So my name is Mary Guevara. I am 39 years old. I live in Buffalo, New York, with my husband and my two daughters. My girls are 13 and 12. I am an elementary school teacher, so that consumes most of my week. And being a mom does too. My girls are athletes, three-sport athletes actually. And I love to read and just spend time at home.

I was first diagnosed at 35, which was back in 2020 when the world had shut down for COVID, and it added a whole different level of challenge on to a cancer diagnosis. I was diagnosed with stage 3 anal cancer. The symptoms that I was experiencing included bleeding while using the bathroom. I had severe itching and just some pain while having a bowel movement. And I had brought all of those symptoms to the attention of my primary and my Ob Gyn. And I was young. So at 35, they kept just telling me that I had had two kids, I had my daughters 16 months apart, and it was hemorrhoids. But I called my primary again to say that something was really wrong. He then directed me to a colorectal surgeon in the area who brought me in right away.

Many doctor's offices at the time were denying patients and saying they were only taking emergencies, but I—this qualified as an emergency. So he brought me in and took a look and immediately told me I needed a colonoscopy, which I had, I think it was only like three days later. And he went in and he told my husband when I had come out of my colonoscopy that I did have a polyp. That's what he called it, even though it was three centimeters. He removed it, and told him he did not feel it was cancer. Cancer usually presents as hard, and this was more of like a fatty tissue when he removed it. And he said he didn't think anything of it, but was sending it to pathology.

And then I went the weekend, and Monday I was at work in my classroom. My Apple Watch indicated that I had a notification in my patient portal where it had told me that it was in fact squamous cell carcinoma. I opted for oral chemo, so I was taking six chemo pills a day. Three in the morning, then I would go to radiation, then I would take three at night. Then, because my anal cancer was so advanced, there was at the time a clinical trial going on that my hospital recommended I try to get accepted for. So I volunteered and I signed the paperwork, and I was picked for a clinical trial as well. So after my treatment—six weeks of chemoradiation—I then did six months of immunotherapy.

I feel like there was a little bit of trauma that came along with my cancer diagnosis in the fact that I had expressed my concerns to my doctors for many years, and, you know, nobody caught this. I have learned a huge lesson from it in that I don't ever let anyone just tell me what they think is wrong with me, I make them confirm what's wrong with me. So, whether it be asking for testing or asking for an exam, I've learned at my appointments that I push for that a lot more now because I kind of rolled my dice initially with letting them just tell me it was hemorrhoids, when in fact it was not. And my body was brewing cancer. And by the time it was caught, I mean, I was lucky it was caught when it was.

So the advice I would give to others about speaking up about their symptoms is that…you never want to be too late. I did speak up about my symptoms, I mean, to my family, and then to my doctors. My sister said, no, you need to tell your doctor about that symptom, and those are big symptoms. And I did. But again, nobody ever confirmed what they thought. So my advice would be: have the conversations, demand the testing, demand an exam. No one should be embarrassed to tell their doctors what they're feeling. Doctors do this day in and day out. That's what they went to school for. That's their passion. That's why they come to work every day. And I know for anal cancer specifically it's sometimes hard to have those conversations because, you know, you're talking about parts of your body that you don't really want to talk about, and you're using words that just feel uncomfortable to say. But talking about your symptoms could essentially save your life.

The biggest thing I found that helped me was to take someone with me to all of my appointments, not only for an extra set of ears, but for… I always joke that they had a scribe for me and write things down, because there's so much information coming at you, you know, at once. And I think my advice to that is also maybe to make that person consistent. I always took the same person with me, which helped because that person then knew everything they needed to know. And it was crucial to just helping me when making decisions or to try, you know, to figure out where I was going next and what I was doing. Like I said, they would write for me, which was huge because I would come home and sometimes I would just be so caught up with the fear and the worry that I forgot, you know, what did he tell me to take or what did they tell me to do? Or, you know, what was their recommendation for this pain or this symptom or issue that I'm having. So having that person with you to kind of help you through that is huge because there's, it's—a lot happens very quickly when you're going through treatment. Well, diagnosis, treatment, and then even life after cancer. It's, it's just very different. And it's hard to understand unless you've actually like walked those shoes.

My advice for anyone fighting anal cancer or just diagnosed with anal cancer is to find that support group. Find the support that works for you, whether it be someone you know in your family or your friend group who's right here physically that can help you through, or like I said, joining some kind of support group that is out there. And it's just so nice to talk to other men and women who have been through this and who can kind of, you know, share their story too, and to know you're not the only one.

So, telling my friends and family about my diagnosis. I didn't hide it. My biggest fear initially was telling my daughters, at the time they were only eight and 10. And I remember asking my husband, do we use the word cancer? But how do you not? I didn't want to shield them from that ugly word because it was our reality at the time, and I needed to be very blunt with them. I find it difficult sometimes to tell people it's anal cancer. They kind of cringe at the word, very cliché. They kind of, you know, seem a little shocked by it. And then when I tell them it's an HPV-related cancer, it usually sparks [actual] questions, because I know so many people are touched by the HPV virus. So I think it, they're kind of like, oh, we hear the stories that HPV can cause cancer, but I don't know anyone that has. So when they hear it, I think it brings that more— it makes it more real. But telling people I had anal cancer is tough.

I look at it this way. I didn't choose where my tumor grew. It did, the tumor chose where it grew, and it chose, you know, the two inches of the anal canal in my body. That's where it, where it grew. And I just have to accept that. And the teacher in me loves to educate, whether it be in my classroom or with this. So I quickly just had to find the comfort with sharing what I had, and what that looked like. And I was pretty open with my journey and with my diagnosis. And I—I tell everybody I'm an open book, if you have questions I am happy, happy to answer them. There's really no question anyone has asked me that I have not been willing to answer. Because there's a lot of people out there that are fighting the fight I fought. And knowledge is power.