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Rectal cancer

Rectal Cancer

 Rectal cancer develops in the large intestine, more precisely in the colon or rectum area, due to cell mutation and uncontrolled cell growth. Some common symptoms  of rectal cancer include anemia, associated with weight loss, changes in bowel habits, and rectal bleeding. The diagnostic tools comprise of sigmoidoscopy and colonoscopy, which are recommended screening options as well after the age of 50,   a simple way to decrease the chance of developing a severe tumor.

Rectal cancer is usually confined within the colon wall; in this stage it can be successfully treated with rectal cancer surgery. If left untreated, however, it can grow and extend into the muscle layers and the bowel wall, when the only options for usually short-term improvement are chemotherapy, radiation and radical lifestyle changes.

Rectal cancer is one of the most commonly diagnosed forms of cancer worldwide, and its annual mortality rates show worrying figures.Rectal-cancer_Small

Signs, Symptoms and Causes

Depending on the location of the tumor or polyp in the bowel, symptoms and signs may vary. Obviously, if the cancer has spread in the body, symptoms are more severe.

Among the most common signs we find:

  • Constipation
  • Blood in the stool
  • Decrease in stool size
  • Loss of appetite
  • Weight loss
  • Nausea
  • Vomiting
  • Rectal bleeding
  • Anemia

Causes for rectal cancer are related to age, gender (more common in males), excessive alcohol intake, high consumption of red meat and fat, obesity, smoking and lack of physical exercise.

Studies suggest that people who suffer from inflammatory bowel disease and certain genetic syndromes, including Gardner syndrome, have an increased risk to develop rectal cancer.

Rectal Cancer Treatment

To diagnose rectal cancer, colonoscopy, sigmoidoscopy and biopsy are the most common diagnostic tools. The severity of the disease is determined through CT scans of the pelvis, abdomen and chest, but other imaging tests such as PET and MRI are also often applied. They are essential in determining the stage of the cancer, whether the lymph nodes are involved and how many metastases there are in the body.

Prevention cannot be emphasized enough. Through increased surveillance and lifestyle changes, most rectal cancers can be avoided. Also, medications such as aspirin along with calcium and vitamin D supplements have been reported to lower the risk of rectal cancer.

In order to manage rectal cancer, there are two possible ways. To eliminate it if the tumor is small and well-positioned, provided that the patient is generally in good health; or to manage it through palliative care, relieving the symptoms and keeping the patient comfortable, when the cancer is found in advanced stages due to metastases.

In the earliest stages of rectal cancer, the tumor is curable, and rectal cancer surgery is the most feasible option. In the surgical treatment rectal cancer requires the precise localization of the tumor to be able to define the margins adequately. In this case, laparotomy and laparoscopy used as standard pre-op examination procedures. On some occasions, chemotherapy is performed before rectal cancer surgery to shrink the cancer and improve the odds for a successful surgery. Liver and lungs are typical sites of recurrence for metastases, so, if only a sporadic tumor has appeared, it can be extracted too.

Chemotherapy is administered when the cancer has entered the lymph nodes. Standard drugs used in chemo include capecitabine, irinotecan, fluorouracil, UTF and epidermal growth factor receptor inhibitors.

Radiation of rectal cancer is also a strong option in later stages of the illness. Survival rate is less than 60%, which figure predisposes a relatively early detection.

Follow-up care involves regular CT scans and colonoscopies.