What is Rectal Cancer?
Rectal cancer begins when normal rectal cells transform and grow uncontrollably, forming a mass or tumor. While its exact cause isn’t fully understood, risk factors like age, family history, and inflammatory bowel diseases increase the likelihood of its development. Recognizing the signs and symptoms of rectal cancer is crucial for early detection and timely intervention.
Symptoms of Rectal Cancer
Symptoms may vary from one person to another, but common signs to watch for include:
- Changes in Bowel Habits: Persistent changes in bowel habits, such as diarrhea, constipation, or a feeling of incomplete evacuation after bowel movements.
- Blood in Stool: Rectal bleeding or the presence of bright red blood in the stool may be visible or detected through blood tests. Dark, tarry stools (melena) can also suggest bleeding higher up in the digestive tract.
- Abdominal Discomfort and Pain: Abdominal discomfort, often crampy and persistent, may be associated with bowel movements. A sense of fullness or bloating, even after a light meal, should be noted, as these sensations may point toward underlying issues requiring medical evaluation.
- Unexplained Weight Loss: Significant and unexplained weight loss not from changes in diet or physical activity.
- Weakness and Fatigue: Generalized weakness and fatigue can result from chronic blood loss due to the cancer’s impact on the digestive tract.
Diagnosis and Screening
Timely diagnosis is critical in tackling rectal cancer. Screening methods, such as colonoscopies, help detect precancerous growths or early-stage cancers. If symptoms are present, various diagnostic tools like imaging studies, blood tests, and biopsies aid in confirming the diagnosis and determining the extent of the cancer. Types of screenings include:
- Colonoscopy: A flexible tube with a camera is inserted into the rectum and passed through the colon to visually examine the lining, identify abnormalities like tumors or polyps, and extract tissue samples (biopsies) for further examination.
- CT Colonography (Virtual Colonoscopy): This non-invasive imaging test uses computed tomography (CT) scans to create detailed images of the colon, helping identify abnormalities or growths.
- Flexible Sigmoidoscopy: Like a colonoscopy but focused on the lower part of the colon, this procedure is particularly useful in detecting abnormalities in the rectum and sigmoid colon.
- Fecal Occult Blood Test (FOBT): This at-home test detects blood in the stool, which can indicate colorectal abnormalities. This test does not identify the source of bleeding.
When symptoms indicate rectal cancer is present, further diagnostic tools come into play to confirm the diagnosis and assess the extent of the cancer.
- Imaging Studies: Advanced imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, provide detailed images of the rectum and surrounding structures, aiding in identifying the stage of the cancer.
- Blood Tests: Specific blood markers, such as carcinoembryonic antigen (CEA), may be elevated in colorectal cancer patients. While not diagnostic on their own, abnormal levels can prompt further investigation.
- Biopsies: A biopsy involves the removal of a small tissue sample from the rectal tumor or suspicious area. This sample is then examined under a microscope to confirm the presence of cancer cells and determine the cancer’s type and aggressiveness.
Rectal cancer treatment often involves a multidisciplinary approach. The choice of treatment depends on factors such as the cancer’s stage, the patient’s overall health, and personal preferences. Standard treatment options include:
- Primary Tumor Removal: Surgical intervention is often a cornerstone of rectal cancer treatment. Surgeons may opt to remove the tumor or the affected part of the rectum – a procedure known as resection. The extent of the surgery depends on factors like the tumor size, location, and whether it has spread to nearby tissues or lymph nodes.
- Minimally Invasive Techniques: Advanced surgical techniques, such as laparoscopic or robotic-assisted surgery, may be used to reduce incisions and enhance recovery.
Radiation Therapy & Chemotherapy:
- Precision Targeting: Radiation therapy employs high-energy rays to target and destroy cancer cells. It is often used in conjunction with surgery or chemotherapy. In cases of rectal cancer, external beam radiation may be directed at the tumor site, especially when the cancer is close to or involves surrounding structures.
- Neoadjuvant or Adjuvant Use: Similar to chemotherapy, radiation therapy can be applied before surgery to reduce tumor size, or after surgery to eradicate residual cancer cells.
- Chemotherapy: This treatment involves using powerful chemical medications that target rapidly dividing cancer cells throughout the body. It can be administered before surgery (neoadjuvant) to shrink tumors, making them more manageable, or after surgery (adjuvant) to get rid of any remaining cancer cells. It’s important to note that the timing of chemotherapy in rectal cancer treatment can vary depending on the specific case and the treatment plan developed by the medical team.
Targeted Therapy and Immunotherapy:
- Precision Medicine: Targeted therapy focuses on specific molecules or pathways involved in cancer growth. In rectal cancer, targeted therapies may include drugs that inhibit specific proteins contributing to tumor development.
- Immunotherapy: This innovative approach harnesses the body’s immune system to identify and attack cancer cells. While still emerging in rectal cancer treatment, immunotherapy shows promise in enhancing the body’s natural defenses against cancer.
Risk Factors and Prevention
Rectal cancer, like many cancers, can be influenced by various risk factors, encompassing a combination of genetic, lifestyle, and environmental elements. While the presence of these factors does not guarantee the development of rectal cancer, being aware of them can aid in proactive health management. Here are key risk factors associated with rectal cancer:
- Age: The risk of rectal cancer increases with age, with the majority of cases diagnosed in individuals over 50. Cases are not uncommon in younger age groups, emphasizing the importance of vigilance across all demographics.
- Family History and Genetics: Individuals with a family history of colorectal cancer or certain hereditary conditions, such as Lynch syndrome or familial adenomatous polyposis (FAP), have an elevated risk. Genetic factors can contribute to the development of precancerous polyps or tumors.
- Dietary Choices: Diets high in red and processed meats, low in fiber, and low in fruits and vegetables may contribute to an increased risk.
- Physical Inactivity: Sedentary lifestyles and lack of regular exercise are associated with higher incidences of colorectal cancers, including rectal cancer.
- Smoking and Alcohol Consumption: Tobacco use and excessive alcohol consumption have been identified as risk factors for colorectal cancers, including rectal cancer. Quitting smoking and moderating alcohol intake can positively impact overall health.
Understanding these risk factors can help you and your gastroenterologist to start preventive measures and early detection strategies. Regular screenings, a healthy lifestyle, and proactive management of predisposing conditions contribute to a comprehensive approach to reducing the risk of rectal cancer and promoting long-term colorectal health.
To take the first step towards safeguarding your health, schedule your screening with the experts at GastroMD today, where your well-being is our top priority!