What are the symptoms of anal cancer? Farrah Fawcett put disease in spotlight

More than 90% of anal cancer cases are believed to be caused by the human papillomavirus (HPV). Here's what to know about the symptoms and risk factors.

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/ Source: TODAY
By A. Pawlowski

No one talked much about anal cancer until Farrah Fawcett made it her mission to break the silence.

This week marks a decade since the star’s death at the age of 62 after being diagnosed with the disease in 2006. After undergoing chemotherapy and radiation, she was declared cancer-free the following year. But three months later, tests showed the cancer had returned and spread to her liver.

She died on June 25, 2009.

Soon after her diagnosis, Fawcett decided to film her medical journey, with the footage turned into a candid documentary, titled “Farrah’s Story.”

“She hated hearing her name and anal cancer in the same sentence, but it was important for the stigma to be broken. She wanted to raise awareness from the very beginning,” her oncologist Dr. Laurence Piro told People.

“She wanted everyone to see, so that people would be motivated to put money towards research, to get the word out about early detection and prevention.”

“She said, ‘I always thought I might get breast cancer or heart disease but never this’ and she started to cry,” Jaclyn Smith, Fawcett’s co-star in “Charlie's Angels,” told the magazine.

Fawcett started the Farrah Fawcett Foundation, which supports research to find a cure for anal cancer, provides support to patients, and promotes cancer awareness and prevention.

More recently, actress Marcia Cross has also been outspoken about battling the same kind of cancer and urged others to be more open about their symptoms and diagnosis.

"I know there are people who are ashamed. You have cancer!” she told CBS News this month. “Like you did something bad… because it took up residence in your anus? I mean, come on, really.”

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After undergoing radiation and chemotherapy, Cross is feeling back to normal, she said.

What is anal cancer?

It develops when malignant cells form in the tissues of the anus.

About 6,530 people are diagnosed with anal cancer each year, with 91% of the cases believed to be caused by the human papillomavirus (HPV), according to the Centers for Disease Control and Prevention.

How to prevent HPV-related cancers

HPV is the most commonly sexually transmitted infection in the U.S., but it’s important to remember the vast majority of people who have it do not get anal cancer, the American Cancer Society said. HPV also causes almost all cervical cancers and many cancers of the vagina, vulva and penis.

An HPV vaccine is available to protect against harmful strains of the virus and it’s the only vaccine that actually prevents cancer. The earlier you get it, the more effective it is, said Dr. Alanna Levine, a pediatrician and spokeswoman for the American Academy of Pediatrics. She recommended it for both boys and girls. "It's made an incredible difference," she said.

What are the risk factors for anal cancer?

Besides being infected with HPV, the National Cancer Institute says they include:

  • Having many sexual partners
  • Having anal sex
  • Being over 50
  • Experiencing frequent anal redness, swelling, and soreness
  • Having anal fistulas (abnormal openings)
  • Smoking

What are the symptoms?

They can be uncomfortable to talk about with a doctor, but early detection is key:

  • Bleeding from the anus or rectum, which is often the first sign of the disease
  • Pain or pressure in the area around the anus
  • Itching or discharge
  • A lump near the anus
  • A change in bowel movements, like narrowing of stools

How is the cancer diagnosed?

It’s often found when a doctor performs a digital rectal examination — inserting a gloved, lubricated finger into the lower part of the rectum to feel for lumps. That’s how Marcia Cross’ cancer was discovered during a routine medical appointment. She credits it for saving her life.

"You can say, ‘OK this is embarrassing, this is uncomfortable’ and by time you know it, it's over. I mean lots of things in life are not fun. But you can bear it," Cross told CBS News.

Thin, flexible instruments with lights and cameras can also help doctors take a closer look at any suspicious spots and a biopsy can determine if cancer is present.

Imaging scans are used to find if the cancer has spread to other parts of the body.

What is the treatment?

It depends where the tumor is located and whether it has metastasized.

Standard treatment includes radiation, chemotherapy and surgery to remove the tumor. Doctors can also remove the anus, the rectum and part of the colon in a major operation called an abdominoperineal resection. It’s used only if other treatments don’t work or if the cancer comes back after treatment, according to the American Cancer Society.

What is the outlook for patients?

As with all cancers, early detection is extremely important. More than 80% of patients whose anal cancer had not spread lived for at least five more years after diagnosis. That number dropped to 30% when the cancer had spread to the liver or lungs.