Elton John, 77, Managed The Stigma of Being Gay, Overcome Prostate Cancer– How Stigma Can Hinder the LGBTQ Community’s Cancer Care?

Helping the LGBTQ+ Community Reduce Cancer Risk

• Hall of Fame singer-songwriter Elton John, 77, is a cancer survivor and a (lesbian, gay, bisexual, transgender, queer) LGBTQ+ advocate having brought added visibility to the community.
• A new study published in “Cancer” notes the LGBTQ+ community faces added societal stressors such as stigma, discrimination, lack of acceptance, and access to care, contributing to this group being more likely to smoke, drink alcohol, and be obese, all known cancer risk factors.
• 1 in 3 LGBTQ+ adults says they’ve been mistreated by a healthcare provider, adding to the stigma this community faces affecting their care, according to KFF, a health policy research organization.
• Anal cancer, cancer that develops in the tissues of the anus, often stems from the human papillomavirus (HPV). Gay and bisexual men are at higher risk of this type of cancer.
• HPV is a collection of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex.
• The HPV vaccine is recommended to protect against HPV and HPV-related cancers. It creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers.

Singer-songwriter Elton John, 77, is one of the most trailblazing musicians alive. Through his generational music, he has created visibility for the LGBTQ+ community. During his Hall of Fame career, he also beat prostate cancer. Understandably, not everyone within the lesbian, gay, bisexual, transgender, queer (LGBTQ+) community traverses everyday life without struggles, most notably discrimination, shame, and stigma because of their sexual orientation and health status. A recent study was published in the medical journal “Cancer” by the American Cancer Society. The researchers behind the study say that members of the LGBTQ+ community “experience discrimination and minority stress that may lead to elevated cancer risk.” The study also concluded that LGBTQ+ individuals are “more likely to smoke cigarettes,” which is a known cancer risk factor. It also says obesity and heavier alcohol consumption compared to people who identify as heterosexual are more prevalent. Obesity and excessive alcohol are also cancer risk factors. Among the cancers affecting a subset of the LGBTQ+ community is anal cancer. Anal cancer forms in the tissues of the anus, and the National Cancer Institute says most anal cancers stem from the human papillomavirus (HPV). American Cancer Society says risk factors for anal cancer include: HIV infection, receptive anal intercourse, multiple sexual partners, and smoking. WATCH: An anal cancer survivor shares his inspiring story and the support he received from his boyfriend during his journey. Dr. Zuri Murrell , a colorectal surgeon at Cedars-Sinai Medical Center, tells SurvivorNet that anal cancer is higher among gay and bisexual men, especially people who are HIV positive. “If you're HIV positive and have anal receptive intercourse, then there is a higher increase in anal cancer, and that's because of HPV,” Dr. Murrell tells SurvivorNet. Dr. Murrell recommends people in this group who engage in anal sex receive an annual pap smear. “Pap smear is basically a brushing that you do in the anus, okay? Women have it in their cervix, but you have a brushing in the anus, and you look for cells that could be undergoing pre-cancerous changes due to HPV,” Dr. Murrell explains.

Helpful Resources on Anal Cancer

• Study: Anal Cancer, and Mortality Rates from the Disease, Have Increased — What’s Going On?
• Clinical Trials for Colorectal Cancer Can Offer Cutting-Edge Treatment
• Why Are More Younger People Getting Colon Cancer? The Theories on Inflammation & Gut Bacteria
• All Americans Should Begin Colorectal Cancer Screening at Age 45, According to New Guidelines; Previous Age Was 50

How Stigma Impacts Care

Many within the LGTBQ+ community face reluctance in receiving healthcare. A recent report by the KFF – formerly the Kaiser Family Foundation – found that “33% of LGBTQ adults say they were mistreated or with disrespect or had at least one negative experience with a healthcare provider” compared to “15%” of heterosexual adults. Dr. Murrell says many physicians are trained on heterosexual white males. He says training becomes less stringent among communities of color and even less for marginalized groups like the LGBTQ+ community. “I don’t fault the patients…I fault us as physicians” when limited trust exists between LGBTQ+ patients and the medical community. WATCH: Be Pushy, Be Your Own Advocate, Don’t Settle Dr. Murrell believes healthcare practitioners must better educate themselves on the populations they serve. Regrettably, he also adds that LGBTQ+ patients must lead the way in advocating for their own healthcare when faced with doctors who are less welcoming. “Be your own healthcare advocate. What does that mean? It means finding a doctor who you trust, and he or she trusts you, and you’re working on a plan together,” Dr. Murrell advises.

Gay & Bisexual Men Are More at Risk for Anal Cancer

The human papillomavirus (HPV), the National Cancer Institute says, is "a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex." “The biggest thing to do, and hopefully this will be a thing of the past, is making sure everybody gets the Gardasil shot,” Dr. Murrell advises. WATCH: Debunking the myths about HPV. The HPV vaccine protects against HPV and 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. According to the Centers for Disease Control and Prevention (CDC), the HPV vaccine is recommended for all male and female preteens 11 to 12 years old, and it is given in two doses between six and 12 months. WATCH: The HPV Vaccine Is Completely Safe 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 who started the series between 15 and 26 should get three doses instead of two. Although adults up to age 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, despite it being less effective in this age range, as more people have already been exposed to HPV by this point. RELATED: Gay Men Get More Skin Cancer– The Perils of Tanning Bed Culture

Elton John’s Cancer Journey

The six-time Grammy winner also battled prostate cancer. He was diagnosed in 2017 and underwent surgery to treat his cancer. Though his surgery was successful, it led to complications that landed him in the hospital for 11 days. “I didn’t really know how close to death I was,” Elton wrote in his autobiography. “I was ill because I kept saying, ‘Please let me get well. I want to see my kids.’ But I had tubes coming out of every part of my body, and it took me seven weeks to recover from that when I went home.” John’s cancer journey contributed to his decision to wrap up his career in conjunction with a desire to spend more time with his family.

More on Prostate Cancer

Prostate cancer is the most common cancer in men. It starts in the walnut-shaped prostate gland between the rectum and bladder, producing the fluid that nourishes sperm. Fortunately, most prostate cancer is caught with screening examinations. Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening. The United States Preventive Services Taskforce recommends men at average risk between the ages of 55-69 years old should talk with their doctor about the pros and cons of prostate cancer screening. The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 40. Men with a close relative diagnosed with prostate cancer should consider annual screenings in their 30s. Most doctors agree that men over the age of 70 do not need screening. SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.