By Sara Bondell
It’s been 10 years since actress Farrah Fawcett passed away from anal cancer. Originally diagnosed with the disease in 2006, she was declared cancer-free the following year. However, the cancer returned a few months later and had metastasized to her liver. She died at the age of 62.
Anal cancer is fairly rare. This year, the American Cancer Society estimates 8,300 men and women will be diagnosed with the disease. Dr. Julian Sanchez, a surgeon in Moffitt Cancer Center’s Gastrointestinal Oncology Clinic, says anal cancer primarily affects postmenopausal women and almost all cases are caused by the human papillomavirus (HPV). HIV-positive patients as well as sexually active gay men are at higher risk for anal cancer.
“HPV is much like many other viruses in the body that never really go away,” said Sanchez. “You get the initial infection when you’re young and then as you age, the virus can resurface. If you have HPV, the body is usually able to keep the virus at bay until it reappears later in life. It can manifest first as a small bump or genital wart, but can come back as a tumor.”
If caught early, Sanchez says anal cancer is very treatable. Most commonly treated with chemotherapy and radiation, early or middle-stage disease has about an 80 to 95% five-year survival rate.
In Fawcett’s case, friends of the actress say she had been exhibiting symptoms for a long period of time before seeing a doctor. “Putting diagnosis and treatment on the back burner led to the poor prognosis,” Sanchez said. “These symptoms usually do not develop overnight. Often patients will have symptoms such as pain and bleeding.”
If anal cancer is not treated early and effectively, the survival odds decrease and patients usually have to have major surgery to remove their anus and rectum. They will also need a permanent colostomy bag, a small pouch that collects waste from the body.
While there are currently no screening guidelines for anal cancer, Sanchez says it’s important to be self-aware and not let any symptoms fester. He recommends routine checkups, including rectal and cervical exams and Pap smears.
Moffitt is pioneering a screening clinic for high-risk patients such as HIV-positive patients and gay men. This first-of-its-kind clinic in the Tampa Bay area partnered with community physicians and the Hillsborough County Health Department to provide anal Pap smears and risk-reducing high-resolution anoscopy therapy.
“The most important thing is prevention,” said Sanchez. “We can’t eradicate HPV, but we can prevent it with a vaccine. The HPV vaccine can prevent the next generation from developing cervical, penile, oropharyngeal and anal cancers.”
Sanchez says it’s also important to raise awareness about the disease. “There are so many myths about anal cancer,” he said. “Most people don’t want to see a doctor or even call it anal cancer because they think there’s a negative connotation associated with it — one that evokes promiscuity or blame on previous partners or spouses. We need to dispel these myths.”