- What is rectal cancer?
- What causes rectal cancer?
- What factors increase the risk of rectal cancer?
- What are the symptoms?
- How is rectal cancer diasgnosed?
- What is the prognosis of rectal cancer?
- How is rectal cancer treated?
- Can rectal cancer be prevented?
Rectal cancer is a type of bowel cancer that occurs when cancer cells form in the rectum, the last 6-7 inches of the large intestine connecting the colon to the anus. Bowel cancer, or colorectal cancer, is one of the most common types of cancer in the UK.
In most cases bowel cancers begin as a bowel polyp, a growth on the lining of the large intestine or rectum. The majority of bowel polyps remain benign (not cancerous). The mutation of DNA in healthy cells can cause them to grow uncontrollably and outlive normal cells. Cells must undergo numerous mutations before they become cancerous, although it’s not clear what caused these mutations. Cancerous cells can destroy healthy neighbouring cells and spread to other parts of the body.
- Age. People over the age of 50 are more likely to develop rectal cancer.
- Other bowel diseases. Inflammatory bowel disease (IBD), Crohn’s Disease and Ulcerative Colitis patients are at higher risk of developing bowel cancer.
- A family history of bowel cancer or other inherited syndromes, such as Lynch syndrome or familial adenomatous polyposis (FAP). Certain genetics can influence the likelihood of cancerous cells occurring.
- Unhealthy lifestyle. Obesity and diabetes increase the risk of bowel cancers, as well as smoking, a lack of exercise, an unbalanced diet and regularly consuming alcohol.
- Previous radiation therapy as a treatment for a past cancer.
- Constant change to bowel movements. Diarrhoea, constipation and more frequent movements can be signs.
- Change in the appearance of the stool over a period of time, often appearing narrow and containing blood.
- Prolonged physical pain, particularly in the abdomen or pelvis.
- Weight loss, tiredness and weakness.
Although these are common signs of rectal, or other bowel, cancers these symptoms aren’t exclusive to this disease and are associated with other illnesses, such as haemorrhoids. In some instances, the patient may be symptomless and the cancer may only be detectable by screenings.
Rectal cancer can be diagnosed through screening for colorectal cancer. Tests and procedures include:
Physical exams and medical history may play a role in the diagnosis of rectal cancer.
The likelihood of surviving rectal cancer depends on numerous factors, like the stage and the location of the cancer, the patient’s age and overall health, whether the bowel has been blocked or irreparably damaged and whether complete removal of the tumour is possible or not. Thanks to advancements in the previous decades, the rate of survival has greatly improved.
Surgery is almost always needed to remove the tumour. A team of doctors usually work together in the treatment of rectal cancer. This team may include a surgical oncologist, a colorectal surgeon and a gastroenterologist. Given the small size of the rectum, operating on it can often be a complex procedure. Depending on the case, the surgeon will enter either through the abdomen or the anus to remove the tumour. Minimally invasive surgery can be in option in some cases. Chemotherapy or radiation may be necessary also, in which case a radiation oncologist would treat the patient.
There are certain steps that can be taken to reduce the risk of developing rectal cancer, such as:
- Genetic testing, if there’s a history of bowel cancers in the family
- Regular screenings
- Increased exercise
- Increased consumption of fruit, vegetables and whole grains
- Quit smoking
- Moderate consumption of alcohol