About Rectal Cancer

The rectum is a part of the body’s digestive system and the last part of the large intestine. Rectal cancer occurs when cells in the rectum turn malignant (or cancerous). The exact cause of rectal cancer is unknown, but it is seen more commonly in older adults, usually over 50 years. Some factors that increase your risk for rectal cancer include: Family history of colon or rectal cancer The individual history of colon or ovarian cancer Medical history of Crohn’s disease Having three or more drinks a day Smoking Obesity There are four primary types of rectal cancers– adenocarcinoma, gastrointestinal stromal tumours, lymphoma and carcinoid tumours, and over 90% of rectal cancers are adenocarcinomas. Rectal cancer life expectancy depends upon the stage of cancer at the time of diagnosis, its spread, and the patient’s overall health. When detected in the early stages, rectal cancer has a good prognosis.

Symptoms

In its early stages, rectal cancer does not cause any symptoms. Few early symptoms as rectal cancer advances are changes in bowel movements (diarrhoea or constipation), rectal bleeding or blood in the stool.

Other symptoms of rectal cancer include:

  • Fatigue
  • Unexplained weight loss
  • Abdominal pain
  • Bloating
  • Feeling that your bowels are not entirely empty
  • Changes in appetite

In advanced stages (stage 3 and stage 4 rectal cancer) when cancer has spread to other parts of the body, symptoms may include:

  • A generalised feeling of tiredness
  • Bone pain
  • Persistent cough
  • Jaundice

 Since some of these signs and symptoms may also be seen in haemorrhoids, you must consult your doctor for further evaluation.

Diagnosis

If your doctor suspects rectal cancer based on your symptoms, medical and family

history, and physical examination, they may recommend the following tests:

  • Digital Rectal Examination

The doctor inserts a well-lubricated, gloved finger inside the rectum to check for

abnormal growths or lumps. 

  • Colonoscopy

This procedure uses a thin, tube-like instrument to look inside the colon and the rectum for abnormalities or growth. The procedure also allows for collecting any abnormal tissue sample for analysis.

  • CEA Assay

Carcinoembryonic antigen assay or CEA assay measures the CEA level (a protein released by cells) in the blood. Though CEA is released by both normal and cancer cells, its increased levels may indicate cancer.

  • Biopsy

A biopsy is usually performed to confirm a rectal cancer diagnosis. A sample of the abnormal tissue from the rectum is collected and sent for laboratory analysis. This tissue sample also helps in staging and grading rectal cancer.

Your symptoms and diagnostic tests results help your doctor

Treatment

Standard rectal cancer treatment options include – surgery, radiation therapy and chemotherapy. The choice of treatment will depend upon the sage of your cancer and its spread. For stage 1 rectal cancers that are localised and have not spread outside the rectal lining, surgery is the primary treatment.

Stage 2 rectal cancers have spread beyond the rectal walls into nearby tissues. So, these cases are usually treated using a combination of surgery, radiation therapy and chemotherapy.

Stage 3 rectal cancers have spread to nearby lymph nodes, but no distant spread is observed. This stage of rectal cancer is treated similarly to stage 2 cancers, but the order of treatments used may differ in every patient.

Stage 4 rectal cancer is characterised by spreading cancer cells to distant sites in the body, including the lungs or the liver. Though many people panic about chemotherapy and rectal cancer side effects, it is one of the primary treatment choices to manage stage 4 rectal cancer.

In advanced cancers that are widespread, different treatment options aim to relieve patients’ symptoms and improve their quality of life.

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