Steve Rothaus' Gay South Florida

Broward hair transplant surgeon accused of HIV bias

A Hialeah man who is HIV-positive has filed suit against a Broward hair transplant surgeon, claiming he was illegally denied a treatment because of his illness.

BY DAVID SMILEY, dsmiley@MiamiHerald.com

Diego Del Rio thought he had finally found his Fountain of Youth.

Tucked between advertisements for Gay Days and pictures of scantily clad men, the 28-year-old from Hialeah says he saw an ad that brought him back nine years to the last time he could run his hand through a full head of hair.

The ad, Del Rio says, was for a Fort Lauderdale doctor who claims to perform hair transplant surgeries comprehensive enough to finish the job most times in one shot, rather than two or three.

Already the recipient of one mildly successful hair transplant, Del Rio said he jumped at the chance for a second and hopefully final surgery under the hands of Dr. Brett Bolton.

But two months later, Del Rio is spending the money he saved for a transplant on an attorney and is headed not toward rejuvenation but litigation.

In a lawsuit filed this week, Del Rio says he was refused a hair transplant by Bolton of the Age Defying Surgical Center on the grounds that Del Rio is HIV-positive.

According to the suit, the two men met June 3 and Del Rio, who has been HIV-positive the last eight years, allegedly discussed the procedure with Bolton, underwent a brief scalp examination and told him about his condition.

The complaint states that Bolton told Del Rio he would contact him June 5 with a price.

But Del Rio says June 5 came and there was no call. After a series of calls to the center, he says, a ''staffing medical coordinator'' told him over the phone that the office would not treat him due to a policy concerning patients with a history of HIV or Hepatitis.

Del Rio, who is suing for $15,000 or more in damages, said he has never been ''belittled and disrespected'' like he was by Bolton and his staff.

''He just turned around and said our policy is we do not accept any patients that have HIV or a history of hepatitis,'' Del Rio said. ``I was completely perplexed. Just because I'm an HIV positive individual doesn't make me less of an individual than anyone else.''

Bolton, who according to his website has specialized in hair transplant surgeries since 1997, did not respond to a message left Wednesday at his office. His attorney, Gabriel Imperato, also did not return a message seeking comment.

According to the Florida Health Department, state laws prohibit discriminating against a patient solely on the basis of illness.

Department spokeswoman Eulinda Smith, speaking generally about state regulations, said a doctor can use case-by-case judgment on whether a patient can receive treatment.

However, she said denying someone treatment simply because he is HIV-positive is against state law.

''HIV patients are covered under the Americans with Disabilities Act,'' said Smith.

``They can not be denied any service solely on the fact that they are HIV positive.''

Del Rio, according to the complaint, told Bolton he was healthy enough to undergo the procedure without complications.

Del Rio's attorney, Matthew Dietz, said that as a doctor, Bolton is guilty of practicing by old wives' tales that plagued HIV and AIDS patients decades ago.

''This goes back to when I was a teen and people were concerned about being near somebody with AIDS or sharing a cup or seat -- myths that were prevalent in the 1980s,'' he said.

``To have a doctor with a medical profession license in Florida give any credence to that is absolutely outrageous.''

At 54, Cleve Jones is ready for his comeback

By LISA LEFF, Associated Press

PALM SPRINGS, Calif. -- Cleve Jones is happy. As happy as he has ever been, thank you. He has a labor union job he loves, powerful allies in Hollywood and Washington, guys to date. Best of all, a new generation of gay activists has embraced him as the mentor he once had, the man whose story he helped deliver to the screen in the movie "Milk."

Call it a cultural confluence, call it a comeback. Now 54 and the closest the gay rights movement has to a living legend, the former protege to a political martyr and creator of the AIDS Memorial Quilt is busily planning his next act - a march on the nation's capital that he hopes will usher in the final era in his community's struggle for acceptance.

"There was a time when I thought I would never be happy again," Jones says, standing barefoot in the tiki-torched yard of the California desert bungalow where he has lived since 1999 but is rarely home long enough to enjoy. "I feel so connected to the movement again."

That he feels compelled to comment on his good fortune says a lot about the twists Jones' own life took after 1978, the year openly gay San Francisco Supervisor Harvey Milk was assassinated.

Culture watchers will remember that Jones, the 23-year-old City Hall intern portrayed in "Milk," went on to create the 47,000-panel quilt that humanized the lives lost to AIDS. Less widely known is that during the decade he spent weaving one of the world's largest folk art projects into the nation's fabric, Jones was preparing to die himself.

Instead, he became one of the AIDS epidemic's earliest survivors.

"If I'd known I was going to live this long, I would have saved money and joined a gym," laughs Jones, who shows the puckish sense of humor actor Emile Hirsch exhibited as his on-screen alter-ego.

When talk turns to the National Equality March scheduled for the second week of October in Washington, however, Jones turns serious.

His goal is to build an army of activists drawn from each of the nation's 435 congressional districts. Afterward, participants will be sent home to pressure their representatives and the White House into removing the remaining barriers to gay equality, such as the policy that prevents gays from serving openly in the military.

If successful, Jones' vision would represent a sea change in the gay rights movement's strategy of securing victories piecemeal on the local or state level.

"We got locked into this pattern of fighting for fractions of crumbs - 'Oh please, sir, in this county could we please not be fired for being gay if it's all right in this county for you to evict us for being gay?'" he says. "It's been this ping-pong with our basic civil rights....If you are a free and equal people, why would you settle for this?"

Jones agreed to organize the march at the urging of veteran activist David Mixner, who proposed it as a way to lobby President Barack Obama to follow through on his campaign promises.

"When he has a sense of righteousness about a mission, he has a tenacity I have rarely seen," said Mixner, who has known Jones since the 1970s. "He is not a person who has ever put himself before the mission."

Many gay leaders quickly dismissed the march idea as a waste of time and money. Jones took to the Internet and the gay political circuit to address the nay-sayers.

During more than 35 years of activism, friends and associates say that Jones has weathered criticism before.

In 1986, when he was trying to amass support for a giant quilt stitched by people who lost loved ones to AIDS, even fellow activists refused to get on board, according to Jones. Many saw the project as a morbid endeavor that would distract them from the serious work of persuading the government to invest in AIDS research.

Jones persisted. The NAMES Project AIDS Memorial Quilt is now recognized as not only a powerful symbol of loss, but a turning point in the public's perception of the disease.

"I thought who is going to grieve the most when I die? It's going to be my family - my parents, my little sister and my grandmothers. I wanted a place in this movement for my grandmothers," he says.

With his health waning, Jones in 1990 relinquished control of the quilt to a nonprofit foundation that eventually moved the 54-ton quilt to Atlanta. He continued to serve as its public face until five years ago, when tensions between him and the foundation's new leadership bubbled over with his firing and an unsuccessful wrongful termination suit.

In recent years, Jones has worked as a gay community liason for the national hotel workers union, an outgrowth of his activism.

He credits Milk, the middle-aged camera store owner turned politician, with transforming him from a shy and somewhat aimless young hippie into a committed activist unafraid to use his voice or to be open about his sexuality.

"Harvey was never a shadow to me. He was an inspiration, a light. His biggest gift to me was to not fear straight people," he said.

Jones' determination not to let Milk's legacy fade was key in getting the movie made, said screenwriter Dustin Lance Black, who won an Oscar for his work on the film. Jones served as the movie's historical adviser.

"Cleve never lost his belief in the power of the grass roots," Black says. "I remember when I first met him, over those first few years of research and even when shooting 'Milk' he would say, 'What is your generation doing? I can't imagine how empty it must be not to have a really strong generational purpose.'"

In Jones, Black sees an heir to Milk's role as an inspirational leader. "Milk" opened last November just before the 30th anniversary of Milk's assassination and just after California voters passed a ballot measure rescinding the right to wed the state Supreme Court had granted gays five months earlier.

For weeks, young activists protested in major cities across the country.

"I saw this man's eyes light up in a way I had never seen," Black says of Jones. "I saw him come to life when the young people started to rise up. I think he recognized in them a purpose he hadn't seen since his own days with Harvey Milk."

Caption:

Gay rights activist Cleve Jones poses for a portrait at his home in Palm Springs, Calif. Jones goal is to build an army of activists drawn from each of the nation's 435 congressional districts. Afterward, participants will be sent home to pressure their representatives and the White House into removing the remaining barriers to gay equality, such as the policy that prevents gays from serving openly in the military. Philip Scott Andrews, file / AP Photo

Ros-Lehtinen to co-sponsor bill requiring health insurance plans to cover routine HIV tests

News release from U,S. Rep Ileana Ros-Lehtinen:

Washington, D.C. --- Congresswoman Ileana Ros-Lehtinen, a senior member of the Florida congressional delegation, is pleased to co-sponsor the “Routine HIV Screening Coverage Act” that would require health insurance companies to cover routine HIV tests. Congresswoman Ros-Lehtinen believes that this bill will help control the spread of HIV and she is working on getting other co-sponsors.

Current health insurance plans generally cover HIV screening when there are clinical indications of infection or when known risk factors are present. This legislation would require insurance plans to cover routine tests under the same terms and conditions as other routine screenings.

The Routine HIV Screening Coverage Act of 2009 would:

-       Require that all health insurance plans cover the costs of routine HIV tests for all those between the ages of 13 – 64.

Said Ros-Lehtinen: “I am all too familiar with the rising spread of HIV/AIDS in my home state of Florida and indeed my own Congressional District, which includes Miami Beach. This legislation will provide Americans with the financial means to get tested and know their status and thus prevent further infections. I have worked to acquire funding for HIV prevention, research, and testing, and I am pleased that such a bill is before the House. I urge my colleagues to support it and help us battle the scourge of HIV/AIDS.”

Aqua Girl 2009 breaks fundraising, attendance records

News release from Aqua Girl:

Aqua Girl continues to shine as the nation’s premier charity women’s week

Miami Beach, FL – After ten years of producing the hottest Women’s fund raising week in the country, the women who steer the Aqua ship stand proud in announcing this year’s most successful Aqua Girl event yet. The annual fundraising week hosted record-breaking numbers with over 9,000 attendees basking in the golden South Florida sun and refreshing in the cool aqua waters of South Beach.

The sputtering economy can’t stop the party for a cause

This year’s festivities launched with a VIP cocktail party, art exhibit and live auction and then dazzled patrons with a variety of social and cultural events including a dive-in movie, pool parties, dance parties, comedy night, a Mother’s Day brunch and T-dance.

Aqua Girl week draws a diverse audience and celebrity entertainers including women of all ages, colors and cultures, all uniting for a good time and more, they know their support is linked to a great cause. With 100 percent of the net proceeds benefiting lesbian, bisexual, and transgender women of South Florida, attendees can feel good that their a part of an organization and event that is changing the lives of South Florida’s LGBT Community.

In addition to this year’s record-breaking attendance, gross proceeds of the event also broke records at $230,000 raised. These crucial dollars will provide financial support and critical resources to dozens of nonprofit organizations and scholarship recipients that share the Foundation’s commitment to promoting the strength, health, equality and visibility, of lesbian, bisexual and transgender women in South Florida.

“The results are outstanding given the current economic environment.” said Aqua Foundation treasurer Yolanda Flores. 

For more information about Aqua Girl, visit www.aquagirl.org

For more information about the Aqua Foundation for Women, visit www.aquafoundation.org

Photos by STEVE ROTHAUS / Miami Herald Staff

United Way conducts online census of South Florida’s gay, lesbian, bisexual, transgender communities

• WLRN-Miami Herald News audio | Steve Rothaus discusses the United Way’s gay-community census

BY STEVE ROTHAUS, srothaus@MiamiHerald.com

United Way of Broward has launched an Internet census to glean detailed information about South Florida's large gay community.

Among the very personal questions asked:

• What sex were you born (and what is your current gender)?

• How many sex partners have you had this year? (And did you practice safe sex?)

• Have you ever suffered physical or mental abuse because of your sexual orientation or gender identity?

The $10,000 nonscientific survey -- funded by the Florida Department of Health -- contains 67 questions ranging from basic demographics to health and community issues, said Dave Wallace, United Way senior development manager and co-chair of the agency's Broward County LGBT Task Group.

The survey, called The Count, is geared to South Florida's ''lesbian, gay, bisexual, transgender and questioning community,'' according to a United Way of Broward website.

''We want to get a clear picture of what we look like in the community [and] with that, to build awareness for the issues in the community,'' Wallace said. ``With the hard data we get from this, that will help get funding for programs. Without that data it's hard to justify getting funding dollars to South Florida.''

The U.S. Census asks few gay-oriented questions. In 2000, Americans were asked for the first time if they lived with domestic partners. Recently, the Obama administration instructed Census officials in 2010 to count same-sex couples married in states where it's legal.

The Broward survey, patterned after a similar census by United Way of Central Ohio, seeks to reach many more people than just those who are partnered.

It's not easy finding everyone, Wallace said.

'You don't know who they are. You can't call 300 registered voters and say, `Are you gay? We'd like to ask you a few questions about that,' '' he said. ``A lot of people in the LGBT community are hidden. They don't all go to the bars.''

The survey, which began June 21 and takes about 15 minutes to complete, will remain online through September at www.lgbtcensus.com. Wallace encouraged all gay people living from Miami-Dade to Palm Beach counties to take it.

Wallace says the survey is completely anonymous. ''The only specific information we're going to get out of a person is their Zip code,'' he said.

The survey is co-sponsored by several groups and agencies including the Gay & Lesbian Community Center of South Florida, Broward Health Department, SunServe and Broward House.

''It will give us information to better tailor our programs to help people in the community,'' said Terry DeCarlo of Broward House, the county's oldest and largest AIDS service organization.

DeCarlo said it's important for his agency to know exactly what gay residents' sexual practices are, whether they have safe sex and whether they've been tested recently for HIV.

''People have to answer honestly. That's a very important part,'' said DeCarlo, who also assures that no one taking the survey will be identified by their Internet addresses.

''The police are not going to come knocking at your door,'' DeCarlo said.

Gay Survey Questions

These are a few of the questions and topics on the United Way of Broward's gay survey:

• Who are you attracted to sexually? (Only men, only women, mostly men, mostly women, men and women, nonsexual, self-defined, not sure)
• What is your current employment status? How LGBT friendly do you consider your workplace?
• What is your annual household income before taxes? Approximately how much money did you donate and/or how many hours did you volunteer to charity last year?
• What is your religious background or affiliation? How active are you in your faith community?
• Drug and alcohol use in the last 30 days
• What is your HIV status and how many sex partners did you have last year?
• Have you ever been a victim of physical violence based on your sexual orientation, gender, gender expression and/or gender identity?

HRC: Enactment of regulation ending HIV travel and immigration ban imminent

News release from Human Rights Campaign (HRC):

“We are one important step closer to finally ending this discriminatory ban once and for all,” said HRC President Joe Solmonese

WASHINGTON – The Human Rights Campaign, the nation’s largest lesbian, gay, bisexual and transgender (LGBT) civil rights organization, responded to the Office of Management and Budget indicating that they have completed review of a proposed regulation which would remove the remaining barrier to HIV-positive visitors and immigrants.  The proposal, which OMB indicates would remove HIV from the list of communicable diseases that bar foreign nationals from entering the United States, is expected to be published on Tuesday, June 30, in the Federal Register and open for a period of public comment.  After reviewing those comments, the Department of Health and Human Services will issue a final regulation.

“We are one important step closer to finally ending this discriminatory ban once and for all,” said Human Rights Campaign President Joe Solmonese.  “This regulation is unnecessary, ineffective and lacks any public health justification.  We are confident that this sad chapter in our nation’s treatment of people with HIV and AIDS will soon be closed.”

In July 2008, President Bush signed into law, as part of the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR), a provision that removed the ban from statute and returned regulatory authority to the Secretary of Health and Human Services to determine whether HIV should remain on a list of communicable diseases that bar foreign nationals from entering the United States.  

HRC has been a lead organization lobbying on Capitol Hill for the statutory repeal and working to ensure that Department of Health and Human Services’ regulations were changed.  The Human Rights Campaign worked closely with the offices of Senator John Kerry (D-MA) and former Senator Gordon Smith (R-OR), as well as Rep. Barbara Lee (D-CA), the sponsors of the effort in Congress last year to repeal the ban.  Since passage of the PEPFAR bill, HRC has lobbied both the Bush and Obama administrations to remove the remaining regulatory ban.   

The current travel and immigration ban prohibits HIV-positive foreign nationals from entering the U.S. unless they obtain a special waiver, which is difficult to obtain and can only allow for short-term travel.  Current policy also prevents the vast majority of foreign nationals with HIV from obtaining legal permanent residency in the United States.  The ban originated in 1987, and was explicitly codified by Congress in 1993, despite efforts in the public health community to remove the ban when Congress reformed U.S. immigration law in the early 1990s.  While immigration law currently excludes foreigners with any “communicable disease of public health significance” from entering the U.S., only HIV was explicitly named in the statute. 

The Human Rights Campaign is America’s largest civil rights organization working to achieve lesbian, gay, bisexual and transgender equality. By inspiring and engaging all Americans, HRC strives to end discrimination against LGBT citizens and realize a nation that achieves fundamental fairness and equality for all.

Video | BroadwayWorld.com: Broadway Bares 19.0 'Click It' Highlights

From BroadwayWorld.com

HRC: Obama administration moves forward on ending HIV travel and immigration ban

News release from Human Rights Campaign (HRC):

“We are one important step closer to finally ending this discriminatory ban once and for all,” said HRC President Joe Solmonese

WASHINGTON – The Human Rights Campaign, the nation’s largest lesbian, gay, bisexual and transgender (LGBT) civil rights organization, responded today to the Office of Management and Budget indicating that they have completed review of a proposed regulation which would remove the remaining barrier to HIV-positive visitors and immigrants.  The proposal, which OMB indicates would remove HIV from the list of communicable diseases that bar foreign nationals from entering the United States, will now be published in the Federal Register and open for a period of public comment.  After reviewing those comments, the Department of Health and Human Services will issue a final regulation.

“We are one important step closer to finally ending this discriminatory ban once and for all,” said Human Rights Campaign President Joe Solmonese.  “This regulation is unnecessary, ineffective and lacks any public health justification.  We are confident that this sad chapter in our nation’s treatment of people with HIV and AIDS will soon be closed.”

In July 2008, President Bush signed into law, as part of the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR), a provision that removed the ban from statute and returned regulatory authority to the Secretary of Health and Human Services to determine whether HIV should remain on a list of communicable diseases that bar foreign nationals from entering the United States.  

HRC has been a lead organization lobbying on Capitol Hill for the statutory repeal and working to ensure that Department of Health and Human Services’ regulations were changed.  The Human Rights Campaign worked closely with the offices of Senator John Kerry (D-MA) and former Senator Gordon Smith (R-OR), as well as Rep. Barbara Lee (D-CA), the sponsors of the effort in Congress last year to repeal the ban.  Since passage of the PEPFAR bill, HRC has lobbied both the Bush and Obama administrations to remove the remaining regulatory ban.   

The current travel and immigration ban prohibits HIV-positive foreign nationals from entering the U.S. unless they obtain a special waiver, which is difficult to obtain and can only allow for short-term travel.  Current policy also prevents the vast majority of foreign nationals with HIV from obtaining legal permanent residency in the United States.  The ban originated in 1987, and was explicitly codified by Congress in 1993, despite efforts in the public health community to remove the ban when Congress reformed U.S. immigration law in the early 1990s.  While immigration law currently excludes foreigners with any “communicable disease of public health significance” from entering the U.S., only HIV was explicitly named in the statute. 

The Human Rights Campaign is America’s largest civil rights organization working to achieve lesbian, gay, bisexual and transgender equality. By inspiring and engaging all Americans, HRC strives to end discrimination against LGBT citizens and realize a nation that achieves fundamental fairness and equality for all.

National Gay and Lesbian Task Force heads up major policy change project

News release from the National Gay and Lesbian Task Force:

National collaboration of organizations launches New Beginning Initiative to advocate for pro-lesbian, gay, bisexual and transgender federal policy changes

WASHINGTON, June 25 — The National Gay and Lesbian Task Force and a collaboration of expert organizations today announced the New Beginning Initiative, designed to push for concrete federal administration policy and regulatory changes directly benefiting the lives of lesbian, gay, bisexual and transgender (LGBT) people and eliminating discrimination from federal policies.

The initiative, which is an outcome of the National Policy Roundtable with organizations opting into the initiative, began more than a year ago in preparation of a more LGBT-favorable administration. The more than 80 initial policies identified and recommended for changes span the authority of the White House and more than 30 federal agencies. The recommendations focus on pro-LGBT public policy changes the Obama administration can implement without legislative action. The New Beginning Initiative is the first time such a coalition of LGBT and allied organizations has come together in this way to affect administration policy. Organizations participating in the initiative are listed here.

“We have an unprecedented opportunity to push the federal government for policy changes that will directly improve the quality of life for LGBT people and families. It is time for the government to step up and fulfill the promise of full equality,” says Rea Carey, executive director of the National Gay and Lesbian Task Force. “By leveraging the expertise and resources of so many and advocating for these changes, we can directly challenge long-standing government-supported discrimination and get federal dollars and attention flowing to vital community services and support for LGBT people across the country. Already, progress is being made on a number of policies in the initiative, including last week’s Census Bureau decision to reverse its previous policy and now count married same-sex couples in the 2010 census.”

The New Beginning Initiative, funded through the generous support of the Open Society Institute, includes concrete policy changes written by the respective participating organizations. Each organization will identify the strategies for accomplishing the respective policy changes it is working on in the coming months and years. The 80-plus policies represent an initial view of the opportunities for federal funding and programmatic attention; additional policy changes will be identified over time.

Examples of the recommended policy changes are:

• Amending the nondiscrimination guidelines for the federal civilian workforce to include gender identity and expression.
• Funding to reduce violence in schools, including preventing bullying and harassment based on sexual orientation and gender identity.
• Including sexual orientation and gender identity categories as a designated and mandated component of federally funded aging research and data collection.
• Ensuring LGBT people are recognized as a population marked by health disparities for appropriate inclusion in federally funded studies.
• Requiring the office of Housing and Urban Development to recognize unaccompanied homeless youth as a special-needs population requiring the development of targeted youth housing models.
• Encouraging U.S. diplomatic engagement on international LGBT issues as legitimate human rights concerns.

Copies of the initial policies identified and recommended for changes were provided to the Obama transition team in November 2008 for inclusion in agency memos for incoming administration personnel. Copies have also been provided to key White House staff in the process of identifying administration and agency staff with authority to change policies and to educate White House staff on the issues facing LGBT people and families.

Participating organizations have already begun meeting with administration officials to pursue some of the policy changes. A meeting of the participating organizations will be held over the summer to map out plans for each recommended policy. As the collaborating organizations succeed in changing policies, press releases will be sent out notifying the LGBT community and broader public about progress made. Additionally, the New Beginning Initiative’s Web page features an electronic scorecard to track progress as policy changes are achieved.

For more information about the New Beginning Initiative, go here.

Organizations participating in the initiative launch (listed alphabetically): Council for Global Equality; Family Equality Council; Gay & Lesbian Advocates & Defenders; Gay, Lesbian and Straight Education Network; Immigration Equality; Lambda Legal; Mautner Project; National Black Justice Coalition; National Center for Lesbian Rights; National Coalition for LGBT Health; National Gay and Lesbian Chamber of Commerce; National Gay and Lesbian Task Force; National Youth Advocacy Coalition; Parents, Families and Friends of Lesbians and Gays; Services and Advocacy for GLBT Elders (SAGE); Servicemembers Legal Defense Network; The Trevor Project. Disclaimer: Each policy proposal should be considered the proposal of the organization(s) responsible for drafting the proposal. There should be no assumption that all organizations adopt, agree with or would prioritize the policies in the same way.

The National Policy Roundtable, established in 1997 and convened by the National Gay and Lesbian Task Force, is a forum for more than 35 institutional leaders to discuss and coordinate public policy strategy related to LGBT issues.

Anal cancer that killed Farrah Fawcett more common in gay men, some doctors believe

BY FRED TASKER, ftasker@MiamiHerald.com

After a lifetime of Hollywood success, actress Farrah Fawcett had the misfortune to die from one of the rarest malignancies, anal cancer.

It's a cancer that struck 5,070 Americans in 2008, compared with 40,740 cases of rectal cancer, 108,070 cases of colon cancer, 184,450 cases of breast cancer and 215,020 cases of lung cancer.

It's so rare, doctors say, that many caregivers don't routinely screen for it and many patients don't notice it until it reaches advanced stages.

''Early on, the patient often doesn't feel anything or know anything,'' said Dr. Michael Hellinger, colorectal surgeon at Mt. Sinai Hospital in Miami Beach. ``As it advances, with rectal bleeding, a little lump, people sometimes think it's hemorrhoids.''

That's tragic, because when anal cancer is caught early, before it has spread to lymph nodes, liver or lungs, the five-year survival rate is 82 percent, according to the American Cancer Society.

The survival rate drops to 60 percent if it has spread to surrounding lymph nodes, 20 percent if it spreads to lungs, liver or other organs. The anus is the opening at the lower end of the digestive tract through which solid waste is excreted. Above it is the rectum, then the colon.

Among patients under 50, anal cancer is more common in men; after 50, it is more common in women. It occurs more often in smokers, people who have many sexual partners, have receptive anal intercourse or have a weakened immune system, the American Cancer Society says.

Some doctors believe that means it's more common among men who have sex with men and have anal intercourse, Hellinger says. ``But that's never been statistically proven. Studies have never been done to look at that.''

Another cause can be chronic infection with the human papilloma virus, in both men and women. HPV can be spread by either straight or gay sex, Hellinger said. And while it can be slowed among women who take the HPV vaccine to avoid cervical cancer, the vaccine never has been studied in men, and men are not routinely vaccinated.

When anal cancer is diagnosed, the standard care is chemotherapy and radiation. Until the 1970s the standard treatment was a ''radical abdominal perineal resection,'' Hellinger said, in which the entire rectum and anal canal are removed, requiring the patient to wear an external colostomy bag.

In her TV program, Farrah's Story, videotaped by Fawcett and her friends and broadcast on NBC on May 15, she made two statements that have led some to question her decisions about her own care.

First, she says her UCLA doctors wanted to do the radical surgery after the cancer had spread to her lymph nodes and liver. Instead, she traveled to Germany and found a surgeon willing to remove the tumor without the wider operation.

Second, until the final months, she insisted that any chemotherapy she was given involved drugs that would not cause her famous hair to fall out.

Hellinger declined to speculate on those decisions.

''It's impossible to judge without more information,'' he said.