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Colon cancer: the importance of early detection

Tips for preventing disease and coping when diagnosed

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My dear friend, Dr. Jose Mendoza, is an incredible inspiration with an invincible spirit and contagious zest for life. He was recently diagnosed with colon cancer and he eloquently manages to maintain a courageous fight with an unflinching positive attitude. Jose is tackling his diagnosis with knowledge and action.

He wrote this piece so the next person may be able to prevent contracting cancer and other health issues.

We all have little pains and medical questions between visits to the doctor. Then we get there and forget everything. As soon as we leave the office, we remember the questions we meant to ask, but it’s too late.

Make a list! After I was diagnosed with colon cancer at age 31, I learned to take better advantage of the five or 10 minutes I have with my doctors. I designed a list, like a laundry or shopping list, which I always prepare a couple days before a visit. You may want to keep a running list that you can update whenever you think of something.

Lists can be designed for different illnesses, like HIV, high blood pressure, renal disease, diabetes or cancer.

It is important to track new symptoms, if you experience any since your last visit, and to note any new family medical history you may discover, any new medicines or natural remedies you take, any lifestyle changes, etc. This information will help your doctor to help you better. If he or she knows you well, together you can prevent many illnesses.

Remember to disclose your sexual orientation, even if it makes you feel uncomfortable. It has repercussions for your health-care management.

Today I want to focus on colorectal cancer because of the upcoming D.C. Goes Blue activities, Sept. 26 to Oct. 3.

Colon cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death. It has no symptoms in most cases and can be diagnosed at any age, especially in at-risk populations.

Anal cancer is almost 60 times more common in HIV-positive individuals, compared with the general population, according to a 2008 study published in the Annals of Internal Medicine. The author’s project rates to increase as HIV-infected persons live longer.

A colonoscopy is indicated for everyone 50 or older. But if you have a family history, or you are African American, Latino, Alaskan native or Native American, you should get your first colonoscopy sooner because you are at higher risk and could be discovered in a more advanced stage before 50.

As part of your laundry list, ask your doctor about ordering a fecal immunochemical test or fecal occult blood test. These are painless exams that could discover blood in your stool. You can’t necessarily see the blood, but if the lab results are positive, the next level of care is indicated: a virtual colonoscopy or regular colonoscopy.

If blood is not found, you are good to go. These tests can be done annually and the only downside is that they do not identify precancerous polyps. You need a colonoscopy to discover those.

The colonoscopy itself is quick and painless. Patients are completely sedated and the procedure normally takes only 15 to 20 minutes. Preparation the day before is now available in a number of options, including liquid and pill forms. I won’t lie; the prep is the worst part.

Colon cancer is beatable in nine out of 10 cases when caught early. Colon cancer is one of the very few cancers that are preventable!

We need to think about our health more comprehensively. Eat a balanced diet, get exercise, don’t smoke, drink moderately or not at all, and get your preventative screening tests. Make your laundry list before your next appointment and tell your doctor you want your colon checked. For additional information, visit the Colon Cancer Alliance website at ccalliance.org.

Dr. Jose Mendoza is former director of Malaria Clinical Trials for the U.S. Navy.  Mendoza is volunteering as Latino medical consultant for the Colon Cancer Alliance and can be reached at [email protected].

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MISTR announces it’s now prescribing DoxyPE

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MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTR’s telehealth platform to receive DoxyPEP online for free, according to a release from the company.

With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.

“Despite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,” said Tristan Schukraft, CEO and founder of MISTR. “I’m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.”

An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV. 

MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.

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UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for women’s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyone’s health is synonymous with protecting everyone’s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world — for everyone,” said Byanyima.

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New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, the National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25 Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”

The study stated that trans women’s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to “survival sex work” and violence, which increases the risk of contracting HIV. 

The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”

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