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Rectal cancer is a type of cancer that arises in the cells of the rectum. The rectum is found beneath the sigmoid colon and above the anus.
Because the rectum and colon are both parts of the digestive system, rectal and colon malignancies are frequently lumped together under the umbrella term colorectal cancer.
Colorectal cancer is the third most frequent type of cancer in the United States. It's also the second most lethal, therefore early discovery and treatment are important. According to Worldwide Cancer Research Fund data from 2020, colorectal cancer is the second most prevalent disease in females and the third most common cancer in males worldwide.
According to the American Cancer Society, 44,850 new cases of rectal cancer will be diagnosed in the United States in 2022. In comparison, there were 106,180 new cases of colon cancer.
WHAT ARE THE SYMPTOMS OF RECTAL CANCER
Rectal cancer may be asymptomatic at first.
Rectal bleeding is the most prevalent symptom as the malignancy advances. Changes in your bowel patterns may occur and remain for many days. You may also suffer unexplained weariness and weakness.
The Centers for Disease Control and Prevention (CDC) lists the following as common colorectal cancer symptoms:
- bleeding in the rectum
- changes in the frequency of your bowel motions
- having the impression that your bowel isn't emptying entirely
- When you have a bowel movement, you may experience pain.
- constipation or diarrhea
- You have blood or mucous in your feces.
- unexpected weight loss and changes in appetite
- inexplicable exhaustion
- abdominal discomfort, flatulence, cramps, and agony on a regular basis
- Iron-deficiency anemia, which can emerge as a result of blood loss, is another probable symptom of rectal cancer.
WHAT ARE THE CAUSES OF RECTAL CANCER?
While the specific cause of rectal cancer is unknown, malignant tumors form when abnormal cells expand uncontrollably. These cells have the ability to enter and destroy healthy tissue. It's not always clear what triggers this process.
Some inherited gene mutations can raise your risk of developing rectal cancer. Hereditary nonpolyposis colorectal cancer (HNPCC), often known as Lynch syndrome, is one of these. This condition increases the risk of colon and other cancers considerably. In some situations, your doctor may advise you to have your colon removed as a prophylactic step.
Familial adenomatous polyposis is another hereditary disease that can lead to rectal cancer (FAP). This is an uncommon condition that can result in the formation of polyps in the lining of the colon and rectum.
While these polyps are initially noncancerous, they have the potential to become cancerous. In fact, the majority of FAP patients acquire cancer before the age of 50. Large bowel removal may also be recommended as a prophylactic operation by your doctor.
HOW DOES RECTAL CANCER SPREAD?
Rectal cancer, like other types of cancer, can spread when malignant cells grow in healthy tissue and move to other parts of the body.
Rectal cancer may first damage the tissues lining the rectum. It can affect the entire rectum in some circumstances. The malignancy may then spread to neighboring lymph nodes or organs, most commonly the liver. Other possible sites of metastasis include:
- abdomen
- brain
- lungs
- ovaries
RECTAL CANCER STAGING
Rectal cancer is classified into five stages. Your diagnosis is determined by the size of the rectal cancer tumor and whether or not it has spread:
Stage 0: On the surface of the rectal lining, cancer cells have been discovered.
Stage 1: The tumor has spread below the lining and may have reached the rectal wall.
Stage 2: The tumor has penetrated the rectal wall and may have spread to the tissues around the rectum.
Stage 3: The tumor has spread to the lymph nodes around the rectum as well as certain tissues outside the rectal wall.
Stage 4: The tumor has migrated to distant lymph nodes or organs at this stage.
HOW IS RECTAL CANCER DIAGNOSED?
If your doctor suspects you have rectal cancer, he or she may request some tests to confirm the diagnosis. These tests may involve the following:
Colonoscopy: A long tube with a small camera is used to inspect the inside of your colon and rectum.
Biopsy: Your doctor extracts a small sample of questionable tissue and sends it to a lab for testing.
CT scan: This imaging test takes X-rays of your body and stitches them together to provide a thorough view of your bones, organs, and tissues.
Magnetic resonance imaging (MRI): MRI, unlike X-rays, captures images inside your body using radio waves and magnets.
PET scan (positron emission tomography): Your healthcare professional may ask you to swallow a specific dye containing radioactive tracers before undergoing a PET scan. (The dye may be injected or breathed in some situations.) The dye highlights diseased parts.
WHAT ARE RECTAL CANCER TREATMENTS?
The location, size, and stage of your tumor, as well as your overall health and personal preferences, all influence rectal cancer treatment. Among the options are:
Surgery
Surgery is one of the most common rectal cancer therapies because it removes cancer cells. Based on your specific demands, you have a few surgical options:
- Transanal endoscopic microsurgery (TEMS): During this treatment, your surgeon uses a special scope inserted into your anus to remove tiny tumors from the rectum. This treatment is advised if your tumor is small, localized, and unlikely to spread.
- Low anterior resection: Larger rectal tumors may necessitate whole or partial rectum excision. The anus is protected in order for waste to exit your body normally.
- Abdominoperineal resection (APR): When cancer is found near the anus, it may be impossible to remove it without causing damage to the muscles that control your bowel motions. Your surgeon may remove the anus, rectum, and a portion of the colon in this scenario. A colostomy is then performed to allow waste to exit your body. (During a colostomy procedure, your surgeon makes an opening in your abdomen called a stoma. The end of your colon is then sewn into place and linked to the opening. When waste exits your body, it is collected in a bag attached to the stoma.)
Chemotherapy
Chemotherapy can be given either before or after surgery to reduce a tumor or to destroy any leftover cancer cells.
Immunotherapy
Immunotherapy involves the use of medications to strengthen your immune system and teach your body how to target cancer cells.
Radiation therapy
Radiation therapy, like chemotherapy, can be given before or after surgery. Radiation therapy employs high-energy beams to either kill or prevent cancer cells from growing and dividing. It is safe to use in conjunction with chemotherapy.
Targeted drug therapy
If you have advanced rectal cancer, your oncologist may advise you to combine targeted medication therapy with chemotherapy. These medicines kill cancer cells by targeting certain defects in their DNA.
What are the side effects of rectal cancer treatment?
Depending on the sort of rectal cancer treatment you receive, complications may arise. Furthermore, everyone's experience will be unique. Just because someone else experienced particular issues does not guarantee that you will as well. The most common adverse effects of most rectal cancer therapies are fatigue, weight fluctuations, nausea/vomiting, and diarrhea.
What steps may be taken to avoid rectal cancer?
A colorectal cancer diagnosis in its early stages, before it spreads, can boost your chances of survival.
The best strategy to minimize your overall risk of acquiring colorectal cancer, according to the CDC and the American Cancer Society, is to begin regular screenings at the age of 45. Your doctor may recommend testing earlier than this based on family history, genetics, and other risk factors.
Colon and rectal cancer can be detected early by standard screenings such as a colonoscopy or stool test. Cancer can be detected with highly sensitive stool testing. If abnormal cells are identified, a colonoscopy should be performed as soon as possible.
Adopting a healthy lifestyle and avoiding risk factors such as inactivity, smoking, and eating red or processed meats may also help prevent rectal cancer.
CONCLUSION
Rectal cancer, often known as colorectal cancer, is frequent in the United States and around the world. Rectal cancer symptoms may not develop until the later stages, making early, regular tests critical for both discovery and treatment.
Treatment and screening alternatives may evolve in the future, but it's also crucial to lower your personal risk whenever possible. Discuss with your doctor any personal concerns you have about the chances of rectal cancer, as well as any odd bowel symptoms.