Rest in peace, Charlie s Angel, Farrah! Take a look at the article pasted below from Lifescript as it talks about Anal Cancer. There is a lot of veryMessage 1 of 1 , Jun 26, 2009View Source
Rest in peace, Charlie's Angel, Farrah!
Take a look at the article pasted below from Lifescript as it talks about Anal Cancer. There is a lot of very important within.
PamelaFarewell, Farrah: TV Star Loses Anal Cancer BattlePublished June 26, 2009After a 2-1/2-year battle with anal cancer, former “Charlie’s Angels” star Farrah Fawcett has passed away at age 62. An NBC special in May highlighted the actress’ grueling fight against the disease, but left us with questions: What is anal cancer? Who’s most at risk? Is it sexually transmitted? Lifescript asked medical experts for answers to these and other questions. Plus, what’s your HPV IQ? Take our quiz to find out…
1. What is anal cancer?
It’s a rare disease that attacks the anus, the body’s opening to the lower intestines. The anal canal and its surroundings are made of several types of cells, and many tumors, malignant or benign, can develop in them.
Not all anal tumors lead to cancer, says the American Cancer Society (ACS). Polyps, for instance, are small, benign tumors that can develop in the anal canal’s inner lining after an injury.
Warts, or condylomas, many of which are caused by the sexually transmitted human papillomavirus (HPV), can also lead to anal cancer. People who have had genital warts are more likely to develop this cancer, although the warts are not malignant.
2. How common is it?
It’s rare, accounting for only 1-2% of gastrointestinal cancers; about 4,000-5,000 new cases are diagnosed each year and about half are women, says Zev Wainberg, M.D., a researcher at Jonsson Comprehensive Cancer Center at the University of California-Los Angeles. In 2008, nearly 700 adults died from anal cancer.
According to the Abramson Cancer Center of the University of Pennsylvania, 85% of cases are Caucasians. And most patients – as with most cancers – are diagnosed in their 60s. Fawcett, 62, was diagnosed almost three years ago.
3. Is it related to colon cancer?
Not really: What they do have in common, though, is that they’re both diseases of the large intestine. But colon cancer is much more common than anal cancer, and its causes are better known.
Another important difference: “Genetics can be a risk factor for colon cancer but not anal cancer, whose risk factors mostly stem from lifestyle,” Wainberg says.
4. Does anal sex increase my risk?
Yes, and so does vaginal sex if you have multiple sexual partners because both increase your chances of contracting HPV, says Ginger Gardner, M.D., a gynecologic cancer surgeon at Memorial Sloan-Kettering Cancer Center in New York City.
Most common anal cancers are associated with HPV (the virus linked to cervical dysplasia, or precancerous cells on the cervix), and cervical cancer, says Janet Horn, M.D., LifeScript’s women’s health expert. During anal sex, HPV could spread into the anus.
“And the more sexual partners one has, the more likely [she or he] will develop abnormal cells in the anus,” Horn says.
Other risk factors include:
- Being a woman with a history of cervical warts
- Having a history of HPV
- Having had other sexually transmitted illnesses (the more STIs one has, the greater the risk of HPV)
- Having a lowered immunity (it increases your risk of HPV)
- Being over age 50
- Smoking cigarettes
5. What are the symptoms?Other signs to watch for:
Some patients have no symptoms, but more than 50% experience rectal bleeding during bowel movements, usually the first sign of the disease.
- Change in bowels, such as constipation, diarrhea, and/or thinning stools
- Rectal itching
- Pain and/or itching in the anal area
- Abnormal discharge – like mucous or pus – from the anus
- Swollen lymph nodes in the anal or groin areas
6. How is it diagnosed?
Several tests can suggest that you have anal cancer although only a biopsy can offer a definite diagnosis. During the procedure, the surgeon removes cells or tissue, usually with a needle or small pair of scissors or clamps. Using a microscope, a pathologist views the cells or tissue to check for abnormalities. But first, your doctor will take one of these steps:
- Digital rectal examination (DRE): The doctor or
nurse inserts a lubricated, gloved finger into the lower part of the
rectum to feel for lumps or any other irregularities.
- Endoscopy: The types of endoscopy include
anoscopy and proctoscopy. During an anoscopy, the doctor inserts a
short, lighted tube, or anoscope, into the anus and lower rectum,
allowing him to examine the area. The proctoscopy is similar to an
anoscope, except that the proctoscope is 10 inches long, enabling the
doctor to view both the rectum and the lower part of the sigmoid colon.
- Endo-anal or endorectal ultrasound: An ultrasound transducer, or probe, is inserted into the anus or rectum and used to bounce high-energy sound waves off internal tissues or organs to make echoes, which form a sonogram, or a picture of the body tissues.
7. How can I prevent it?
You can’t totally prevent it, the ACS says, but you can reduce your risk by doing the following:
- Get regular check-ups, which include digital rectal exams that scan for abnormalities
- Stop smoking
- Avoid sexual practices that carry a high risk of HPV and HIV infection (HIV infection leads to a lowered immune system)
- If you’re at risk, ask your doctor about anal cancer screening. This may include an anal pap smear or anoscopy, an examination of the anal canal.
- If you have anal sex, use a condom. This isn’t foolproof but it can lower risk of getting HPV.
8. Can an HPV vaccination decrease my risk?
Maybe – and it couldn’t hurt.
“Because anal cancer is frequently associated with HPV, vaccination may decrease one's risk of getting the disease,” Gardner says. “However, the theoretical benefit of the vaccination for anal cancer would be most effective before a person is sexually active.”
The three main treatments are surgery, radiation therapy and chemotherapy. The best approach is chemoradiotherapy, which uses radiation and chemotherapy over five to six weeks, Wainberg says.
“Since most anal cancer is localized, which means it has not spread outside of the anal canal area, we try not to use surgery, [which] would mean the anal canal is removed and the patient is left with a colostomy. We try to spare patients a colostomy bag,” he says.
Fawcett underwent chemoradiotherapy in late 2006, and her doctor declared her cancer-free in February of 2007. But after a routine check-up three months later, Fawcett learned the cancer had returned.
Later that year, she traveled to Germany to explore other treatment options. Oncologist Ursula Jacob, M.D., medical director of Alpenpark Clinic in Bad Wiessee, Germany, and one of Fawcett’s doctors, has said in a TV interview that the actress was given natural supplements and treatments boosting the immune system, which shrank Fawcett’s tumor, although Jacob didn’t elaborate. The Food and Drug Administration (FDA) has not approved those treatments for use in the U.S.
10. What’s the cure rate?
That depends on the type of anal cancer and how far it has advanced.
Generally, the earlier the cancer is found, the higher the cure rate, Wainberg says.
“Detected early, patients with anal cancer have an 82% five-year survival rate,” says Edward C. Geehr, M.D., Lifescript’s chief medical officer. “For those with metastatic disease, as in Fawcett’s case, five-year survival is only 19% from the time of initial diagnosis.”
Overall, more women survive the disease – about 73% versus 61% for men. Wainberg speculates men may be more susceptible to the more aggressive cancers.