Rectal cancer is a type of cancer that originates from the end of the large intestine. The rectum is a part of the digestive system that is located between the colon and the anus.

Rectal tumors first appear as very small lesions or even as small non-cancerous (benign) polyps. Over time and if not diagnosed or followed up in the early stages, these lesions gradually grow and can turn into cancer. These early polyps and lesions may be asymptomatic.

Over time, cancer cells can grow and invade surrounding normal tissues such as the bladder, prostate, vagina, and uterus. Cancer cells can spread through the blood or lymph tissues to other parts of the body and cause metastasis.

Rectal cancer or tumor can occur at any age, but its prevalence is usually higher in middle-aged and elderly people. Some people may get this type of cancer at a young age due to genetic or family predisposition.

Symptoms of rectal cancer

• Bleeding during defecation or seeing blood in stool
• Recent change in bowel habits (for example, diarrhea or constipation that has recently developed)
• Anemia of unknown cause
• Change in shape (thinning) or consistency of stool
• Difficulty in elimination
• Chronic abdominal pains
• Abdominal bloating that has not been treated with conventional treatments
• Unexplained weight loss
• Weakness or tiredness for no reason

Risk factors in developing rectal cancer

• old age
  Rectal cancer can occur at any age, but its prevalence is usually higher in middle-aged and elderly people. The rate of this cancer in young people is also increasing, but doctors are not sure why.
• Family history of colon or rectal cancer
• History of cancers related to colon cancer (such as gastrointestinal, breast or gynecological cancers)
• History of single or multiple colon polyps
• Inflammatory diseases of the large intestine (such as ulcerative colitis or Crohn's disease)
• Hereditary and family syndromes (such as Lynch syndrome and...)
• low-fiber, high-fat diet
• Sedentary lifestyle
• Diabetes
• Alcohol
• History of radiation therapy to the pelvis to treat previous cancers
• Obesity
• cigarette

rectal cancer screening

Regular screenings are recommended for all people to prevent rectal cancer by identifying and removing small initial lesions before they turn into cancer. Screening has been shown to reduce the risk of death from bowel cancer.

Guidelines generally recommend that colorectal cancer screening begin at age 45. But people who are at higher risk should start screening earlier and do this screening with less intervals.

There are different ways to screen for colon and rectal cancers. These methods include examination of occult blood in stool, rectosigmoidoscopy and colonoscopy. If there is occult blood in the stool test, it will be necessary to perform a colonoscopy.

For more information, refer to the relevant article in the "Colorectal Cancer Screening" section.

rectal cancer diagnosis

Certain diagnosis of this disease is by colonoscopy and sampling. If during colonoscopy, your doctor or surgeon encounters a suspicious lesion or polyp in your rectum, he will take a sample from it. Then he sends the tissue sample for pathology examination. In response to the pathology, the diagnosis of colon cancer is confirmed.
After the definitive diagnosis, a series of measures including blood tests and imaging are requested for the patient to check the spread of the tumor in the body.

Rectal cancer treatment

While rectal and colon cancers are similar in many ways, their treatment methods are somewhat different. In the past, the treatment of this disease was associated with many challenges and in many cases it was not possible. But thanks to today's modern and precise surgical methods, radiation therapy and new chemotherapy drugs, the treatment of patients with rectal cancer has made significant progress. And even in many cases their disease is completely cured.

The treatment of this disease consists of several stages, which are done based on the extent of the disease and according to your doctor's opinion.

If the rectal cancer is early, localized, small, and completely at the top of a polyp, your doctor may be able to remove it completely during a colonoscopy. In addition, there are other minimally invasive methods of removing these lesions through the anus, which can be performed by a colorectal surgeon. In some of these cases, removing that small lesion can lead to your complete treatment.

In larger lesions and based on the degree of local tumor involvement, radiotherapy may be recommended at first. ) dill During radiation therapy, the tumor is exposed to radiation. One to two months after the completion of radiation therapy, it is time to perform surgery. During surgery, the patient's rectum is removed. If the tumor is far from the anus, the surgeon can connect the end of the colon to the anus. In these cases, often the patient's small intestine is temporarily placed outside the abdominal wall (ostomy or temporary bag) and is closed after a few months. "Ostomy" is a hole in the abdominal wall through which a part of the remaining intestine is removed for defecation. For easier cleaning, a bag is placed over its opening. But in cases where the tumor is close to the anus or has involved the anal muscles, in addition to the rectum, the anus is also removed and a permanent colostomy (permanent bag) is installed for the patient.

After the surgery and full recovery, based on your disease and the pathology (histology) result of the surgery, you may be advised to do additional chemotherapy.
If the cancer is very advanced and unresectable or in cases where the cancer has spread to other parts of the body (metastasis) and cannot be removed, the doctor may not recommend surgery for the patient and chemotherapy may be recommended for the patient.

There is a possibility of disease recurrence after surgery. For this reason, after surgery, you should be under the supervision of your colorectal surgeon frequently and at regular intervals and be sure to perform the recommended tests.

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