The good news and the bad news

The good news is that the skin tag/lesion that was removed in mid-September, which we now call a tumour, was very small; less than a millimeter deep (stage T1), and was completely excised.

The bad news is that the pathology of the area around the tumour shows superficial squamous cell cancer, Anal Intraepithelial Neoplasia (AIN), to be exact.

AIN is the name given to the appearance dysplasia, abnormal cells, in the skin just inside or immediately outside the anus. There are very few symptoms of AIN and it will often go undetected. The cause is of AIN is not known but it is often associated with the human papilloma virus (HPV).

AIN has the potential to become anal cancer and/or invade the lymph nodes.

The risk of developing anal cancer from AIN increases in people who are immune-compromised, including HIV, and when it occurs, the AIN to anal cancer progression may happen faster.

There are different grades of AIN (1, 2 and 3) depending on how they look under a microscope.

Typically in a healthy person the body can completely heal itself from AIN1. AIN3 is more serious.

I have AIN3 and it is located on the skin outside the anus.

I was given two treatment options.

Option 1. Close follow up and monitoring of the affected area.

Option 2. Radiation therapy to the affected area and the lymph nodes of the pelvis and chemotherapy.

The good news is that the tumour and the AIN were found very early and the prognosis with treatment is excellent, over 90%.

The bad news is that because I am HIV positive and because I already had a small tumour removed option 2 is the favoured and recommended course of treatment.

References

Anal Intraepithelial Neoplasia (AIN) Information for patients

The Christie NHS Foundation Trust

http://www.christie.nhs.uk/media/2617/697.pdf