ANAL CANCER & DISABILITY
WHAT IS ANAL CANCER?
Anal cancer is a relatively rare type of cancer that develops in the tissues of the anus. The anus is the opening at the end of the digestive tract, through which stool passes out of the body. Anal cancer usually begins in the cells that line the inside of the anus.
Anal cancer is more common among women than men. However, age is a factor in who develops the disease. It is more common among people in their 50’s and 60’s, than in younger adults. Anal cancer is much rarer than colon cancer or rectal cancer. There are only about 7,200 new cases in the US each year and most of those cases are in people who are over 60 years old.
The number of new anal cancer cases for the US in 2023 are about 9760, which includes 1870 deaths in 2023. These figures are from the American Cancer Society. Your risk factor for getting the disease is much higher if you have had anal warts, HPV infection, or cancer of the cervix, vagina, or vulva.
CAUSES OF ANAL CANCER
The main cause of anal cancer is infection with a virus called human papillomavirus (HPV). HPV is a common sexually transmitted infection. It occurs along with various types of cancer, including cervical, anal, and genital cancers.
Other factors that can increase the risk of getting anal cancer include having multiple sexual partners. Additionally, other behavior that increases the risk of getting anal cancer is having anal sex, having a weak immune system (such as due to HIV infection), and having a history of certain types of cancer conditions.
SYMPTOMS OF ANAL CANCER
If you have any of the following symptoms, it is important to visit the doctor. Even if the symptoms end up being an infection, you should still get treatment right away. Here is a list of common symptoms that you may have if you have anal cancer:
- Bleeding: The most common symptom of anal cancer is rectal bleeding. This may be seen as blood in the stool or on toilet paper after wiping.
- Anal pain: Persistent pain in the anal area, including the rectum, is another common symptom. It may be a dull ache or a sharp pain.
- Itching or a rash: Some people with anal cancer may experience itching or pain in the anal area. This may occur along with a rash.
- Changes in bowel habits: Anal cancer can cause changes in bowel movements. This may include chronic diarrhea or constipation, or a feeling of incomplete bowel movements.
- Abnormal discharge: In some cases, anal cancer can lead to the production of discharge from the anus. The discharge may be bloody or contain puss.
- Feeling of a lump or mass: A lump or mass near the anus or in the rectal area may be a symptom of anal cancer. It may be felt as a small, firm nodule or a larger mass.
- Problems with bowel movements: Anal cancer causes problems with bowel movements, such as pain or problems with passing stool. Also, you could feel obstruction in the bowel.
- Weight loss and fatigue: As with many types of cancer, anal cancer can cause weight loss and fatigue. These symptoms may be worse in advanced stages of the disease.
It’s important to note that these symptoms can also be caused by various other conditions, such as hemorrhoids, anal fissures, or infections.
PREVENTION OF ANAL CANCER
There are many ways to prevent anal cancer and keep yourself as free from the cancer as possible. Here are some of your options:
- Vaccination against HPV can reduce the risk of getting anal cancer. The HPV vaccine is for both males and females. Get the vaccine during your teenage years.
- Practicing safe sex, including the use of barrier methods such as condoms, can help reduce the risk of getting HPV.
- Regular testing, such as Pap tests, can help detect changes in the anus or cervix before they progress to cancer.
TREATMENT FOR ANAL CANCER
The treatment for anal cancer and for cancer of the large intestine, depends the stage of your cancer, the location of the tumor, and your overall health. Your team of doctors will develop your treatment plan. The doctors on your team may include surgeons, radiation doctors, and other cancer experts. Here are some common treatment options for this form of cancer:
SURGERY
Surgery is a common treatment for anal cancer. It removes tumors along with nearby lymph nodes and tissues. Tumor removal is the surgery that is done when the cancer is caught at an early stage. The extent of surgery can vary and may involve partial or total removal of the anus, rectum, and part of the colon. Once that surgery is complete the patient will need a colostomy, which is an opening in the abdominal wall to allow feces to be collected in a bag. In some cases, doctors also remove nearby lymph nodes.
CHEMOTHERAPY
Chemotherapy uses drugs to kill cancer cells or slow down their growth. For example, people undergo chemotherapy prior to surgery to shrink the tumor. Also, they undergo chemo after surgery to destroy any remaining cancer cells. Sometimes, it is the primary treatment for advanced cancer cases. Chemotherapy may be used in combination with other treatments.
RADIATION THERAPY
Radiation therapy uses high energy beams to target and destroy cancer cells. The most common type of radiation is called external beam radiation therapy, which is radiation from a machine outside the body. If you have internal radiation therapy, then your radiation uses implants. Radiation shrinks tumors prior to surgery. Also, radiation kills any remaining cancer cells after surgery. In some cases, doctors use radiation to relieve symptoms in advanced stages of the disease.
Unfortunately, there are side effects from radiation. The side effects can include fatigue, skin reactions, upset stomach, urinary symptoms, loose bowel movements, and pain when having a bowel movement. Scar tissue can also form from the damage to anal tissue and the scar tissue can interfere with bowel function. Most side effects go away soon after treatment is complete.
IMMUNOTHERAPY
Immunotherapy uses the body’s immune system to fight cancer. Certain drugs may be used in some cases of advanced anal cancer to help the immune system recognize and attack cancer cells. Memorial Sloan Kettering Cancer Center treated 14 people with immunotherapy for rectal cancer and in every case, the rectal cancer disappeared after this type of therapy. None of the patients needed the standard treatments or surgery, radiation, or chemotherapy. Additionally, the cancer has not returned in any of the patients and they have all been cancer free for two years. This treatment worked on people with mismatch repair deficient (MMRd) cancer tumors. Talk to your doctor to see if you qualify for this kind of treatment.
PALLIATIVE CARE
Palliative care focuses on giving relief from symptoms. It also improves the quality of life for those with advanced anal cancer. This type of care focuses on helping you with your physical and mental health. For example, you may learn meditation skills or obtain emotional or spiritual support. You will want this type of support when you experience the changes with your body after dealing with anal cancer.
WHEN RECOVERY IS NOT POSSIBLE
People who have advanced anal cancer or cancer that has spread to another organ in their body, may have less than 6 months to live. Therefore, they may want to consider hospice care. Hospice care provides the best possible quality of life for people who are near the end of life. You and your family should talk with your health care team about hospice care options. For example, this includes hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a good option for many families.
LISTING 13.18 FOR LARGE INTESTINE AND ANAL CANCER
In order for you to win benefits for anal cancer, you will need to meet the elements of the following listing. It is important to note that your cancer must be inoperable or that it must have spread to your lymph nodes after surgery. Please read the following listing:
LARGE INTESTINE AND ANAL CANCER – 13.18 Large intestine (from ileocecal valve to and including anal canal).
A. Adenocarcinoma that is inoperable, unresectable, or recurrent.
OR
B. Squamous cell carcinoma of the anus, recurrent after surgery.
OR
C. With metastases beyond the regional lymph nodes.
OR
D. Small-cell (oat cell) carcinoma.
Your medical records must show that you have every element of the above listing for you to meet the SSA’s rules and be paid SSDI and SSI benefits.
APPLY FOR SSDI & SSI BENEFITS FOR ANAL CANCER
If you have anal or large intestine cancer, then there are two types of benefits you can file for under the Social Security program: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. In order to receive benefits, you must first file an application. You can do this online at Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you have anal cancer:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who have worked in the recent past and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history.
To qualify for SSDI, you must have earned enough “work credits” to qualify. A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, you will only qualify for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income. If you have a spouse who earns more than $4000 a month, for example, then that income will be the factor in whether you can receive SSI benefits. You cannot qualify for SSI benefits, no matter how severe your anal cancer, if you do not meet the income and asset rules for SSI.
ANAL CANCER & YOUR RESIDUAL FUNCTIONAL CAPACITY (RFC)
If you don’t meet listing 13.18, you can still win SSDI and SSI benefits through another argument. This argument takes your anal cancer symptoms, medical conditions, your age, work history, skills, and education into account.
When the SSA decides your residual functional capacity (RFC), they use your statements on the forms you fill out for them. For example, when you fill out forms about your past work, you state how much you had to lift on the job and how also tell them how much you stood or sat during a work day.
Your answers on these forms are often some of the most important statements you make. If you state on your Work History form that you lifted nothing on the job, then that is what the SSA assumes is correct. Frankly, there are no jobs where you lift “nothing.” But for some reason, many people write that down as an answer. Even desk jobs require some lifting. You might, for example, lift files, boxes of paper, books, or supplies. The SSA also wants to know what weight you lifted on your job.
Think about it. Failing to tell the SSA about the lifting you had to do at your past jobs, makes it easier for them to return you to your past jobs. In other words, you are making it easier for them to deny your case.
THE MEDICAL EXPERT CAN TESTIFY ABOUT YOUR ANAL CANCER
Medical Experts (ME) or MEs commonly testify at Social Security hearings. They are called by the ALJ to review your medical records for anal cancer. Also, they explain your medical conditions to the judge. Additionally, they testify as to whether or not your medical condition meets or equals an SSA listing, like 13.18. Similarly, an ME can be requested by your attorney. This is, however, mostly done in complex medical cases.
The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the medical expert is there to give testimony about your medical records and should not be for either side of the case.
Medical experts are doctors who the SSA calls to testify about your stomach cancer at the hearing. Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone.
It is also possible for an ME to answer written questions after the hearing. These written questions are sent to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of not preparing for the medical expert.
THE VOCATIONAL EXPERT AT YOUR HEARING
The vocational expert (VE) is also an expert witness, just like the medical expert. Normally, the Social Security Judge calls a VE to testify at the hearing. The Judge calls the expert to talk about jobs that are available to you based upon your ability. VEs have training in placing people in jobs. They also understand the numbers and types of jobs that exist in the nation. They are at the hearing in order to answer questions about jobs in the national economy.
Once the Judge asks you questions about your medical conditions, she will decide what you are capable of doing during an 8 hour work day. The SSA calls this your RFC. Your RFC what you can physically do throughout an 8 hour work day. Therefore, your answers to the questions at the hearing are very important. Just as the important as the medical records you submit.
The Judge listens to your hearing testimony and the takes the symptoms from your medical records to determine how your medical conditions impact you on the job. At the end of your hearing, the Judge will ask the VE questions. Likewise, your attorney will also ask questions. Your attorney can also question the VE. Often it is VEs testimony that determines whether you win or lose your SSD benefits.
HYPOTHETICAL QUESTIONS FOR THE VE
The Judge will ask questions to the VE about whether or not a person with your medical conditions can work. Typically, the Judge will use three to four different questions. These questions can include many different symptoms from your medical issues.
For example, the Judge may ask if a person cannot concentrate on the job, could they work. Or, the Judge may ask what kind of work would be available to a person who cannot lift more than 20 pounds. The Judge’s questions will include your RFC. Learn more here about your residual functional capacity.
Once the Judge is done asking questions, your attorney has the right to question the VE. For those who do not hire an attorney, they are left to try to ask the VE questions on their own. Obviously, most people do not know what questions to ask because they have never been to a hearing. Nor do they have the training they need in order to understand what questions to ask.
Vocational experts testify about what kinds of jobs are available to you. However, they also testify as to the number of jobs that exist in the national economy. For example, a VE may testify as to whether your work skills can be used in other work. They will also testify about the specific jobs in which they can be used.
A VE may also testify as to the effects of solely nonexertional impairments on the range of work a person can do. Likewise, the VE can testify about the erosion of the job base caused by all of your medical conditions.
HIRE AN ATTORNEY WITH EXPERIENCE TO HELP YOU
Unfortunately, if you do not hire an attorney to help you, you will probably lose your case. Most cases turn on the VE’s testimony at the hearing. If you are not capable of questioning the VE, you will not win. The judge relies on the VE’s testimony. So, you need to be able to prove, using VE testimony, that you cannot work. An attorney can make sure that all of your symptoms are taken into account in the VE’s testimony.
Also, the attorney who has experience is familiar with the jobs in the national economy. If the attorney has experience, then they also know what jobs the VE is likely to say that you can do. This part of the hearing is difficult. Trying to do it yourself will not work. If nothing else, you should hire an attorney to represent you if the Judge has called a VE to your hearing.
SUBMIT ALL OF YOUR ANAL CANCER MEDICAL RECORDS
Prior to your hearing, you can review the medical experts resume. If an ME is going to testify at your hearing, then they must submit a resume to the court. Your attorney can review the resume of the medical expert. They can also object to the appearance of the ME. Remember, at the hearing, the burden to prove that you deserve benefits is on you.
There are firm time lines in which you must submit your medical records. The SSA rule states that all medical records must be sent to the judge five days prior to your hearing. This means five “working” days. In other words, you must submit all medical records SEVEN days prior to a hearing. If you submit evidence past the seven days, then you must have a good reason as to why you did not submit the records on time. Learn more about the SSA evidence hearing rules.
Remember, everything must be in the SSA record one week prior to the hearing. There are good reasons for this rule. The SSA is dealing with thousands of hearings across the nation. It helps the SSA to have the evidence so the judge and experts can review it. The bottom line is this: one week prior to the hearing is the final date for you to submit all of your medical records. You need to do this even if you have lung cancer or breast cancer. If you have an attorney to help you do this, it will help your case.
WHAT WE DO TO HELP YOU WIN SSDI AND SSI BENEFITS
If you have anal cancer, then you need help to apply for Social Security benefits. You can always call our law firm and we will help you. We can help you file your application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSDI and SSI benefits
- Inform the SSA they should pay your benefits under the Compassionate Allowance Rules
- Appeal if you receive an initial denial from DDS
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing and question the witnesses
- Read more about job experts
- Learn more about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you don’t send it back, the SSA will not process your application. Sign it and send it back as soon as you can.
HIRE US FOR OUR YEARS OF LEGAL EXPERIENCE
If you have anal cancer or cancer of the large intestine, then you need to hire a law firm with experience to help you win your benefits. We are one of the best Social Security law firms in the country. We are one of the best Social Security benefits firm in Las Vegas, Nevada. Also, we are one of the best Social Security law firms in Salt Lake City, Utah.
Learn more about Utah SSD benefits here. Nevada SSI Information is on this website. We also represent clients in Idaho. For Idaho benefits read here. Find out more about Colorado SSDI benefits. Likewise, if you are from California, read about California SSD & SSI information.
Over the last 30 years, we have won thousands of SSDI and SSI claims. Additionally, we have won over $100 million in SSD and SSI benefits for our clients. It has become more difficult to win Social Security cases. Also, SSA’s listing rules are harder to meet. That is why you need an attorney who will help you win your case.
We recommend you do not go to your hearing without an attorney. Why? Because a lawyer can prepare you for your hearing. She can explain the judge’s questions. Preparation will help you win your case.
Those who come to the hearing without counsel are usually not successful in winning benefits. You should hire an attorney who has legal experience winning SSD and SSI benefits. Contact Cannon Disability Law today. We can help you win benefits for anal cancer. Call us today and ask us for a free review of your case.
