Anal Cancer Survivor

Moving Forward after Facing Cancer

Marcia Cross waited about a year post-treatment to begin sharing that she had completed successful treatment for Stage II anal cancer. In doing so, she brought much-needed attention to a cancer that people seem reluctant to discuss. Best known for her roles on “Desperate Housewives” and “Melrose Place,” the busy wife and mother is now cancer-free. She feels incredibly lucky to be back at work and is enthusiastic about helping others learn more about this rare cancer.

When I needed a prescription in the fall of 2017, my gynecologist insisted I see her first because I was overdue for my annual appointment. I was surprised to learn it had been 14 months since my last visit but, like so many women, I was busy and time got away from me. At the appointment, my doctor gave me a vaginal exam, Pap smear and then a digital rectal exam. After the rectal exam, she said she didn’t quite like what she felt. She made a quick phone call and told me she’d made an appointment down the street with a surgeon. All that was on my mind was that I was going to miss my daughter’s basketball game, but off I went as the appointment was made.

During that visit, the surgeon performed a rectal exam. At this point, I wasn’t concerned that there was anything wrong because I wasn’t having any real symptoms. My tush was occasionally a little sore, but I attributed that to doing lots of long-distance driving. This doctor also felt something and decided I needed a biopsy. When she looked at me and said that whatever it was would be curable, I was stunned.

Feeling like I was having an out-of-body experience, I scheduled the procedure and then went home to tell my husband. I waited several days to get the results and when I did, the doctor told me the biopsy was inconclusive but that she still felt that it was cancer. Because it was not definitive, I was in a state of denial. My husband, a throat cancer survivor, contacted the cancer center near our home where he’d been treated and another biopsy was scheduled to get a conclusive diagnosis. The official diagnosis from that biopsy was Stage II anal cancer (squamous cell carcinoma).

After sitting with this news for some time, we then explained my diagnosis to our 10-year-old daughters. I assured them that I was going to be okay and that this wasn’t something that would take my life. After learning about the treatment protocol for anal cancer and its gnarly side effects, I was concerned about going through it at home. I didn’t want them to see me suffering. We found a well-known cancer center out of town that had extensive anal cancer treatment success, and I thought it might be a good option for me.

My husband and I traveled to the cancer center, under the impression we were getting the lay of the land and planning treatment. I was surprised to find they wanted me to stay so I could start right away. My husband flew home to be with our daughters, and I had every intention of beginning treatment. But suddenly, I realized I didn’t want to stay there alone. I needed to be at home with my support system. I called my husband, got on the next plane and went back to the cancer center where my husband was treated.

My treatment plan, which began right before Christmas, consisted of 28 radiation appointments with chemotherapy in the first and fifth weeks. I felt very fortunate that the tumor was small enough that I didn’t need surgery. As we all know, the anus has a really important job, and if the muscles around it are affected by surgery, you can lose functionality.

At first, I thought I was having no adverse reaction to the treatments but then was hit with mouth sores and gastric pain from the chemo. I hadn’t been doing anything proactively because all seemed fine, but when symptoms appeared, luckily I was well prepared. I highly recommend having all your medications and supplies at the ready and just assume you will need them.

I got through the treatment with the help of my amazing girlfriends whom I call my “anal angels.” While my wonderful husband focused on our girls and kept their lives going along as normally as possible, my girlfriends took care of me around the clock. I didn’t truly need around-the-clock care, at least at the beginning, but they did it anyway. I have never felt so loved. I understand now what people mean when they say “cancer is a gift.” You are stripped down to the only thing that is really important and that is love.

Three months post-treatment, just as I was ready to get back to my life, my hair started falling out. Hair loss wasn’t supposed to be a side effect of the type of chemotherapy I was given, but nonetheless, it was coming out by the handfuls. It was torturous because I kept thinking it would stop, but it never did. It turned out not to be a side effect of the chemo, but rather a stress response called acute telogen effluvium. It can occur as the body’s reactions to a few things, one being a “shock to the system.” I guess you could say getting a cancer diagnosis fits that bill.

I am actually happy now that it happened. Because of that experience, I have developed so much empathy and awareness of how many people have hair issues. Feeling that vulnerability, searching for hairpieces and wigs to try and look “normal” and waiting for what seems like forever for the hair to grow back — all of these things clued me into a world unknown to me before when I took my healthy head of hair for granted.

I am now cancer-free and follow up with my GI doctor every three months for a scope and periodic CT scans. I will be forever grateful that I was surrounded by such a skilled medical team, but I am most indebted to my gynecologist, who saved my life. Had she not been such a thorough doctor my story could be quite different.

My experience also made me realize how ridiculous it is that there is such a stigma around anal cancer. I have a newfound respect for the anus! Thankfully there are resources like this guide and those available from the Anal Cancer Foundation. We’ve come a long way, but there is still much to do. The more we put anal cancer in the spotlight, the more comfortable people will be talking about it, making sure they get rectal exams, learning about prevention and HPV screening, and what they can do if they are diagnosed.

Practical Pointers from Marcia

1. Radiation therapy caused my skin to be incredibly raw. I had the most trouble for about two weeks following treatment. My bottom was incredibly sore, and it was very painful when urine or even water touched it. I kept disposable paper cups near the toilet. When I’d tinkle, I placed it close and it blocked the urine from touching the areas that were burned. It sounds so simple, yet it worked wonders!
2. I was incredibly consistent about moisturizing with heavy cream after every radiation treatment. I also refrigerated an aloe plant and used the aloe to relieve the burning feeling in my skin. I had more baths than I could ever count just to relieve the pain.
3. I paid attention to what I ate, especially avoiding foods, such as salads, that increased bowel movements because that was painful. I made sure to drink smoothies loaded with nutrition.
4. I took prescription medication for the pain. Getting off of pain medication can be a process in and of itself, so I think it’s important for everyone to be aware that it’s critical to make a plan with your doctor about weaning off pain meds.
5. Explore gynecologic after-care, including having your gynecologist examine your cervix and vaginal canal after treatment to make sure it doesn’t close up. Using a vaginal dilator is important, too. That might sound odd because we’re talking about anal cancer, but the scar tissue can actually cause it to close up. Use a soft dilator with lubricant frequently. Just think of it as a job for a while. If your doctor doesn’t mention these things to you, be sure to ask. Don’t shy away from it.
6. Ask lots of questions about things like rehabilitation, pelvic floor exercises and unique potential side effects. I called, texted and used my medical portal for this. I had severe back pain on the backside of where I was radiated. My doctor suspected a sacral fracture. After a CT and two MRIs, I learned it was sacral inefficiency, caused by my bones thinning because of the radiation. I wish the radiologist would have let me know that was a possibility. It was really scary to have pain there and not know why. Educate yourself about everything.