Rectal cancer as the name suggests is cancer forming in the rectum. It develops over a long period. The rectum is the part of your digestive system. You can find it above the anus and below the pelvic colon (sigmoid colon). The rectal and colon cancers are usually grouped under the common term of colorectal cancer. It is the second most common cancer affecting women and the third most type of cancer affecting men. Every year, doctors detect new cases of cancerous presence in the rectal region. With early intervention, the deadly disease is easy to cure. But, you need to undergo screening frequently to detect the issue and nip it at its budding stage.
Symptoms Of Rectal Cancer
- Weakness
- Appetite changes
- Fatigue
- Weight loss
- Abdominal pain or discomfort (gas or cramps)
Other Signs
You can also experience other signs due to the problem like:
- Changes in the frequency of the bowel movements
- Always feeling full (the feeling that bowel is not empty)
- Pain during bowel movement
- Blood/mucus in the stool
- Constipation or diarrhea
- Narrow stool
- Iron deficiency (anemia)
Staging Of Rectal Cancer
The staging of rectal cancer is necessary to find the ideal treatment option and detect the prognosis. No matter where the cancerous cells develop, it spreads to other parts of the body. It can metastasize through the bloodstream, lymph system or tissue. Staging can indicate the extent of cancer and its progression. Therefore, your doctor stages cancer to decide on the treatment that will show results. The different stages of rectal cancer are:
Stage 0 (Carcinoma In Situ)
When a person develops cancerous cells on the innermost layer of the rectum wall alone, the doctors classify it under stage 0.
Stage 1
The abnormal cancer cells spread to other areas past the innermost layer of the rectum wall. But, cancer does not spread to the lymph nodes.
Stage 2
This stage is further classified as 2A and 2B. When the cancer cells spread through or into the rectum wall’s outer muscle layer, it comes under 2A. But, it does not spread to lymph nodes. In 2B, the abnormal cells spread to the abdominal lining of the affected person.
Stage 3
The cancerous cells spread to the innermost layer of muscles in the rectum as well as one or more lymph nodes. Based on the amount of lymph tissue affected by cancer, it is further classified into 3A, 3B, and 3C.
Stage 4
Cancer cells spread to other organs like lungs or liver.
Causes Of Rectal Cancer
Any mutations in the DNA cause the cells in the human body to grow out of control. The faulty cells tend to pile up and develop into tumors. The cells can penetrate a healthy cell and destroy it completely. But, what triggers the mutation of the cells remains unclear. The risk factors associated with the problem are:
Inherited Gene Mutations
Some people inherit the gene mutation from their parents. Such individuals are more at risk of developing rectal cancer. Lynch syndrome or hereditary nonpolyposis colorectal cancer is one of the problems that put you at risk of developing the deadly disease. It increases your chances of developing colon as well as other cancers. People who face risk can develop the disease before they reach fifty years.
Adenomatous polyposis is another syndrome increases the risk of cancer. It is a rare disorder triggering the development of polyps in the colon and rectum lining. Without medical assistance, the affected people face the risk of rectal and colon cancer before the age of 40.
Age
People above fifty years of age are at risk of developing cancer in their rectum.
Race
African-American people are more prone to the problem compared to people of European descent.
Family History
People with a family history of colorectal cancer have a high chance of developing them.
Radiation Treatment
People who have undergone radiation treatment for abdominal cancer can have a high risk of developing the problem.
Other Conditions
Some health issues can put you at risk of the problem compared to others. The known risk factors associated with the issue are:
- Polyps
- Ovarian Cancer
- Inflammatory Bowel Disease
- Obesity
- Type 2 Diabetes (not under control)
Certain lifestyle factors also play a significant role in developing colorectal cancer. So, people who follow a bad lifestyle are prone to the issue like:
- A high-fat diet with red meat and a few vegetables
- Lack of exercise
- Consuming excess alcohol
- Smoking
Diagnosis Of Rectal Cancer
If you see the signs or have a high risk of developing the problem, then you need to see a doctor. Getting a professional diagnosis is important to get proper medical attention as early as possible. To make a diagnosis, the doctor can perform the following:
Physical Assessment
When you consult a doctor, a thorough physical examination and knowing about medical history will offer insight on your condition. The doctor checks for lumps and bumps by inserting a gloved finger in the rectum.
Colonoscopy
To detect the issue conclusively, your doctor suggests colonoscopy. It is the procedure that uses a thin, flexible tube with light as well as a camera at one end. Passing it into the rectum helps view any abnormalities. The camera sends images of rectum and colon. Using the images, the doctor can detect the presence of abnormal tissue or polyps. The procedure is also helpful in removing small polyps.
It is also used to extract a sample of the tissue for testing. The sample gets assessed in the lab under a microscope. The tests can reveal the presence of cancerous cells. The sample is also used for testing genetic mutation, triggering colorectal cancer.
Blood Tests
You need to provide a sample of your blood for testing. Different blood tests can help determine the presence of cancer. Your doctor can suggest the following blood tests:
Complete Blood Count (CBC)
The CBC helps detect the total number of different types of cells present in your bloodstream. The CBC test helps detect the low red blood count (anemia), which occurs due to tumor formation. A cancerous tumor can cause blood loss. While a high level of white blood cells indicates the presence of infection. It indicates a high risk if the rectal tumor tends to grow into the rectal wall.
Carcinoembryonic Antigen (CEA)
When cancer cells develop in the human body, it produces substances called tumor markers. These tumor markers are detected in the blood. CEA or carcinoembryonic antigen is one such marker. If the blood has high levels of CEA, then it indicates the presence of colorectal cancer. CEA is also used by the doctors to monitor the response of a patient to the treatment.
Chemistry Panel
It is the test used to detect and measure the number of chemicals in the blood. When the results show abnormal levels of the chemicals, it indicates cancer has spread to other organs like the liver. High levels of other chemicals indicate problems with organs like kidneys.
Imaging Tests
It is mostly used in the detection of the stage of rectal cancer. The imaging tests can help identify if cancer has spread to surrounding organs. The types of imaging tests used for the purpose are:
Chest CT Scan
CT scan is a sophisticated imaging technique used to detect the spread of cancer from the rectum to other body parts. Your doctor suggests a chest CT scan to see if cancer has spread to the lungs and liver.
Pelvic MRI
MRI (magnetic resonance imaging) of the pelvis can provide a detailed image. The images consisting of organs, muscles, and other tissue surrounding the rectal tumor can help determine the extent of the problem. The imaging tests also show the lymph nodes in the rectal region. It also provides an image of different tissue layers in the rectal wall.
Treatment Options For Rectal Cancer
Your doctor recommends treatment for the condition based on the stage. The treatment option chosen for the condition depends on the following factor:
- The size of the tumor in the rectum
- The spread of cancer to other organs
- Age of the patient
- The overall health of the affected person
It helps determine the ideal treatment. In most cases, doctors recommend combination therapy. So, they combine two or more treatment methods to get good results. The doctor also decides the timing of each treatment for positive results. So, the treatment based on the stage of cancer are:
Treatment For Stage 0 Rectal Cancer
It is the initial stage of rectal cancer. So, the cancerous polyps are still developing. Your surgeon can suggest the following:
- Colonoscopy to see the extent of cancer and remove any suspicious tissue.
- Remove cancerous polyps during a separate surgery.
- Invasive surgery to remove the affected tissue and the part surrounding the area.
Treatment For Stage 1 Rectal Cancer
During the stage, the cancerous mass is larger than stage 0. But, it remains in the rectal region. So, the options to treat the problem include:
Local Excision
The procedure takes out the cancerous rectal tumor. But, it also takes a margin of healthy tissue along with the section of the rectal wall under the cancerous tumor.
Low Anterior Resection
It is an invasive procedure that is selected when the tumor is located on the upper part of the affected person’s rectum. The invasive procedure leaves the anus intact while removing the tumor. A part of the healthy tissue is removed along with the tumor.
Radiation Therapy
It uses high powered x-rays beams to kill the cancer cells affecting the rectum. So, the tumor shrinks in size.
Chemotherapy
The treatment uses two or more drugs to target and kills cancer cells. In most of the cases, it is combined with radiation therapy to get desired results. It is used before or after the surgery as per the patient’s condition.
Treatment For Stage 2 And Stage 3 Rectal Cancer
The treatment option available for stages 2 and 3 is the same. Your doctor can decide the best option based on your condition. So, the options include:
- Surgery
- Radiation therapy
- Chemotherapy
Treatment For Stage 4 Rectal Cancer
Stage 4 of the disease spreads to other parts of the body. The cancer metastasized to different organs. In most cases, cancer spreads to the liver. The treatment during stage 4 focuses on relieving the symptoms. It is not possible to cure cancer completely. So, the treatment focuses on improving the quality of life. The treatment options available are:
Surgery
It is an invasive procedure to remove the metastatic tumor that can appear in different areas of the body. In most cases, the tumor forms in the liver. Your doctor detects the primary tumor the rectum confined in the rectum as well as nearby lymph nodes.
Chemotherapy
It extends the life for patients suffering from stage 4 rectal cancer. It is usually provided after invasive surgery to remove the cancerous tumor.
Radiation Therapy
In stage 4 cancer, the doctor opts for radiation therapy to relieve the symptoms. Your surgeon selects it because the cancerous tumor is too extensive to remove it using the invasive procedure.
Other Treatment Options
Apart from the above-mentioned treatments, your doctor can also suggest the following to relieve the symptoms:
- Targeted Therapies (Angiogenesis inhibitors or Monoclonal antibodies)
- Cryosurgery (A procedure used to destroy abnormal tissue using cold liquid or a cryoprobe)
- Radiofrequency ablation (A procedure using radio waves to destroy cancer cells)
- Place a stent to keep the rectum open (It is selected when a tumor blocks the rectum)
Palliative Care
To improve the overall quality of a patient’s life, the doctor suggests supportive care or palliative care. The care focuses on providing relief from pain as well as other symptoms of the serious disease. A team of specialists offers palliative care. The care specialists work with the patient, their doctor, and family members to work out a customized care plan. The extra layer of supports compliments the ongoing treatment.
The palliative care team consists of doctors, specially trained professionals, and nurses. The care aims to improve the quality of life. In most cases, the palliative form of care along with curative as well as other treatments offer relief.
Clinical Trials
For final stage cancer, you should talk to your doctor about the clinical trials available. Some trials may fit your needs perfectly. Clinical trials are research studies involving people. Doctors test groundbreaking drugs on patients to relieve the symptoms. The new techniques try to prevent, aid in detection or offer treatment for the disease. You need to talk to your doctor about the different trials.
Preventing Rectal Cancer
It is possible to reduce the risk factor associated with developing cancer in the rectum. If you experience any of the risk factors affecting the high probability of the disease, then you need to follow the suggestions. It will help you reduce the risk of getting rectal cancer in the future.
Screening Tests
You need to undergo screening tests. Talk to your doctor about when you must start screening tests for detecting cancer in the rectal region. In normal cases, the guidelines suggest undergoing the screening tests after you complete fifty years. If you have other risk factors like family history, then your doctor suggests earlier or more frequent screening tests. Colonoscopy is the most common test for detecting the presence of the problem. During the test, your doctor examines the rectum lining as well as the large intestine using a camera.
The procedure uses a colonoscope, the instrument with a flexible and long tube with a camera at its one end. The doctor inserts the instrument in your anus. It travels through rectum and colon taking real-time images of the organs. It also moves through the bowel to send pictures of the rectal and colon lining. Your doctor can see the pictures on the video monitor. When the doctor finds a suspicious polyp, he/she extracts a sample tissue using instruments inserted in the colonoscope. The lab technicians test it in the lab. Based on the test results, your doctor suggests plans.
Reduce Risk With Lifestyle Changes
You can reduce your risk of developing the disease by changing your lifestyle. The good changes will have an overall positive effect on your health. It will also keep you protected from diseases like cancer. So, make the following changes:
Eat A Well-Balanced Diet
You need to eat a well-balanced diet rich in fruits and vegetables. It must have low animal and dairy fat. You need to eat at least five servings of vegetables and fruits every day. So, eat such a diet rich in vitamins and minerals will keep you protected from deadly diseases. Try to include the following food items in your diet:
- Whole grain bread
- Beans
- Cereal
- Grains
- Pasta
- Rice
- Food rich in calcium
- Folic acid (broccoli, citrus fruits, legumes)
Including these foods in your diet can reduce your risk of cancer in the rectum.
Regular Exercise
An inactive lifestyle puts your health at risk. So, include at least a moderate level of physical activity. You need to spend at least thirty minutes every day for exercise. If you have no time to go to the gym or include exercise, then try the following activities to keep you fit:
- Climb stairs or steps instead of taking the lift
- Rake leaves in your garden
- Walk
Maintain Healthy Weight
Obesity is one of the risk factors associated with cancer in the rectum. So, try to shed excess pounds. You can combine exercises and diet to achieve a weight loss goal.
Quit Smoking
Smoking nicotine products put your health at risk. So, stop smoking completely. If you cannot quit it by yourself, then take the assistance from your doctor.
Conclusion
Early diagnosis is the key to eliminate rectal cancer. So, it is essential to undergo regular cancer screening to detect the presence of the disease and take the necessary action as early as possible. The screening tests help identify precancerous growths before they can progress into cancer. As cancer in the rectal region develops over a long period, the screening tests can detect any changes before they turn cancerous. With early medical attention, it is possible to eliminate the disease. You can also prevent the development of the problem by following a healthy lifestyle.
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