Anal cancer is a rare malignancy

Farrah Fawcett had the misfortune to die from one of the rarest malignancies, anal cancer.

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It's a cancer that struck 5,070 Americans in 2008, compared with 40,740 cases of rectal cancer, 108,070 cases of colon cancer, 184,450 cases of breast cancer and 215,020 cases of lung cancer.

It's so rare, doctors say, many caregivers don't routinely screen for it and many patients don't notice it until it reaches advanced stages. "Early on, the patient often doesn't feel anything or know anything," said Dr. Michael Hellinger, colorectal surgeon at Mount Sinai Hospital in Miami Beach. "As it advances, with rectal bleeding, a little lump, people sometimes think it's hemorrhoids."

That's tragic, because when anal cancer is caught early, before it has spread to lymph nodes, liver or lungs, the five-year survival rate is 82 percent, according to the American Cancer Society. The survival rate drops to 60 percent if it has spread to surrounding lymph nodes, 20 percent if it spreads to lungs, liver or other organs.

Among patients under 50, anal cancer is more common in men; after 50, it is more common in women. It occurs more often in smokers, people who have many sexual partners, have receptive anal intercourse or have a weakened immune system, the American Cancer Society says.

Some doctors believe that means it's more common among men who have sex with men and have anal intercourse, Hellinger says. "But that's never been statistically proven. Studies have never been done to look at that."

Another cause can be chronic infection with the human papilloma virus, in both men and women. HPV can be spread by either straight or gay sex, Hellinger said. And while it can be slowed among women who take the HPV vaccine to avoid cervical cancer, the vaccine never has been studied in men, and men are not routinely vaccinated.

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Terra/AP