Rectal cancer accounts for 25% of colorectal cancer cases, which is the second leading cause of cancer deaths in Poland. The tumor takes many years to develop, yet it is often detected too late for effective treatment. It is worth finding out what are the methods of prevention, causes, symptoms and treatments for rectal cancer.

Contents:

  1. Rectal cancer: risk factors
  2. Rectal cancer: symptoms
  3. Rectal cancer: diagnosis
  4. Rectal cancer: treatment
  5. Rectal cancer: prevention

Rectal cancermost often affects men over 60. The methods of treating the early stages are effective and screening tests are reliable, so it is worth checking yourself frequently.

Theper rectumexamination is of no less importance since colonoscopy in detecting rectal cancer. Colorectal cancer, including rectal cancer, is very common, and it is dangerous in the advanced stage, so you cannot ignore the symptoms it can cause, and if they occur, seek medical advice.

It is worth remembering that rectal cancer and anal cancer are two completely different diseases - these neoplasms, although located close to each other, have different risk factors, microscopic structure, and thus treatment methods.

Rectal cancer and colon cancer are cancerous diseases of the large intestine. They appear as a consequence of uncontrolled, rapid multiplication of cells of this organ, most often the starting point is the mucosa - epithelium, which is why these neoplasms are called adenocarcinomas in terms of their histological structure.

Rectal cancer: risk factors

Rectal cancer has many causes, including:

  • genetic predisposition and the occurrence of this neoplasm in relatives, especially at a young age, people suffering from the so-called familial polyposis, characterized by the presence of many polyps throughout the large intestine, are particularly vulnerable to cancer; the risk is that some of them may develop into cancer; in addition, mutations that impair the repair of cells that are undergoing neoplastic transformation or promote their multiplication are known, they also significantly contribute to the occurrence of the disease, in such cases we are talking about the so-called diseasesfamily;
  • presence of a genetic syndrome related to cancer, e.g. Turcot's syndrome, Gardner's syndrome;
  • suffering from so-called inflammatory bowel disease - Crohn's disease and ulcerative colitis;
  • lifestyle: smoking, obesity, improper diet - urea residue, high in calories, high in processed food and trans fats, and lack of physical activity;
  • presence of polyps, in this case the risk depends on their number, size and histological structure;
  • previous cancer;
  • Some people also see the causes of rectal cancer in irregular bowel movements (constipation), proving that certain toxins contained in the stool work on the mucosa for a long time, favoring neoplastic transformation, but this theory is not fully confirmed.

Rectal cancer: symptoms

Some of the symptoms of this cancer are similar to those caused by cancer of other parts of the colon, they are:

  • presence of blood in the stool,
  • changing the pattern of bowel movements - alternating constipation and diarrhea or the presence of one of them for a long time,
  • stomach pains,
  • flatulence.

Late symptoms include:

  • weight loss,
  • lack of appetite,
  • anemia,
  • fecal incontinence.

Symptoms more typical of rectal cancer are:

  • rectal bleeding,
  • change in the shape and size of the stool (the so-called "pencil stool"),
  • pressure on the stool, which makes it impossible to pass it.

It should be remembered that the severity as well as the occurrence of individual symptoms depends primarily on the advancement of the cancer, but also on the accompanying diseases.

If the cancer is advanced enough to metastasize, it is most often found in the lymph nodes - sacral, internal iliac, and superficial inguinal, then in other organs, first in the liver, then in bones, lungs and brain.

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Worth knowing

The rectum ( rectum ) is the end of the large intestine, an extension of the sigmoid colon, and ends with the anus. Within it, water is absorbed, feces are formed and stored, the rectum is also involved in defecation.

Like the entire colon,the rectum is lined with a mucosa with a monolayer cylindrical epithelium containing goblet cells responsible for the production of mucus. The inner layer of the rectum creates numerous transverse and longitudinal folds.

The muscle layer is located deeper, with circular and longitudinal bands of the smooth muscle, it is responsible for moving the food content. From the outside, the rectum is covered partly by the peritoneum and partly by the adventitia.

Rectal cancer: diagnosis

There are many tests that allow the preliminary diagnosis of cancer, depending on the reported ailments, the doctor decides which are necessary and when to perform them.

Some of the tests belong to the so-called screening tests carried out on he althy, asymptomatic people in order to detect cancer early.

The basis of diagnostics is a finger examination ( per rectum ), it enables palpation of the rectum, it is important because it detects most neoplasms of this part of the large intestine.

Laboratory tests include:

  • fecal occult blood test (it finds slight bleeding in the large intestine)
  • CEA blood test, used in disease monitoring rather than diagnosis

In the field of endoscopic examinations, rectoscopy is used to detect rectal cancer, thanks to which you can see the inside of the entire rectum and parts of the sigmoid colon.

Colonoscopy, in turn, enables the visualization of the entire large intestine, thus detecting possible neoplasms also in other parts of this organ, and is the basic screening method.

Both of these methods allow you to download snippets of a suspicious change.

Imaging tests are primarily a contrast infusion, it consists in administering a contrast agent to the large intestine and taking a series of X-rays, as well as computed tomography and magnetic resonance imaging of the abdomen and pelvis to assess the tumor stage - possible infiltration of other organs and the occurrence of reloads.

Endoscopic ultrasound is less frequently used, thanks to which it is possible to check how deeply the tumor is infiltrating the rectal wall. It is worth remembering that confirmation of the diagnosis is possible only after the histopathological evaluation of the samples taken.

Rectal cancer: treatment

The treatment method depends on the stage of the cancer. If it is small, limited to the polyp in the organ lumen, you can limit yourself to removing it (alone or with a small fragment of the mucosa) during rectoscopy, colonoscopy (this is reserved for furthersections of the large intestine) or open surgery.

Most often, however, it is necessary to remove a larger section, the entire rectum or even part of the sigmoid colon (the so-called anterior or abdominocerebral amputation of the rectum), the procedure extends to the removal of lymph nodes.

This operation is performed under general anesthesia and usually ends with the creation of a stoma, or "artificial anus" on the skin of the abdomen. This is the place where the end of the large intestine goes, through which the stool is drained into the bag.

The stoma may be temporary or permanent, depending on the extent of the surgery and further treatment plans.

Although the mainstay of treatment for rectal cancer is surgery, chemotherapy and radiotherapy are also often used, the latter method is particularly often used in this cancer.

These therapies can be used both before surgery to reduce the size of the cancer and facilitate successful surgery, and after surgery to remove any remaining cancer cells, this is called combination therapy.

In the most advanced cases - extensive infiltration of adjacent organs and the presence of numerous metastases, palliative treatment is used in order not to cure but only bring relief to the sick person.

In recent years, new methods of surgical treatment have been used more and more often, i.e. the use of laparoscopy in surgical procedures, which reduces the convalescence time, but is reserved for small, easily accessible neoplasms, because in the case of cancer, the priority is to remove as much tissue as possible in which the cancer process may take place.

In the case of pharmacotherapy, a novelty is molecular therapy, monoclonal antibodies, i.e. preparations that act on receptors present only on tumor cells, causing their destruction with maximum protection of he althy tissues.

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Rectal cancer: prevention

Unfortunately, the incidence of colorectal cancer, including rectal cancer, is increasing, so it is important to learn and implement the principles of prevention. The methods of avoiding this cancer depend on the risk factors of its occurrence. The easiest to apply are:

  • an appropriate diet based on fruit and vegetables (fiber-containing foods), lean meat and dairy products;
  • regular physical activity;
  • smoking restrictionsmoking and drinking alcohol;
  • avoiding constipation.

These methods reduce the risk of the disease, but they do not guarantee that it will not develop, so you should be screened often enough.

These include colonoscopy, which is recommended to all people over 55 at least once every 10 years.

Currently, the Screening Program finances a once-in-a-lifetime colonoscopy for people between 55 and 64 years of age. This test detects cancer and polyps in the large intestine, including the rectum.

In terms of prophylaxis, rectoscopy also works, but it does not have such an important position in cancer screening as colonoscopy (because we only observe the final segment of the large intestine).

Occasionally, fecal occult blood tests (preferably every year) and the aforementioned rectoscopy (approximately every 5 years) are also used.

It is worth emphasizing that in colon cancer screening none of the methods is as effective and reliable as colonoscopy.

For family members with cancer-related genetic syndromes, screening starts earlier, checks are more frequent, and sometimes even preventive removal of the entire colon is necessary.

Similarly, intensified oncological surveillance is used in patients with inflammatory bowel disease, those who previously had cancer, and in patients who had polyps removed from the large intestine.

Rectal cancer most often affects men over 60. The methods of treating the early stages are effective and screening tests are reliable, so it is worth checking yourself frequently. No less important than colonoscopy in detecting rectal cancer is rectal examination.

Colorectal cancer, including rectal cancer, is very common, and it is dangerous in the advanced stage, so you cannot ignore the symptoms it may cause, and if they occur, seek medical advice.

Category:

Oncology