Rectal Cancer

Why choose us for Rectal Cancer care?

What you need to know about Rectal Cancer

Rectal cancer is a type of cancer that develops in the rectum, which is the final part of the large intestine, just before the anus. It typically starts as small, benign clumps of cells called polyps that can, over time, become cancerous.

How to talk to your doctor about Rectal Cancer

  1. Prepare Ahead of Time

    • Write down your symptoms, including when they started and how they have changed over time.
    • Make a list of any questions or concerns you have.
    • Bring a list of all medications, supplements, and vitamins you are taking.

  2. Bring a Support Person

    • Consider bringing a family member or friend to help you remember information and provide emotional support.

  3. Be Honest and Open

    • Share all relevant information about your health, even if it feels embarrassing or difficult.

  4. Ask Specific Questions

    • What type of rectal cancer do I have?
    • What stage is my cancer?
    • What are my treatment options?
    • What are the risks and benefits of each treatment?
    • What side effects can I expect?
    • How will treatment affect my daily life?
    • Are there clinical trials available for my type of cancer?

  5. Understand Your Diagnosis and Treatment Plan

    • Ask your doctor to explain your diagnosis and treatment plan in simple terms.
    • Request written information or resources that you can review at home.
    • Don’t hesitate to ask for clarification if you don’t understand something.

  6. Discuss Your Prognosis

    • Ask about the expected outcomes of your treatment.
    • Inquire about survival rates and factors that might influence your prognosis.

  7. Explore Support Services

    • Ask about support groups, counseling services, and other resources that can help you cope with your diagnosis.

  8. Consider a Second Opinion

    • It’s okay to ask for a second opinion if you have doubts or want to explore all your options.

  9. Follow Up

    • Schedule follow-up appointments to monitor your progress and address any new concerns.
    • Keep a record of your appointments, treatments, and test results.

  10. Communicate Continuously

    • Maintain open lines of communication with your healthcare team.
    • Inform them about any new symptoms or side effects you experience.

By being proactive and engaged in your care, you can work with your doctor to make informed decisions about your treatment and manage your rectal cancer effectively.

  1. Adenocarcinoma

    • Most common type of rectal cancer.
    • Subtypes:
      • Mucinous (Colloid) Adenocarcinoma: Contains significant amounts of mucin.
      • Signet Ring Cell Carcinoma: Rare, aggressive, with cells containing mucin-filled vacuoles.

  2. Carcinoid Tumors (Neuroendocrine Tumors)

    • Arise from hormone-producing cells in the intestines.
    • Tend to grow slowly.

  3. Gastrointestinal Stromal Tumors (GISTs)

    • Originate from interstitial cells of Cajal in the gastrointestinal tract.
    • Less common in the rectum.

  4. Lymphoma

    • Primary rectal lymphomas are rare.
    • Involve lymphatic tissue in the rectum.

  5. Sarcomas

    • Arise from connective or muscle tissue.
    • Subtypes:
      • Leiomyosarcoma: Originates from smooth muscle cells in the rectal wall.
      • Kaposi’s Sarcoma: Involves blood vessels and connective tissues; more common in immunocompromised patients.

  6. Squamous Cell Carcinoma

    • Less common in the rectum.
    • Originates from squamous epithelial cells lining the rectal mucosa.

  7. Melanoma

    • Rare in the rectum.
    • Originates from melanocytes, the pigment-producing cells.

Each type requires specific diagnostic and treatment approaches, with adenocarcinoma being the most prevalent form of rectal cancer.

Several factors can increase the risk of developing rectal cancer

Genetic Factors

  1. Inherited Syndromes:

    • Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer, HNPCC): Increases the risk of colorectal cancer, often at a younger age.
    • Familial Adenomatous Polyposis (FAP): Leads to hundreds of polyps in the colon and rectum, with a high potential to become cancerous if untreated.

  2. Family History:

    • A family history of rectal cancer or colorectal polyps can increase the likelihood of developing rectal cancer due to inherited genetic mutations.

Lifestyle and Environmental Factors

  1. Diet:

    • High intake of red and processed meats (e.g., beef, pork, lamb, hot dogs, sausages).
    • Low-fiber and high-fat diets, particularly those high in animal fats.

  2. Smoking and Alcohol:

    • Smoking: Long-term use is associated with a higher risk of rectal cancer.
    • Alcohol: Heavy alcohol consumption, and even moderate drinking when combined with other risk factors.

  3. Obesity:

    • Being overweight or obese increases the risk due to hormone and growth factor imbalances.

  4. Physical Inactivity:

    • Lack of regular physical activity contributes to an increased risk.

Medical Conditions

  1. Inflammatory Bowel Disease (IBD):

    • Conditions like Crohn’s disease and ulcerative colitis increase the risk due to chronic inflammation.

  2. Type 2 Diabetes:

    • Higher risk due to insulin resistance and elevated levels of insulin or insulin-like growth factors.

Other Factors

  1. Age:

    • Risk increases with age, particularly in individuals over 50, but can also occur in younger people with genetic predispositions.

  2. Radiation Therapy:

    • Previous radiation treatment to the abdomen or pelvis can increase the risk.

Mechanisms of Cancer Development

  1. DNA Mutations:

    • Genetic mutations (inherited or acquired) can lead to the transformation of normal cells into cancerous ones.

  2. Polyps:

    • Rectal cancer often starts as benign polyps that can become cancerous over time if not removed during screenings.

Conclusion

Understanding the diverse causes of rectal cancer, including genetic factors, lifestyle choices, medical conditions, and age, can aid in developing preventive measures and emphasizing the importance of regular screenings for early detection, particularly for those at higher risk.

Early stages of rectal cancer might not present any symptoms. However, as the cancer progresses, symptoms may include:

  • Changes in bowel habits (diarrhea, constipation, or narrowing of the stool)
  • Rectal bleeding or blood in the stool
  • Persistent abdominal discomfort (cramps, gas, or pain)
  • A feeling that the bowel doesn’t empty completely
  • Weakness or fatigue
  • Unexplained weight loss

Diagnosing rectal cancer typically involves several steps:

  • Physical Exam and History: Including a digital rectal exam (DRE).
  • Imaging Tests: Such as colonoscopy, which allows for direct visualization and biopsy of suspicious areas. Other imaging tests might include CT scans, MRI, or PET scans to determine the extent of the disease.
  • Laboratory Tests: Blood tests to check for anemia and to assess liver and kidney function, and a test for carcinoembryonic antigen (CEA), a marker sometimes elevated in colorectal cancer.

Staging

Staging is crucial to determine the extent of cancer and plan treatment:

  • Stage 0: Cancer is in the inner lining of the rectum (in situ).
  • Stage I: Cancer has grown into the muscle layer but not beyond the rectum.
  • Stage II: Cancer has grown through the rectal wall but not reached lymph nodes.
  • Stage III: Cancer has spread to nearby lymph nodes.
  • Stage IV: Cancer has spread to distant organs (metastasis).

Treatment depends on the stage and may involve one or a combination of therapies:

  • Surgery: To remove the tumor and surrounding tissue, often including lymph nodes. Types of surgery include local excision for early stages or more extensive procedures like low anterior resection (LAR) or abdominoperineal resection (APR).
  • Radiation Therapy: Often used before surgery to shrink tumors or after surgery to kill remaining cancer cells.
  • Chemotherapy: Uses drugs to destroy cancer cells, typically administered after surgery if the cancer has spread to lymph nodes or other organs.
  • Targeted Therapy: Focuses on specific molecules involved in cancer growth, such as bevacizumab (Avastin) or cetuximab (Erbitux).
  • Immunotherapy: Uses the body’s immune system to fight cancer, effective in some cases, particularly with specific genetic markers.

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