Symptoms and treatment of Rectal cancer

Description

Rectal cancer is a type of cancer that begins as a growth of the cells in the rectum. The rectum is the last several inches of the large intestine. It starts at the end of the last segment of your colon and ends when it reaches the short, narrow passage known as the anus.

Cancer in the rectum and cancer in the colon are often referred to together as colorectal cancer.

While rectal and colon cancers are similar in many ways, their treatments are very different. This is mainly because the rectum is barely separated from other organs and structures. It is located in a small space that can do the surgery to remove the cancer of the rectum complex.

Rectal cancer treatment usually involves surgery to remove the cancer. Other treatments may include chemotherapy, radiation, or a combination of the two. Targeted therapy, immunotherapy, and may also be used.

Symptoms

Rectal cancer may not cause early signs or symptoms. The symptoms of rectal cancer tends to occur when the disease is advanced.

The signs and symptoms of rectal cancer are:

A change in bowel habits, such as diarrhea, constipation, or more frequent urge to defecate.
A feeling that the bowel does not empty completely.
The Abdominal pain.
Dark brown or bright red blood in the stool.
Narrow stool.
Weight loss that happens without trying.
Weakness or fatigue.

When to see a doctor

Make an appointment with your doctor or other health care professional if you have any symptoms that worry you.

Causes

The exact cause of the majority of rectal cancers is not known.

Rectal cancer occurs when the cells in the rectum develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes, to tell the cancer cells to make many more cells quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells may form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

Risk factors

Factors that may increase the risk of cancer of the rectum are the same as those that increase the risk of colon cancer. Colorectal cancer risk factors include:

A personal history of colorectal cancer or polyps. Your risk of colorectal cancer is higher if you have already had cancer of the rectum, colon cancer or adenomatous polyps.
The black race. Black people in the united States have an increased risk of colorectal cancer than people of other races.
Diabetes. People with type 2 diabetes may have an increased risk of colorectal cancer.
The consumption of alcohol. Excessive consumption of alcohol increases the risk of colorectal cancer.
A diet low in vegetables. Colorectal cancer may be related to a diet low in vegetables and high in red meat.
Family history of colorectal cancer. You're more likely to develop colorectal cancer if you have a parent, sibling or child with cancer of the colon or rectal cancer.
The inflammatory bowel disease. Chronic inflammatory diseases of the colon and rectum, such as ulcerative colitis and Crohn's disease, may increase your risk of colorectal cancer.
Inherited syndromes that increase the risk of colorectal cancer. In some families, the changes in the DNA passed from parents to children can increase the risk of colorectal cancer. These changes are involved in only a small percentage of cancers of the rectum. Hereditary syndromes can include familial adenomatous polyposis, also known as the FAP and Lynch syndrome. Genetic testing can detect these, and other, more rare, hereditary colorectal cancer syndromes.
Obesity. People who are obese have a higher risk of colorectal cancer compared with people considered to be at a healthy weight.
Advanced age. Colorectal cancer can be diagnosed at any age, but most people with this type of cancer are older than 50 years. The rates of colorectal cancer in people under 50 years old that have been on the rise, but health care professionals are not sure why.
Radiation therapy for the cancer earlier. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colorectal cancer.
The habit of smoking. People who smoke may have an increased risk of colorectal cancer.
Very little exercise. If you are inactive, you are more likely to develop colorectal cancer. Regular physical activity can reduce your risk of cancer.

Complications

The cancer of the rectum can lead to complications, including:

Bleeding in the rectum. Rectal cancer often the cause of bleeding in the rectum. Sometimes the amount of blood that is worrisome, and the treatment could be required to stop immediately.
Intestinal obstruction. The cancer of the rectum can grow to a blockage of the intestines. This prevents the stool out of the body. The surgery to remove the cancer often relieves the obstruction. If you can not have surgery right away, you may need other treatments to relieve the obstruction.
The perforation of the Bowel. The cancer of the rectum can cause a tear in the intestines. Perforation usually requires surgery.

Prevention

There is No sure way to prevent cancer of the rectum, but you can reduce your risk if you:

Ask about the detection of cancer of the rectum

Colorectal cancer screening reduces the risk of cancer by finding precancerous polyps in the colon and rectum that may become cancerous. Ask your health care professional about when to start screening. Most medical organizations recommend starting screening is around 45 years of age. You can be seen earlier if you have risk factors for colorectal cancer.

Several screening options exist. Discuss your options with your health care professional. Together you can decide which tests are right for you.

Drink alcohol only in moderation, if at all

If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.

Eat more fruits and vegetables

Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful.

Exercise most days of the week

Try to do at least 30 minutes of exercise most days of the week. If you haven't been active lately, ask your health care professional if you feel well and start slowly.

Maintain a healthy weight

If your weight is healthy, work to maintain that weight. If you need to lose weight, consult with a health care professional about the healthy ways to lose your weight. Eating fewer calories, and gradually increase the amount of exercise.

Stop smoking

Talk with your health care team about the strategies and aids that can help you stop smoking. Options include nicotine replacement products, medications and support groups. If you've never smoked, don't start.

Diagnosis

Rectal cancer diagnosis often begins with a test image to see the rectum. A thin, flexible tube with a camera can be passed into the rectum and colon. A tissue sample may be taken for laboratory testing.

Rectal cancer may be found during a screening test for colorectal cancer. Or may be suspected based on symptoms. Tests and procedures used to confirm the diagnosis are:

Colonoscopy

Colonoscopy is a test to examine the colon and rectum. It uses a long, flexible tube with a camera on one end, called a colonoscope, to show the colon and the rectum. Your health care professional for signs of cancer. Medicines are given before and during the procedure to keep you comfortable.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. To obtain the tissue sample, a professional of the health passes of special cutting tools through a colonoscope. The healthcare provider uses the tools to remove a small sample of tissue from the inside of the rectum. The tissue sample is sent to a lab to look for cancer cells.

Other special tests to give more details on the cancer cells. Your health care team uses this information to make a treatment plan.

Tests for cancer of the rectum spread

If you are diagnosed with cancer of the rectum, the next step is to determine the cancer of the measure, called the stage. Your healthcare team uses the stage of the cancer, the results of the test to help you to create your treatment plan.

Essay tests include:

Complete blood count. Also known as CBC, this test reports the number of different types of cells in the blood. A CBC shows if your red blood cell count is low, called anemia. Anemia suggests that the cancer is causing the loss of blood. A high level of white blood cells is a sign of infection. The infection is a risk in the case of a rectal cancer grows through the wall of the rectum.
Blood tests to measure the function of the organ. A chemistry panel is a blood test to measure the levels of different chemicals in the blood. The worrying levels of some of these chemicals suggest that the cancer has spread to the liver. High levels of other chemicals could mean problems with other organs, including the kidneys.
The carcinoembryonic antigen. Cancers sometimes produce substances called tumor markers. These tumor markers can be detected in the blood. One of these markers is the carcinoembryonic antigen, also called CEA. CEA may be higher than usual in people with colorectal cancer. CEA testing can be useful in monitoring the response to treatment.
Computed tomography of the chest, abdomen and pelvis. This image test will help determine if the rectal cancer has spread to other organs, like the liver or the lungs.
Magnetic resonance imaging of the pelvis. An mri scan provides a detailed picture of the muscles, organs, and other tissues associated with cancer in the rectum. An mri also shows the lymph nodes near the rectum and the different layers of tissue in the rectal wall with more clarity that the TC does.

The stages of rectal cancer range from 0 to 4. A stage 0 rectal cancer is small and consists only of the surface of the mucosa of the rectum. As the cancer grows and grows the most in the rectum, the stages get more. A stage 4 rectal cancer has spread to other parts of the body.

Treatment

The treatment for rectal cancer can begin with the surgery to remove the cancer. If the cancer grows or spreads to other parts of the body, treatment can begin with the medicine and radiation in its place. Your health care team takes into account many factors when creating a treatment plan. These factors can include your general health, the type and stage of your cancer, and your preferences.

Surgery

The surgery to remove the cancer can be used alone or in combination with other treatments.

The procedures used for the rectal cancer may include:

The removal of very small cancers of the inner part of the rectum.Very small cancer of the rectum can be removed using a colonoscope or another specialized type of scope inserted through the anus. This procedure is called a local excision transanal. The surgical instruments can be passed through the scope to cut out the cancer and some healthy tissue around it. This procedure may be an option if the cancer is small and is not likely to spread to the nearby lymph nodes. If a test laboratory of cancer cells shows that are aggressive or more likely to spread to the lymph nodes, additional surgery may be necessary.
The removal of all or part of the rectum.Large rectal cancers that are quite far from the anus can be removed in a procedure that removes all or part of the rectum. This procedure is referred to as low anterior resection. The nearby tissues and lymph nodes have been removed as well. This procedure preserves the anus so that waste can leave the body normally would. How the procedure is performed depends on the cancer's location. If the cancer affects the upper portion of the rectum, part of the rectum is removed. The colon joins the rest of the rectum. This is called the colorectal anastomosis. All of the rectum can be removed if the cancer is in the lower part of the rectum. Then, the colon has the form of a bag attached to the anus, called coloanal anastomosis.
The removal of the rectum and anus.For rectal cancers that are located near the anus, it may not be possible to completely remove the cancer without damage to the muscles that control the movements of the intestine. In these situations, surgeons may recommend a surgery called an abdominoperineal resection, also known as the apr. With April, the rectum, the anus, and some of the colon are removed, as well as the nearby tissues and lymph nodes. The surgeon creates an opening in the abdomen and attached to the rest of the colon. This is called a colostomy. Waste leaves the body through the opening and accumulates in a bag that connects to the abdomen.

The removal of very small cancers of the inner part of the rectum. Very small cancer of the rectum can be removed using a colonoscope or another specialized type of scope inserted through the anus. This procedure is called a local excision transanal. The surgical instruments can be passed through the scope to cut out the cancer and some healthy tissue around it.

This procedure may be an option if the cancer is small and is not likely to spread to the nearby lymph nodes. If a test laboratory of cancer cells shows that are aggressive or more likely to spread to the lymph nodes, additional surgery may be necessary.

The removal of all or part of the rectum. Large rectal cancers that are quite far from the anus can be removed in a procedure that removes all or part of the rectum. This procedure is referred to as low anterior resection. The nearby tissues and lymph nodes have been removed as well. This procedure preserves the anus so that waste can leave the body normally would.

How the procedure is performed depends on the cancer's location. If the cancer affects the upper portion of the rectum, part of the rectum is removed. The colon joins the rest of the rectum. This is called the colorectal anastomosis. All of the rectum can be removed if the cancer is in the lower part of the rectum. Then, the colon has the form of a bag attached to the anus, called coloanal anastomosis.

The removal of the rectum and anus. For rectal cancers that are located near the anus, it may not be possible to completely remove the cancer without damage to the muscles that control the movements of the intestine. In these situations, surgeons may recommend a surgery called an abdominoperineal resection, also known as the apr. With April, the rectum, the anus, and some of the colon are removed, as well as the nearby tissues and lymph nodes.

The surgeon creates an opening in the abdomen and attached to the rest of the colon. This is called a colostomy. Waste leaves the body through the opening and accumulates in a bag that connects to the abdomen.

Chemotherapy

Chemotherapy treats the cancer with strong medications. Chemotherapy drugs are typically used before or after surgery in people with cancer of the rectum. Chemotherapy is often combined with radiation therapy and is used before surgery to reduce the size of a large cancer so that it is easier to remove with surgery.

In people with advanced cancer that has spread beyond the rectum, chemotherapy may be used alone to help relieve the symptoms caused by the cancer.

Radiation therapy

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. For rectal cancer, radiation therapy is most often done with a procedure called external-beam radiation. During this treatment, you will lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

In people with rectal cancer, radiation therapy is often combined with chemotherapy. It can be used after surgery to destroy any cancer cells that may remain. Or it can be used before surgery to shrink the cancer and make it easier to remove.

When surgery is not an option, radiation therapy can be used to relieve the symptoms, such as bleeding and pain.

Combined chemotherapy and radiation therapy

The combination of chemotherapy and radiation therapy may improve the efficacy of each treatment. Combined chemotherapy and radiation may be the only treatment you receive, or combination therapy may be used before surgery. The combination of chemotherapy and radiation treatments increases the likelihood of side effects and their severity.

Targeted therapy

Targeted therapy for cancer is a treatment that uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die.

For rectal cancer, targeted therapy may be combined with chemotherapy for advanced cancer that cannot be removed with surgery or the cancer returning after treatment.

Some targeted therapies only work in the people that the cancer cells have been certain changes in the DNA. Cancer cells can be analyzed in a laboratory to see if these medications can help.

Immunotherapy

Immunotherapy for cancer is a treatment with a medication that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells.

For rectal cancer, immunotherapy is sometimes used before or after surgery. It can also be used for advanced cancers that have spread to other parts of the body. Immunotherapy only works for a small number of people with cancer of the rectum. Special tests can determine if immunotherapy could work for you.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve the pain and other symptoms. A health care team that may include doctors, nurses and other specially trained health professionals providing palliative care. The care team's goal is to improve the quality of life for you and your family.

Palliative care specialists work with you, your family and your care team. They provide an extra layer of support, while you have cancer treatment. You can have palliative care at the same time that you are getting strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

The use of palliative care with other appropriate treatments can help people with cancer feel better and live longer.

Coping and support

With time, you will find what helps you to deal with the uncertainty and the concern of a rectal cancer diagnosis. Until then, you can find help for:

Learn enough about rectal cancer to make decisions about your care

Ask your health care team about your cancer, including your test results, treatment options, and, if you like, your prognosis. As you learn more about cancer of the rectum, may be more confident in making treatment decisions.

Keep friends and family close

Keep your close relationships strong can help you deal with the cancer of the rectum. Friends and family can provide the practical support that you may need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the fact of having cancer.

Find someone to talk to

Find someone who is willing to listen to you talk about your hopes and concerns. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful.

Ask your health care team about support groups in your area. Other sources of information are the National Cancer Institute and the American Cancer Society.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

If your healthcare provider thinks you might have cancer of the rectum, you may be referred to a doctor who specializes in the treatment of diseases and conditions of the digestive system, called a gastroenterologist. If a diagnosis of cancer, you may also be referred to a doctor who specializes in the treatment of cancer is called an oncologist.

Because appointments can be brief, it is a good idea to be prepared. Here's some information to help you prepare.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
Write down key personal information, including major stresses or recent life changes.
Make a list of all medications, vitamins or supplements you are taking and the dose.
Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For rectal cancer, some basic questions to ask include:

In what part of the rectum is my cancer is found?
What is the stage of my cancer of the rectum?
Has my rectal cancer spread to other parts of my body?
More evidence is needed?
What are the treatment options?
How much does it cost each treatment to increase my chances of a cure?
What are the possible side effects of each treatment?
How will each treatment affect my daily life?
There is a treatment option which you think is the best?
What would you recommend to a friend or family member in my situation?
You should see a specialist?
Are there brochures or other printed material that I can take with me? What sites do you recommend?
What is going to determine whether I should plan for a follow-up visit?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

When did your symptoms begin?
The symptoms been continuous or occasional?
How severe are the symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?