Our goal is to discover what works better. For some people, a clinical trial may be the best treatment.”
The colorectal cancer team is actively engaged in clinical research testing potentially more effective treatments while reducing side effects and improving quality of life. Froedtert & MCW Cancer Network offers the largest cancer clinical trial treatment program in Wisconsin.
Don’t be ashamed, be aware of anal cancer and take action.
“Everyone should talk to their doctor about their risk factors for anal cancer and consider screening tests,” Dr. Erickson says.
Screening is usually a manual test where your doctor senses abnormal growths or other problems. If you are at high risk or have been exposed to HPV, talk to your doctor about monitoring. Those at high risk may be candidates for the Froedtert & MCW Anal Dysplasia Clinic, which provides regular monitoring to detect and treat the disease early. Megan’s conversation is just beginning. She volunteers with peer-to-peer programs to help people survive difficult diagnoses.
“Some patients are devastated,” Dr. Erickson said. They make the path for the next person so much easier. ”
Megan and her care team hope her story will encourage others to seek treatment if they notice troubling symptoms such as lumps or anal bleeding.
Dr. Ludwig said, “Don’t be embarrassed. There’s nothing to be ashamed of about your diagnosis.”