What is Rectal Cancer?

Rectal cancer is the cancer of the rectum, which is the lowermost part of the digestive system. Rectal cancer is often referred in combination with the colon as colorectal cancer.

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the second leading cause of cancer deaths in the United States. It is estimated that 1 in 20 (5%) persons will develop colorectal cancer during their lifetime in the US.

1. Symptoms of Rectal Cancer

Most patients with colon cancer do not have symptoms. However, as the disease progresses they may experience one or more of the following symptoms:

A change in bowel habits or a change in the consistency of stool.
Rectal bleeding.
Rectal itching.
A sensation of incomplete evacuation after passing stool.
Unexplained weight loss.
Excessive tiredness, weakness or fatigue.
Persistent abdominal discomfort, such as cramps, gas or pain.
Nausea or vomiting.
Low iron level (iron deficiency anemia).

2. Causes of Rectal Cancer

Rectal cancer occurs when the cells lining the rectum multiply rapidly out of control. Although the exact cause of colorectal cancer is unknown, various risk factors have been identified.

3. Risk Factors of Rectal Cancer

Risk factors of rectal cancer include:

Age 50 or older.
A family history of colorectal cancer.
Patient history of other cancer.
Smoking.
Excessive alcohol consumption.
Decreased dietary fiber intake.
Eating red or processed meats.
Obesity.
Inflammatory bowel disease.
Colorectal polyps.

4. Prevention of Rectal Cancer

Prevention actions to lower the chance of rectal cancer include:

Losing weight.
Stopping smoking.
Eating a healthy diet with increased consumption of fiber-rich fruits and vegetables.

It is recommended those above 50 years old should undergo a regularly scheduled colonoscopy to screen for cancer and locate suspicious colorectal polyps at the earliest stage possible.

5. Complications of Rectal Cancer:

Untreated and undiagnosed rectal cancer is lethal. Rectal cancer will continue to grow and may cause complete intestinal obstruction resulting in severe abdominal pain, constipation, and vomiting.

Rectal cancer may grow and invade neighboring organs. It may invade the urinary bladder and cause urinary problems. It may also invade the vagina causing gynecological issues.

Rectal cancer may also involve other organs of the body such as the liver, stomach, lungs, and brain, creating widespread problems — ultimately resulting in death.

6. Diagnosis of Rectal Cancer

If your doctor or nurse is concerned that you could have colorectal cancer, they may advise for colonoscopy.

Colonoscopy is a procedure in which a scope is inserted into your anus allowing the colon to be visualized. Cancers growing within the large intestine and rectum can be seen during a colonoscopy. At the same time, a piece of abnormal-looking tissue can be taken for examination (biopsy), confirming the presence of cancer.

7. Treatment of Rectal Cancer

When rectal cancer is confirmed by biopsy, further testing (“staging”) is required to know the extent of rectal cancer, if the cancer is limited to the rectum only, or if it has grown outside the rectum and spread to other organs of the body.

Most rectal cancers are treated with a combination of surgery, radiation therapy, and chemotherapy depending upon the staging of rectal cancer and the general health of the patient.

Surgical Management of Rectal Cancer

Surgery is often the initial treatment of colorectal cancer. During the surgery, the cancerous part of the rectum is removed along with the surrounding tissue.

Medical Management of Colon Cancer

Medical management usually comprises of chemotherapy and correction of anemia. Chemotherapy is an aggressive treatment given to slow or stop the growth of cancer cells. After the surgery, microscopic cancer cells may still be present. These cells should be removed for a complete cure. If these cells are left without treatment, they will multiply and form cancer again. Most chemotherapy treatments involve a combination of several drugs. These drugs are given at different times. Your health care provider will inform you in detail regarding the drugs, the duration and the expected side effects from your treatment.

8. Follow Up

Follow-up care after treatment for rectal cancer is crucial. Undetected cancer cells can remain in the body after treatment. Healthcare providers will monitor recovery and check for cancer recurrence at specific intervals by ordering different blood tests, CT scan imaging, or repeating colonoscopy. Follow-up doctor visits may occur as often as every three months for at least two years, and then possibly reducing in occurrence thereafter. Follow-up exams will depend upon your condition.

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