For more than a decade, Daniel Garza had been urging others to keep an eye on their health.
In 2000, the actor and California native learned he had human immunodeficiency virus (HIV), a virus that attacks the body’s immune system and leaves it unable to fight off foreign invaders.
In the wake of his diagnosis, Garza dedicated his free time to being an advocate for HIV prevention, urging at-risk groups, such as drug users and gay men, to get tested and stay on top of treatment regimens.
What he didn’t know was that HIV had put him at a significantly greater risk of developing anal cancer, which memorably killed Charlie’s Angels star Farrah Fawcett in 2009 and is most often caused by sexually transmitted infections.
For many of the 11,000 Americans diagnosed with the disease every year, the symptoms begin subtly. They can include dabs of blood on toilet paper after a bowel movement and lingering abdominal pain.
This was the case for Garza, who noticed specks of blood and intense pressure with bowel movements in the spring of 2014. Over the next few weeks, Garza, who was 45 at the time, became bloated and was in so much abdominal pain that he was limited to a ‘practically all liquid diet.’
Still, and contrary to what you might expect for cancer patients, he actually packed on weight, going from about 150lbs to 170lbs in a matter of months, despite exercising regularly and hardly eating.
Roughly one year later, Garza underwent surgery for a hernia. At a follow-up appointment after the surgery, doctors felt a mass in his anal sphincter, a group of muscles that help release stool from the rectum.
Daniel Garza (pictured) was diagnosed with anal cancer in 2015. Doctors believe HIV had increased his risk
On May 5, 2015, a colonoscopy and biopsy revealed stage two anal squamous cell carcinoma, which makes up nine in 10 anal cancer cases.
For early stages such as this, where the anal cancer has not spread, the five-year survival rate is 85 percent, according to the American Cancer Society. If it spreads, however, that rate drops to 36 percent.
Despite spending 15 years advocating for HIV awareness and risk factors, Garza was blindsided, never envisioning the disease could cause cancer.
Studies show HIV can raise the risk of several forms of cancer, including anal cancer, because of its effects on the immune system.
HIV has also been shown to increase the risk of contracting human papillomavirus (HPV), another sexually transmitted infection that causes more than nine in 10 cases of anal cancer. Garza believes he acquired HPV at some point in the early 2000s.
Research also estimates that men who have sex with men, such as Garza, are up to 20 times more likely to be diagnosed with anal cancer, as HPV can be transmitted to the anus through anal sex.
‘After all these years of doing education and prevention and advocacy, I had never heard of the cancers that were associated with HIV,’ Garza, now 55, told the Daily Mail.
‘I didn’t know that. I’ve never heard it talked about. It was never brought up. As gay and Latino men, we don’t talk about any cancers below the belt, and it just never came up.’
Each year, anal cancer affects about 11,000 Americans, roughly 70 percent of whom are women due to a higher likelihood of contracting HPV. Anal cancer kills just under 2,200 people, with an even split between men and women.
The overall risk of being diagnosed with the disease is about one in 500, according to the American Cancer Society, and it accounts for just 0.5 percent of all new cancer cases.
Data from the National Cancer Institute (NCI) estimates 30 percent of anal cancer patients are between 55 and 64 years old, and the average age at diagnosis is 64. However, HIV is most often diagnosed in people between the ages of 25 and 34, which could be contributing to anal cancer in people under 50.
Pictured: Garza during his cancer treatments. He is now cancer-free, but the disease caused him to lose half of his anal sphincter
The above graph from the American Cancer Society shows the gradual increase in anal cancer cases from 1975 through 2023, the latest data available
Anal cancer in the US saw an average yearly increase of three percent from 2001 to 2015. Federal data suggests there was a 46 percent surge between 2005 and 2018, largely among older people who did not get the opportunity to be vaccinated for HPV when they were younger.
The HPV vaccine was first introduced in 2006 and was only recommended for girls and women between the ages of nine and 26. It was approved for boys in 2009. The recommended age range meant that much of the still-vulnerable, older population missed out.
HPV can also lay dormant for decades, which may be fueling an increase of anal cancer in people in their 50s and 60s.
After his diagnosis, Garza immediately went into advocate mode and began documenting parts of his cancer journey. He made a series of YouTube videos for the first 30 days after his diagnosis, which went up until he shaved his head before receiving chemotherapy.
‘That side of me was like, “Yes, let’s do this. Let’s talk about this,”‘ he told the Daily Mail. ‘If I didn’t know how to start the conversation, there was going to be millions of people out there that don’t know how to either, we need to learn together.
‘But the other part of me, as a Latino gay man, did feel some shame.’
When Fawcett died of anal cancer at age 62, it sparked an overwhelming amount of speculation from fans and tabloids about her sex life. Anal cancer was long seen as taboo and inherently tied to sexuality and sex habits.
Pictured: Garza (right) with his partner, Christian (left). Garza told the Daily Mail that he struggled with feelings of shame after being diagnosed with anal cancer
The above graph from a 2022 study in the Journal of Clinical Oncology shows an increase in anal cancer in men and women above the age of 50 in 2014 – 2018 compared to 2001 – 2005
Garza also told the Daily Mail that he worried damage to his anus from cancer and treatments could impact intimacy with his longtime partner.
‘It’s a lot of trauma,’ he said. ‘It’s part of our identity, so I developed some shame and some stigma. There was a time where I was like, “Is this my fault? Is this the punishment for my sexuality?”‘
Garza started treatment in late May 2015, which included 38 rounds of radiation, weekly chemotherapy and 40 rounds of hyperbaric oxygen therapy (HBOT).
HBOT involves lying flat in a chamber with up to three times more air pressure than normal. The goal is to breathe pure oxygen, allowing the blood to carry more of it than usual to damaged tissues and accelerate healing.
While lifesaving, the radiation used to destroy his cancer caused Garza to lose half of his anal sphincter. This may later lead to pain and issues controlling bowel movements. To combat this, Garza was fitted in April 2016 with an ostomy bag, which diverts waste from the digestive tract through an opening in the abdomen.
Garza stayed on maintenance treatments until 2017, when he was declared cancer free. Doctors believe his chance of the cancer returning is slim, but he undergoes regular blood tests to check for elevated tumor markers like carcinoembryonic antigen (CEA) and to keep an eye on his HIV.
Garza said anal cancer has, however, changed his relationship with his partner, who was also his main caregiver during treatments.
Garza has now shifted his advocacy work to focus on both HIV and anal cancer. He is the director of outreach at Cheeky Charity
‘When a partner becomes a caregiver, there is this new connection between the patient and the caregiver, because you have to put aside the relationship part,’ Garza told the Daily Mail. ‘It changed the way we saw each other mentally because we both went through this journey together.’
Damage to Garza’s body has also made intimacy a challenge for the couple, though he said they have adapted.
Garza has also shifted his advocacy work to focus not just on HIV but on anal cancer and other forms of the disease that are more prevalent among the HIV-positive community.
‘I participate in HIV conferences, I go to cancer conferences,’ he said. ‘I’ve done some research and study conferences. I’ve added information about HPV, mental health, body dysmorphia, sexuality – my story has grown.’
He also encouraged others experiencing symptoms like anal bleeding, abdominal pain and bloating to seek a second opinion if they feel dismissed.
‘Don’t ignore the signs,’ he told the Daily Mail. ‘If you know something’s going on and you’ve done all the recommendations and it’s still happening, get a second opinion. It’s okay to offend your doctor a bit, as long as it’s about your body.’
