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Rectal Cancer

What is cancer?

Rectal Cancer

An abnormal growth of cells in any part of the body is termed as a tumor. When this tumor is malignant, it is termed as cancer. These cancerous cells can destroy the tissues in an organ. If these cells separate away from the tumor and flow in the bloodstream, they invade other organs and make the cells in the other organ also cancerous.

What is rectal cancer?

Rectal Cancer is referred to the abnormal growth of cells which have turned malignant in the lining of the rectum (last part of the large intestine). Malignant tumors formed in the rectum can spread and destroy the nearby organs as well. Rectal cancer can also spread to the lungs and the liver.

Rectal cancer has a very high probability of recurring locally.

What are the signs and symptoms?

You can have rectal cancer without any symptoms showing for a few years. However after a few years following symptoms do show up:

  • Rectal bleeding
  • Anaemia leading to fatigue, breathlessness.
  • Weakness
  • Constipation
  • Abdominal pains and cramping
  • Unexplained weight loss
  • Pencil-thin stools

What are the causes?

  • Polyps: Most of the times, rectal cancer is caused due to the polyps which go undetected for many years.
  • A family history of colorectal cancer.
  • Diet: Having a high intake of fatty foods in your diet. It is believed that when the breakdown of the fatty food takes place inside the intestine, chemicals are produced which are known to cause cancer (carcinogens).
  • Increasing age
  • History of polyps or colorectal cancer.

What are the risk factors involved?

You are at a greater risk for getting rectal cancer if:

  • You have not got yourself screened for colorectal cancer.
  • You are above the age of 60.
  • You have a family history for colorectal cancer.
  • You are obese.
  • You have a sedentary lifestyle with no exercise at all.
  • You have had a polyp in the last few years.

When to seek medical advice?

You should go for normal regular check ups.

ou should seek immediate medical advice if:

  • Your normal check up shows up an indication of rectal cancer.
  • Acute rectal bleeding
  • You are experiencing fatigue and breathlessness.

What is the method for screening and diagnosis?

During your normal medical checkups, your blood and stool reports or a digital rectum exam could have shown a possibility of rectal cancer.

To confirm the presence of rectal cancer, following tests can be done:

  • Colonoscopy: Using a thin flexible tube which is inserted through the rectum, the entire large intestine is checked for tumors.
  • Sigmoidoscopy: A long slender tube with a camera is inserted through the anus into the rectum. The camera (endoscope) will show a complete picture of the rectum along with its linings.

If a tumor is found, using colonoscopy the tumor will be removed. A thorough examination of the removed tumor will be done to check if the tumor is cancerous.

Alternatively, small tissue samples can be obtained by bioscopy to confirm the presence of rectal cancer.

Once rectal cancer is confirmed, the stage of the cancer has to be determined. If the cancer is limited to only the innermost lining of the rectum, it is defined as stage 0 cancers. If the cancer is limited to an area with a tumor of less than 2 cm, it is also known as stage 1 cancer. Stage 2 cancers has a tumor of more than 2 cm. Stage 3 cancer would have spread to nearby areas like lymph nodes and other organs. Stage 4 cancers would have spread to distant organs as well.

Tests will be performed to see if the cancer has spread to other organs. For this staging examinations like chest X-ray, Ultrasonography or a CAT scan of the lungs, liver and abdomen are performed.

What is the treatment?

Treatment for rectal cancer depends on which stage the cancer is. This means whether the cancer is limited to a particular area or has it spread to other parts. It is also dependant on the health and age of the patient.

  • Transanal excision: If the cancer is limited to the mucosa membrane in the rectum wall, the tumor is removed via the anus in this procedure.
  • Low anterior resection: This procedure is formed if the cancer is located in the upper part of the rectum. An incision is made through which the affected part of the rectum along with the lymph nodes is removed. After this the colon is joined back to the remaining part of the rectum.
  • Abdominoperinal resection: This procedure is performed if the cancer is located close to the anus. In this procedure, the anal sphincter (muscle) is removed. Along with this procedure, colostomy is a must. Colostomy is actually an alternative exit for fecal waste. It is a hole connected to the colon and passes the waste out through the wall of the abdomen into a bag.
  • Chemotherapy: Drugs are used to stop the growth of cancerous cells.
  • Radiation: High energy X-rays are used to kill the cancerous cells.

If the rectal cancer is detected to be in either stage 2 or 3, chemotherapy and radiation is usually advised before going in for surgery. Repeated checks are performed every 6 months to see whether the cancer has resurfaced again.

If the cancer has already spread to other areas, surgery and radiation will only be performed if there is persistent rectal bleeding or bowel obstruction. As of today, there is no cure for stage 4 of rectal cancer. Only the surviving period can be increased due to medications.

How to prevent?

  • Eat healthy food, avoid fatty foods.
  • Exercise regularly.
  • Go for regular medical checkups which should include digital rectum exam and stool test.


