Former Charlie's Angel Farrah Fawcett faced many foes in her years playing private detective Jill Munroe, but she may now be facing her toughest enemy yet -- cancer.
While her publicist, Mike Pingell, did not confirm the type of cancer, actor Ryan O'Neal told People magazine that Fawcett had been diagnosed with anal cancer, a relatively rare cancer that occurs in the anus. The anal canal is a small section, about an inch and a half long, that connects the rectum to the outside of the body.
"The reason people don't hear so much about anal cancer is not because it's taboo or a body part that we don’t often talk about, it is because it is such an uncommon type of cancer,"says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society (ACS) in Atlanta.
In 2006, there will be 4,660 new cases of anal cancer in the U.S. and about 660 deaths, according to ACS statistics.
When celebrities like Fawcett come forward with a cancer diagnosis, it can raise awareness and often change health behaviors, Saslow tells WebMD.
"When [CBS anchorwoman] Katie Couric talked about colon cancer, she really increased awareness about screening, but with anal cancer, we don’t have screening, so we won't see the same behavior change," she says.
Couric became an advocate for colon cancer following the death of her husband, Jay Monahan, from the cancer at age 42. She underwent a colonoscopy live on the Today show in March 2000 and as a result, test rates jumped more than 20 percent nationwide.
The HPV Connection
"There is nothing recommended that we can do to screen for or prevent anal cancer," Saslow says. But "some people are looking at what causes anal cancer and focusing on human papillomavirus (HPV) infections," she says. A sexually transmitted infection, HPV has also been linked to cervical cancer. This summer, the FDA approved a vaccine against the virus.
"There aren't any studies to show that a vaccine will prevent anal cancer, but we have every reason to believe that it will," says Saslow. Fawcett's diagnosis may increase awareness about the recommendation to get vaccinated against HPV, she speculates.
"The HPV virus associated with cervical cancer is also associated with anal cancer, so it's a very reasonable expectation that incidence of anal cancer should decrease further if the population gets vaccinated," says Leonard Saltz, MD, an attending physician at Memorial Sloan-Kettering Cancer Center in New York City.
This is probably one more good reason for people to get the HPV vaccine, he tells WebMD.
In addition to HPV infection, smoking, multiple sex partners, and having a weakened immune system may increase risk for anal cancer.
However, some patients who develop anal cancer don't have any risk factors.
Symptoms may include bleeding or itching around the anus, pain in the anal area, a change in bowel habits, a lump in the anal area, swollen lymph nodes in the anal or groin area, and abnormal discharge from the anus.
"Anal cancer is rare, but colorectal cancer is common and people tend to associate them together, so an awareness of nonspecific symptoms like rectal bleeding may encourage people to see a doctor," Saltz says.
The good news is that most people with anal cancer will be cured. Treatment typically entails surgery, radiation, or chemotherapy. Media reports suggest that Fawcett is being treated with a combination of chemotherapy and radiation.
"There is a misconception in our society that cancers can't be beaten and cancer can't be treated, but many times, we can successfully treat and cure cancer, and anal cancer, when it's caught early, is quite treatable," says Saltz.
Doctors may find anal cancer early with a rectal exam. During this test the doctor inserts a gloved finger into the anus to feel for lumps or growths.
People at high risk for anal cancer should talk to their doctor about their risk. Those considered at high risk include transplant recipients, HIV-positive people, women who have had cervical cancer or vulvar cancer, and all men who have sex with men.
Fawcett remains optimistic. "I am resolutely strong and I am determined to bite the bullet and fight the fight while going through the next six weeks of cutting edge, state of the art treatment. I should be able to return to my life as it was before at the end of my treatment," she said in a prepared statement.
By Denise Mann, MS, reviewed by Louise Chang, MD
SOURCES: Debbie Saslow, PhD, director of breast and gynecologic cancer, American Cancer Society.Leonard Saltz, MD, attending physician, Memorial Sloan-Kettering Cancer Center, New York City, Farrah Fawcett statement on Charlie's Angels web site.