Rectal Cancer

In rectal cancer, the cells in the rectum’s lining become malignant and grow out of control. The rectum is located at the end of the large intestine and right before the anus. It’s estimated that about 1 in 23 men and 1 in 25 women are at risk of rectal cancer.

Adenocarcinoma is the most common type of rectal cancer. It begins in the epithelium lining that makes the mucus in either the colon or the rectum. Both rectal cancer and colon cancer can be referred to as colorectal cancer.

Most colorectal cancers originate from precancerous polys, which gradually become large and cancerous. However, it allows for early detection and treatment before the cells become malignant.

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Symptoms:

In the early stages, rectal cancers don’t cause any symptoms. When symptoms do appear, they may include:

Constipation
Chronic diarrhoea
Changes in stool colour
Blood during bowel movement
Abdominal pain and cramps
Sudden weight loss

If anyone has these symptoms for more than a week, they should consult with an oncologist for rectal cancer screening.

Causes:

Rectal cancer is caused when healthy cells in the rectum start mutating and forming polyps. Over time, these malignant cells begin to destroy the healthy cells and spread to other parts of the body.

Risk factors:

While the exact causes of rectal cancer are unknown, various factors can increase the risk. These factors are:

Ageing as people over 50 are more prone to rectal cancer than younger people.
Colon polyps, which can turn cancerous over time.
Inflammatory bowel syndromes, such as ulcerative colitis and Crohn’s disease.
Low fibre diet and obesity
Smoking and heavy drinking

Diagnosis:

Our doctors will evaluate the patient’s symptoms and medical history for the signs of rectal cancer. If rectal cancer is suspected, they will perform a physical examination and screening tests for further diagnosis, which may include:

Faecal tests to detect blood and other cancer markers in the stool.
Blood tests to identify the possible causes and to rule out other disorders.
Sigmoidoscopy to examine the colon for any abnormalities and symptoms.
Carcinoembryonic antigen (CEA) to test for cancer markers in the blood
MRI and CT scan to determine the stage of cancer and how far it has spread.
Colonoscopy to examine the inside of colon and rectum. Our doctors will use a colonoscope that has a tiny camera attached to it. It allows the doctor to see inside the rectum and check for cancerous growths.
Biopsy is performed to confirm whether the polyps in the rectum are cancerous or not. Our doctors can either use a surgical tool or a colonoscope to take a tissue sample for tests and analysis. It will help them determine the prognosis and treatment options effectively.

Based on the test results and how far cancer has spread, our doctor may categorize cancer from stage 0 to 4:

In stage 0, the rectal cancer is in the early phase and remains within the rectum lining.
In stage 1, cancer has spread into the intestine but hasn’t reached the muscle layer or lymph nodes.
In stage 2, cancer has spread past the intestine and into the adjacent tissues.
In stage 3, cancer has spread into the other part of the abdomen and lymph nodes.
In stage 4, cancer has spread into other organs, such as the liver, lungs or ovaries.

Treatment:

Treatment for rectal cancer often requires a combination of therapies. Based on the cancer stage, possible complications and the patient’s preference, our doctors will recommend the most-effective treatment option for rectal cancer, which include:

Surgery:

It’s the most common treatment option in which our surgeon will surgically remove the tumour and the surrounding tissues through various approaches, which are:

Removal of cancers from inside the rectum in which our surgeons will remove only the tumour. They may use a colonoscope or a scope to cut away cancer and some surrounding tissues inside the rectum.
Removal of the rectum to remove all or part of the rectum. The procedure depends on cancer’s location and the affected area. During the procedure, our doctor will surgically remove the rectum and the lymph nodes, leaving the anus intact.
Removal of the rectum and anus is performed to remove cancer without damaging the surrounding muscles, essential for bowel movements. During the surgery, our surgeon may perform abdominoperineal resection (APR) to remove the rectum, anus and nearby tissues.

Chemotherapy:

In chemotherapy, our doctors will use a group of drugs to stop cancer from spreading. Cancer cells absorb the drugs faster than normal cells, thus slowing their growth. These drugs can be delivered through a vein or a catheter, depending on the stage of cancer.

Radiation therapy:

Our surgeon will use controlled radiation to damage or destroy the DNA of cancer cells. Our radiation oncologist will use a machine to direct the energy beams on the cancer cells. It can be used in combination with chemotherapy if surgery isn’t an option.