Anal Cancer Is Very Treatable When Detected Early

BY ROSEMARY BLACK
DAILY NEWS STAFF WRITER

Tuesday, April 14th 2009

(Note: Actress Farrah Fawcett lost the battle to anal cancer on June 25, 2009 after this article was printed.)

Anal cancer, which "Charlie's Angels" star Farrah Fawcett is battling, is uncommon and very treatable, but its symptoms can often be overlooked, experts say. It accounts for just 1.5 percent of all digestive tract cancers, and it's got a cure rate of at least 85 percent when caught early, says colorectal surgeon Dr. Stephen M. Cohen.

But since the symptoms (pain and bleeding) are similar to those caused by hemorrhoids, some people don't seek prompt medical care, says Dr. Mark Dobriner, a colorectal surgeon at St. Francis Hospital.

"The take home message here is that no rectal bleeding is normal and all rectal bleeding should always be evaluated," says Dobriner. "If caught early, anal cancer is much more treatable than rectal cancer." Last year, some 5,070 new cases of anal cancer were diagnosed in the U.S., according to the American Cancer Society.

About 680 people will die of the disease this year. That's a tiny number compared how many people get colon and rectal cancer: the Cancer Society says there will be about 108,070 new cases of colon cancer and 40,740 new cases of rectal cancer in 2008 in the United States.

Together, colon and rectal cancer will claim 49,960 lives this year. Women are slightly more prone to getting anal cancer than men, and it's a disease of grownups: most anal cancer occurs in adults over age 35, according to the American Cancer Society.

Besides advancing age, other risk factors for anal cancer include smoking, lowered immunity or HIV infection and having sex with multiple partners, according to the American Cancer Society. Though it's not common, anal cancer may be on the increase. "As a colorectal surgeon, I am seeing more of it," Cohen says. "It is more common in patients with a compromised immune system."

When caught early, a cure often can be achieved with chemotherapy and radiation, sparing the patient from surgery, says Dr. Peter Sean Kozuch, an oncologist at Beth Israel Medical Center. Besides anal bleeding, symptoms include unexplained weight loss, anal pain, a hard mass in the area, and swollen lymph nodes in the "bikini area," Kozuch says.

"There are also benign conditions that cause swollen lymph nodes in that area, but it is a concern," he says. Unlike rectal cancer, anal cancer is a squamous cell type, similar to skin cancer, says Dobriner. "It evolves from the lining of the anal canal which is similar to skin," he says. Fawcett, 62, was diagnosed with anal cancer in 2006 and has suffered a series of setbacks in her battle against the illness.

Most recently she was hospitalized for what was reported to be internal bleeding not directly linked to the hospital, but was reportedly released from the hospital late last week. The chances of surviving anal cancer drop off considerably when it spreads, Cohen says, and places where it could spread to are the brain and liver. Once it spreads, the five year survival rate is less than 10 percent, he says.

Early detection is essential, and everyone over the age of 50 should have an annual rectal exam, Cohen says.

"That is the best way to diagnose anal cancer," Cohen says. "A lot of people don't like going to the doctor, but the earlier you present with it, if there is something abnormal, the better it is that it was caught early."