Rectal Cancer

The colon and rectum are the two main parts of the large intestine. Although the colon is only one part of the large intestine, because most of the large intestine consists of colon, the two terms are often used interchangeably. The large intestine is also sometimes called the large bowel.

Digestive waste enters the colon from the small intestine as a semi-solid. As waste moves toward the anus, the colon removes moisture and forms stool. The rectum is about six inches long and connects the colon to the anus. Stool leaves the body through the anus. Muscles and nerves in the rectum and anus control bowel movements.

Colorectal cancer describes any cancers of the bowel, including those of the large intestines, colon, rectum and appendix. Rectal cancer begins in the rectum, which is the last several inches of the colon.

Treatments for Rectal Cancer

If you have rectal cancer, we'll talk everything over with you, and include your family if you like. Because we always pursue the newest available technology and treatments, we leave nothing to chance. If your cancer has not spread to the colon, for example, surgical options are likely to be your first line of defense. For a little anatomy to help you understand, the rectum is about four to five inches inside your body. Because of the compact area this organ occupies, precision is key.

We offer not only that exacting skill, but we care deeply about making you better as comfortably as possible. Think of us as your team, ready to conquer together. Learn more about treatments for rectal cancer here and let's get started.

Chemotherapy
This well-known cancer treatment uses medicines taken intravenously or by mouth to kill cancer cells throughout the body. Chemotherapy may be given before surgery to shrink tumors, or after to fight cancer cells that have potentially spread.

Endocavity Radiation Therapy
High-intensity radiation is delivered through a small device into a specific cancerous area. This allows some patients to avoid major surgery. It may be appropriate for some early rectal or esophageal cancers.

Excision Surgery
If cancer has not spread from the rectal wall, only this portion of the rectum will be removed.

Internal Radiation Therapy
For this treatment, a radioactive source is put next to or into the tumor. The advantage of this approach is that the radiation reaches the tumor without passing through the skin and other tissues, which means it is less likely to cause side effects.

Interstitial Radiation Therapy
This delivers radioactive pellets directly into the tumor through a tube.

Polypectomy
If a rectal polyp is cancerous, a colonoscopy can actually treat cancer. Just as with a colonoscopy, general anesthesia isn't required. This is a simple treatment for early stage rectal cancer.

Robotic–Assisted Surgery
We have staff surgeons who specialize in using the daVinci(R) robotic system to treat various UGI cancers. Allowing greater dexterity and precision, robotic-assisted surgery can reduce complications and speed recovery.

Targeted Therapy
Targeted drugs have advanced the treatment of rectal (and colon) cancers. "Targeted" therapy destroys cancer cells, leaving normal cells alone. It stops cancer cells from dividing or destroys them directly.

Transanal Endoscopic Microsurgery
Newer techniques like this are promising for treatment of some colon and rectal cancers. Flexible surgical instruments allow removal of cancerous lesions rectally. Because it's less invasive, you may enjoy faster recovery and fewer complications.

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What Is Rectal Cancer?

The rectum is part of the colon (large intestine) in the digestive tract. It’s the last 10 inches or so of the colon and ends at the anus, which is the opening to the outside. Rectal cancer is cancer that grows in the rectum. It tends to happen more with older age, especially in men, and usually grows slowly. Most of the time, it starts as a small growth called a polyp.

What Causes Rectal Cancer?

The cause is unknown.

What Are the Symptoms of Rectal Cancer?

People may not have symptoms for a long time, especially if the growth is small. Sometimes, people have blood in the stools (bowel movements). The stool may be thinner than usual, because it squeezes past the cancer. People may also feel urges to have bowel movements, but nothing comes out.

How Is Rectal Cancer Diagnosed?

The health care provider makes a preliminary diagnosis from a medical history, physical examination, and laboratory tests. The doctor will do a colonoscopy. The doctor puts a small flexible tube into the anus. The tube has a light at the tip, so the doctor can see inside the rectum and colon. It’s long enough to go into the whole colon. It also has a tool at the tip so the doctor can take a small sample of tissue (biopsy) to be checked with a microscope to see if it has cancer cells.

If cancer is found, the health care provider will do other tests to see if the cancer has spread. This is called staging. These tests include computed tomography (CT) of the abdomen (belly) and pelvis, x-rays, and blood tests.

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How Is Rectal Cancer Treated?

Small polyps and very small rectal cancers may be removed during colonoscopy. Larger cancers will be removed by surgery. The type depends on the size and location of the cancer and how far it has spread. Anticancer medicines (chemotherapy) and radiotherapy may also be used to shrink the cancer. If the cancer is large, the doctor may have to remove the whole rectum and anus. If this happens, the doctor will do a colostomy. In this procedure, a pouch is made from the colon and comes out through the skin. Stool will come out into a small bag.

DOs and DON’Ts in Managing Rectal Cancer:
  • DO understand the importance of colon screening for everyone starting at age 50, and earlier for family members of people with colon cancer.
  • DO make sure that you have a colonoscopy generally 1 year after surgery and regularly after that, or as recommended by your health care provider, to screen for return of cancer.
  • DO call your health care provider if you have trouble moving your bowels, abdominal pain, or blood in the stool.
  • DON’T miss follow-up appointments with your primary health care provider and specialists who treated you for rectal cancer.
  • DON’T be afraid to ask your primary health care provider about support groups. In these groups, you can share your concerns with others who have also been diagnosed and treated for rectal cancer.
  • DON’T forget the importance of good nutrition after surgical treatment.
  • DON’T delay telling your health care provider about new symptoms or concerns.
FOR MORE INFORMATION

Contact the following sources:

  • American Cancer Society
    Tel: (800) 227-2345
    Website: http://www.cancer.org
  • American College of Surgeons
    Tel: (312) 202-5000, (800) 621-4111
    Website: http://www.facs.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor