What are the symptoms of rectal cancer? What causes rectal cancer? How is rectal cancer treated? Get the answers to these questions and more.

Understanding Rectal Cancer

Rectal cancer is a type of cancer that develops in the cells of the rectum, which is the lower part of the digestive system, located between the colon and the anus. Rectal cancer is often grouped together with colon cancer under the term “colorectal cancer,” as they share many similarities.

In the United States, colorectal cancer is the third most common type of cancer and the second deadliest, making early detection and treatment critical. Worldwide, colorectal cancer is the second most common cancer in females and the third most common cancer in males, according to a 2020 report from the Worldwide Cancer Research Fund.

Symptoms of Rectal Cancer

At first, rectal cancer may be asymptomatic, meaning it doesn’t cause any noticeable symptoms. As the cancer progresses, the most common symptom is rectal bleeding. Other potential symptoms include changes in bowel habits, unexplained weakness and fatigue, and other gastrointestinal issues.

According to the Centers for Disease Control and Prevention (CDC), common symptoms of colorectal cancer may include:

• Rectal bleeding
• Changes in bowel movements
• Feeling that the bowel isn’t emptying completely
• Pain during bowel movements
• Diarrhea or constipation
• Blood or mucus in the stool
• Unintentional weight loss and appetite changes
• Unexplained fatigue
• Frequent abdominal discomfort, gas, cramps, or pain

Another possible sign of rectal cancer is iron-deficiency anemia, which may occur as a result of blood loss.

Causes of Rectal Cancer

The exact cause of rectal cancer is unknown, but it is known to develop when cancerous cells grow out of control and multiply, eventually penetrating and destroying healthy tissue. While the precise trigger for this process is not always clear, there are certain factors that can increase the risk of developing rectal cancer.

Genetic Factors

Certain inherited gene mutations can increase the risk of rectal cancer. Two genetic conditions that are associated with an increased risk are hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, and familial adenomatous polyposis (FAP).

Other Risk Factors

Other factors that may increase the risk of rectal cancer include:

• Age (diagnosis usually occurs after age 50, although rates are increasing among younger people)
• Race (Black Americans are at higher risk than other groups)
• Personal or family history of colorectal cancer
• Previous radiation therapy to the abdomen
• Certain medical conditions, such as ovarian cancer, inflammatory bowel disease, and type 2 diabetes
• Lifestyle factors, such as a diet low in vegetables and fiber, a diet high in red and processed meat, lack of exercise, smoking, and heavy alcohol consumption

Diagnosing Rectal Cancer

Rectal cancer is typically diagnosed through a combination of physical exams, screening tests, and colonoscopy.

Physical Exam and Screening Tests

The doctor will likely begin by taking a medical history and performing a physical exam, which may include a digital rectal exam to feel for any lumps or abnormalities. The doctor may then recommend a fecal immunochemical test (FIT) or a sigmoidoscopy to screen for signs of cancer.

Colonoscopy

If the screening tests are positive for cancer, the next step is a colonoscopy. During a colonoscopy, the doctor uses a thin tube with a light and camera to examine the inside of the rectum and colon. They can also collect tissue samples for further examination in a lab.

Treating Rectal Cancer

The treatment for rectal cancer will depend on the stage of the cancer, its location, and the overall health of the patient. The main treatment options include:

Surgery

Surgery is often the primary treatment for rectal cancer. The type of surgery will depend on the size and location of the tumor, as well as whether the cancer has spread to nearby lymph nodes or other organs.

Radiation Therapy

Radiation therapy may be used before or after surgery to shrink the tumor or kill any remaining cancer cells.

Chemotherapy

Chemotherapy may be used in combination with radiation therapy or surgery to help kill cancer cells and prevent the cancer from spreading.

Targeted Therapy

In some cases, targeted therapy drugs that target specific genetic mutations or proteins in the cancer cells may be used in addition to other treatments.

Prognosis and Survival Rates

The prognosis and survival rates for rectal cancer can vary depending on the stage of the cancer at the time of diagnosis. Early-stage rectal cancer has a higher 5-year survival rate compared to late-stage cancer. However, with advancements in treatment and early detection, the overall survival rates for rectal cancer have been improving in recent years.

Conclusion

Rectal cancer is a serious condition that requires prompt diagnosis and treatment. By understanding the symptoms, risk factors, and available treatment options, individuals can take steps to reduce their risk and seek early medical attention if they experience any concerning symptoms. Regular screening and proactive management of risk factors can also help improve outcomes for those affected by this disease.

Causes, Symptoms, Treatment, and More

Rectal cancer is cancer that develops in cells in the rectum, which is below the sigmoid colon and above the anus.

Your rectum and colon are both part of the digestive system, so rectal and colon cancers are often grouped under the term colorectal cancer.

In the United States, colorectal cancer is the third most common type of cancer. It’s also the second deadliest, making early detection and treatment critical. Worldwide, colorectal cancer is the second most common cancer in females and the third most common cancer in males, according to a 2020 data from Worldwide Cancer Research Fund.

The American Cancer Society estimates there will be 44,850 new cases of rectal cancer in the United States in 2022. This compares with 106,180 new cases of colon cancer.

At first, rectal cancer may be asymptomatic.

As the cancer progresses, rectal bleeding is the most common symptom. Changes in your bowel habits may occur, lasting for more than a few days. You may also experience unexplained weakness and fatigue.

According to the Centers for Disease Control and Prevention (CDC), common symptoms of colorectal cancer may include:

• rectal bleeding
• changes in how often you have bowel movements
• feeling that your bowel isn’t emptying completely
• pain when you have a bowel movement
• diarrhea or constipation
• blood or mucus in your stool
• unintentional weight loss and appetite changes
• unexplained fatigue
• frequent abdominal discomfort, gas, cramps, pain

Another possible sign of rectal cancer is iron-deficiency anemia, which may occur as a result of blood loss.

While the exact cause of rectal cancer is unknown, malignant tumors develop when cancerous cells grow out of control and multiply. These cells can penetrate and destroy healthy tissue. What sets off this process isn’t always clear.

There are some inherited gene mutations that can increase your risk for rectal cancer. One of these is hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome. This disorder significantly raises the risk of colon and other cancers. In some cases, your doctor may recommend removing your colon as a preventive measure.

Another genetic condition that may cause rectal cancer is familial adenomatous polyposis (FAP). This is a rare disorder that can cause polyps to grow in the lining of the colon and rectum.

While these polyps start off as noncancerous, they may become malignant. In fact, most people with FAP develop cancer before the age of 50. Large bowel removal may also be a preventive surgery your doctor may recommend.

Like other types of cancers, rectal cancer can spread when cancerous cells grow in healthy tissue and travel to other areas of the body.

At first, rectal cancer may affect the tissues lining the rectum. In some cases, it affects the entire rectum. The cancer may then spread to nearby lymph nodes or organs, with the liver being commonly affected. Other possible areas of metastasis can include the:

• abdomen
• brain
• lungs
• ovaries

While there’s no single known cause of rectal cancer, a number of known factors may increase your risk for developing this cancer at some point. These include the following:

• Age. Diagnosis usually occurs after age 50, although rates are increasing among younger people.
• Race. Black Americans are at higher risk than other groups of developing rectal cancer. One reason for this may be inequities in healthcare access.
• Family history. Personal or family history of colorectal cancer can raise risk.
• Genetics. Lynch syndrome or FAP are two genetic conditions that may increase your risk.
• Radiation therapy. Previous radiation treatment to the abdomen can increase risk.

Other conditions that may increase risk include:

• ovarian cancer
• polyps
• inflammatory bowel disease, especially if you’ve lived with it for 8 years or longer
• obesity
• type 2 diabetes that’s not well managed

Some lifestyle factors that may play a role in colorectal cancer are:

• eating a diet low in vegetables and fiber
• eatinga diet high in red and processed meat
• a lack of exercise
• smoking
• consuming three or more alcoholic drinks per day

Rectal cancer is diagnosed with a combination of the following:

Physical exam and screening tests

The doctor will likely begin by taking your medical history and performing a physical exam. This may include inserting a gloved finger into your rectum to feel for lumps.

The doctor might next recommend a fecal immunochemical test (FIT) or a sigmoidoscopy. The screening schedule for these tests will vary depending on your risk level. If these tests are positive for cancer, a colonoscopy is the next step.

Colonoscopy

In a colonoscopy, a doctor uses a thin tube with a light and camera at the end to view the inside of your rectum and colon. They can usually remove any polyps they find at this time.

During the colonoscopy, the doctor can also collect tissue samples for later examination in a lab. These samples can be viewed under a microscope to determine if they’re cancerous. They can also be tested for genetic mutations associated with colorectal cancer.

Blood tests

The doctor may also order a blood test. A high level of carcinoembryonic antigen (CEA), a substance made by cancerous tumors, in your bloodstream may indicate rectal cancer.

Imaging tests

Once the doctor makes their diagnosis of rectal cancer, their next step is to determine how far it might have spread.

The doctor may use an endorectal ultrasound to examine your rectum and surrounding area. For this test, a doctor inserts a probe into your rectum to produce a sonogram, a type of image.

The doctor may use other imaging tests to look for signs of cancer throughout your body. These include:

• CT or PET scan, which may help the doctor see the extent of cancer in the rectum, colon, and other organs
• MRI, which can help the doctor determine the stage of the cancer

No matter where it starts, cancer can spread, or metastasize, through tissue, the lymphatic system, or the bloodstream to reach other parts of the body.

Staging cancer indicates how far the cancer has progressed, which can help doctors decide the best treatment.

Below are the stages of rectal cancer.

Stage 0 (carcinoma in situ)

Only the innermost layer of the rectum wall contains abnormal cells.

Stage 1

Cancer cells have spread past the innermost layer of the rectum wall but not to lymph nodes.

Stage 2

Cancer cells have spread into or through the outer muscle layer of the rectum wall but not to lymph nodes. This is often referred to as stage 2A. In stage 2B, the cancer has spread into the abdominal lining.

Stage 3

Cancer cells have spread through the outermost muscle layer of the rectum and to one or more lymph nodes. Stage 3 is often broken up into substages 3A, 3B, and 3C based on the amount of lymph node tissue affected.

Stage 4

Cancer cells have spread to distant sites, like the liver or lungs.

In recommending treatment, the doctor and care team will consider:

• tumor size
• where cancer may have spread
• your age
• your general health

This can help them determine the best combination of treatments, as well as the timing of each treatment.

Below are the general guidelines for treatment by stage. This list contains potential treatment options. Not all patients may require the treatment options listed for each stage.

Stage 0

• removal of suspicious tissue during colonoscopy
• removal of tissue during a separate surgery
• removal of tissue and part of the surrounding area

Stage 1

• local excision or resection
• radiation therapy for some patients
• chemotherapy for some patients

Stages 2 and 3

• surgery
• radiation therapy
• chemotherapy

Stage 4

• surgery, possibly in more than one area of the body
• radiation therapy
• chemotherapy
• targeted therapies, such as monoclonal antibodies or angiogenesis inhibitors
• cryosurgery, a procedure that uses a cold liquid or a cryoprobe to destroy abnormal tissue
• radiofrequency ablation, a procedure in which radio waves are used to destroy abnormal cells
• a stent to keep the rectum open if it’s blocked by a tumor
• palliative therapy to improve overall quality of life

You can also ask your doctor about clinical trials that might be a good fit. Many current therapies for cancer began as clinical trials. These trials may try different combinations of current treatment, treatments that have been approved by the U.S. Food and Drug Administration (FDA) for other conditions, or new treatments.

In some cases, therapy as part of a clinical trial may be covered by insurance or covered by a sponsor of the trial.

Clinical trials can help advance scientists’ understanding of cancer and investigate new treatment options. Participating may offer additional options for your treatment. You can learn more about clinical trials for rectal cancer at the National Cancer Institute.

Rectal cancer may spread outside of the rectum, eventually affecting surrounding tissues, lymph nodes, and organs.

You may also be at risk of developing second cancers, which occur after treatment of the initial cancer. Rectal cancer may especially increase the risk of secondary cancers affecting the:

• anus
• colon
• kidneys
• lungs
• small intestine
• vagina

A diagnosis of colorectal cancer in the early stages, before it spreads, can improve your chances of survival.

According to the CDC and the American Cancer Society, the best way to reduce your overall risk for developing colorectal cancer is to begin regular screenings beginning at age 45. Depending on family history, genetics, and other risk factors, your doctor may recommend screenings sooner than this.

Colon and rectal cancer can be diagnosed early when discovered through routine screenings, such as a routine colonoscopy or stool test. Highly sensitive stool tests can detect the presence of cancer. If abnormal cells are discovered, a timely colonoscopy should also be performed.

You may also be able to help prevent rectal cancer by adopting a healthy lifestyle and eliminating related risk factors such as inactivity, smoking, and eating red or processed meats.

Advances in treatment over the last few decades have improved the overall outlook for people with rectal cancer. In fact, many cases of rectal cancer can be treated successfully.

It’s also important to consider the 5-year survival rate, which is determined based on the average number of people who are alive after 5 years or being diagnosed with a certain type of cancer and its stage. The overall 5-year survival rate for rectal cancer is 67 percent for all stages combined.

The 5-year relative survival rate by stage is:

• Localized: 89 percent
• Regional: 72 percent
• Distant: 16 percent

It’s important to note that these figures are based on information between 2010 and 2016. Since then, treatments may have been modified and improved. These numbers may not reflect current survival rates.

For people with rectal cancer, your outlook can depend on other factors that can include:

• where cancer may have spread
• whether your bowel is blocked
• if the entire tumor can be surgically removed
• age and general health
• whether this is a recurrence
• how well you tolerate treatment

When it comes to your individual outlook, the best source of information is your own doctor.

Rectal cancer, commonly referred to as colorectal cancer, is common in both the United States and worldwide. The symptoms of rectal cancer may not appear until the later stages, which makes early, regular screenings an important factor in both detection and treatment.

Treatment and screening options may continue to evolve, but it’s also important to reduce your own risk if you can. Talk with your doctor about any personal concerns you have about rectal cancer risks, and whether you’re experiencing any unusual bowel-related symptoms.

Anal cancer | NHS inform

Anal cancer is a rare type of cancer that affects the very end of the large bowel.

Symptoms of anal cancer

The symptoms of anal cancer are often similar to more common and less serious conditions affecting the anus, such as piles (haemorrhoids) and anal fissures (small tears or sores).

Symptoms of anal cancer can include:

• bleeding from the bottom (rectal bleeding)
• itching and pain around the anus
• small lumps around the anus
• a discharge of mucus from the anus
• loss of bowel control (bowel incontinence)

However, some people with anal cancer don’t have any symptoms.  

Speak to your GP if you develop any of the above symptoms. While they’re unlikely to be caused by anal cancer, it’s best to get them checked out.

Diagnosing anal cancer

Your GP will usually ask about your symptoms and carry out some examinations.

They may feel your tummy and carry out a rectal examination. This involves your doctor inserting a gloved finger into your bottom so they can feel any abnormalities. Your GP will refer you to hospital if they think further tests are necessary. 

The National Institute for Health and Care Excellence (NICE) recommends in its 2015 guidelines that GPs should consider referring someone with an unexplained anal lump or anal ulcer. The person should receive an appointment within 2 weeks.

If you’re referred to hospital, a number of different tests may be carried out to check for anal cancer and rule out other conditions.

Some of the tests you may have include a:

• sigmoidoscopy – where a thin, flexible tube with a small camera and light is inserted into your bottom to check for any abnormalities
• proctoscopy – where the inside of your rectum is examined using a hollow tube-like instrument (proctoscope) with a light on the end
• biopsy – where a small tissue sample is removed from your anus during a sigmoidoscopy or proctoscopy so it can be examined in a laboratory under a microscope 

If these tests suggest you have anal cancer, you may have some scans to check whether the cancer has spread. Once these are complete, your doctors will be able to ‘stage’ the cancer. This means giving it a score to describe how large it is and how far it has spread.

You can read more about the stages of anal cancer on the Cancer Research UK website.

How anal cancer is treated

If you’re diagnosed with anal cancer, you’ll be cared for by a multidisciplinary team. This is a team of different specialists who work together to provide the best treatment and care.

The main treatments used for anal cancer are:

• chemoradiation – a combination of chemotherapy and radiotherapy
• surgery – to remove a tumour or a larger section of bowel

In cases where the cancer has spread and can’t be cured, chemotherapy alone may be considered to help relieve symptoms. This is known as palliative care.

Chemoradiation

Chemoradiation is a treatment that combines chemotherapy (cancer-killing medication) and radiotherapy (where radiation is used to kill cancer cells). It’s currently the most effective treatment for anal cancer. You don’t usually need to stay in hospital when you’re having chemoradiation.

Chemotherapy for anal cancer is usually given in 2 cycles, each lasting 4 to 5 days, with a 4-week gap between the cycles. In many cases, part of the chemotherapy is delivered through a small tube called a peripherally inserted central catheter (PICC) in your arm, which can stay in place until your treatment has finished.

The tube means you don’t need to stay in hospital during each of the cycles of chemotherapy. However, you’ll be attached to a small plastic pump, which you take home with you.

A few hospitals now offer tablet chemotherapy for anal cancer, which avoids the need for the pump and PICC.

Read more about how chemotherapy is carried out

Radiotherapy is usually given in short sessions, once a day from Monday to Friday, with a break at weekends. This is usually carried out for 5 to 6 weeks. To prepare for radiotherapy, additional scans will be required.

Read more about how radiotherapy is carried out

Both chemotherapy and radiotherapy often cause significant side effects, including:

• tiredness
• sore skin around the anus
• sore skin around the penis and scrotum in men or vulva in women
• hair loss – limited hair loss from the head, but total loss from the pubic area
• feeling sick
• diarrhoea

These side effects are usually temporary, but there’s also a risk of longer-term problems, such as infertility. If you’re concerned about the potential side effects of treatment, you should discuss this with your care team before treatment begins. 

Other possible long-term side effects can include:

• bowel control problems
• long-term (chronic) diarrhoea
• erectile dysfunction
• vaginal pain when having sex
• dry and itchy skin around the groin and anus
• bleeding from the anus, rectum, vagina or bladder

Tell your doctor if you develop any of these symptoms so they can be investigated and treated.

Surgery

Surgery is a less common treatment option for anal cancer. It’s usually only considered if the tumour is small and can be easily removed, or if chemoradiation hasn’t worked.

If the tumour is very small and clearly defined, it may be cut out during a procedure called a local excision. This is a relatively simple procedure, carried out under general anaesthetic, that usually only requires a stay in hospital of a few days.

If chemoradiation has been unsuccessful or the cancer has returned after treatment, a more complex operation called an abdominoperineal resection may be recommended. As with a local excision, this operation is carried out under general anaesthetic.

An abdominoperineal resection involves removing your anus, rectum, part of the colon, some surrounding muscle tissue, and sometimes some of the surrounding lymph nodes (small glands that form part of the immune system) to reduce the risk of the cancer returning. You’ll usually need to stay in hospital for up to 10 days after this type of surgery.

During the operation, a permanent colostomy will also be formed to allow you to pass stools. This is where a section of the large intestine is diverted through an opening made in the abdomen called a stoma. The stoma is attached to a special pouch that will collect your stools after the operation.

Before and after the operation, you’ll see a specialist nurse who can offer support and advice to help you adapt to life with a colostomy. Adjusting to life with a colostomy can be challenging, but most people become accustomed to it over time.

Read more about living with a colostomy

Follow-up

After your course of treatment ends, you’ll need to have regular follow-up appointments to monitor your recovery and check for any signs of the cancer returning.

To start with, these appointments will be every few weeks or months, but they’ll gradually become less frequent over time.

What causes anal cancer?

The exact cause of anal cancer is unknown, although a number of factors can increase your risk of developing the condition. These include:

• infection with human papilloma virus (HPV) – a common and usually harmless group of viruses spread through sexual contact, which can affect the moist membranes lining your body
• having anal sex or lots of sexual partners – possibly because this increases your risk of developing HPV
• having a history of cervical, vaginal or vulval cancer
• smoking
• having a weakened immune system – for example, if you have HIV

Your risk of developing anal cancer increases as you get older, with half of all cases diagnosed in people aged 65 or over. The condition is also slightly more common in women than men.

Further information about anal cancer

• Cancer Research UK: anal cancer
• Macmillan: anal cancer

Colorectal cancer: symptoms, diagnosis – laboratory article DNAOM

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Published:
06/19/2019

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Updated:

07/07/2022

• Oncology

What is colorectal cancer?

Colon and rectal cancer is cancer that starts in the colon or rectum. Colon and rectal cancers are often grouped together because they share many common features. Colorectal cancer is a tumor that originates from the epithelial cells of the large intestine.

Colorectal cancer ranks third among malignant neoplasms after lung and skin cancer in Russia.

How does colorectal cancer start?

Polyps in the colon or rectum.

Most cases of colorectal cancer are associated with the formation of polyps, outgrowths of the mucous membrane of the colon or rectum. Some types of polyps can transform into malignant tumors over time, but not all. The process of malignancy depends on the type, size, localization and type of polyp.

There are 3 main types of polyps:

1) Adenomatous polyps or adenomas. In 9% of cases, they turn into cancer, so their formation is identical to precancerous conditions.

2) Villous polyps. The probability of malignancy is 50%.

3) Hyperplastic polyps and inflammatory polyps. These polyps are more common, but in general, are not precancerous.

Factors that increase the risk of colorectal cancer

• Detection of a polyp larger than 1 cm.

• Detection of more than 2 polyps.

• Dysplastic processes in the mucous membrane of the colon at the site of removal of the polyp. Dysplasia implies the presence of cells with atypia. The cells are not cancerous, but are able to transform into them with the development of carcinoma in situ and invasive cancer.

Other risk factors for disease:

• Features of nutrition. The prevalence of animal fats and protein, easily digestible carbohydrates and a low proportion of fiber in the diet are a risk factor for colorectal cancer. It is believed that the above food components change the metabolism and composition of bile acids, as well as the qualitative and quantitative composition of the intestinal microflora, thereby increasing the risk of disease.

• Obesity and overweight.

• Alcohol.

• Age. The likelihood of colorectal cancer increases with age and peaks in the age group of 70 years and older.

• Low physical activity.

• Genetic factors. Some congenital diseases, such as adenomatous polyposis, Gardner’s syndrome, Turcot’s syndrome, hereditary non-polyposis colon cancer, increase the likelihood of developing colorectal cancer in the future.

Colorectal cancer risk groups

Those at high risk for colorectal cancer include those with ulcerative colitis, Crohn’s disease, celiac disease, and other chronic inflammatory bowel diseases. Additionally, at risk are people cured of cancer of the colon, ovary, uterine body and mammary glands and treated for intestinal polyposis. Patients with close relatives suffering from colon and rectal cancer deserve special attention.

Cancer classification

Most often, a cancerous tumor is localized in those departments where intestinal contents are retained – in the sigmoid and caecum.

Depending on the type of tumor, there are exophytic and endophytic (infiltrative) forms of the tumor. Exophytic tumors grow into the lumen of the large intestine in the form of a polyp or nodule. Infiltrative tumors affect the entire thickness of the intestinal wall, covering it along the entire perimeter and narrowing the lumen.

Malignant cells of tumor tissue can penetrate into local blood or lymphatic vessels, spread to regional lymph nodes and further to the rest of the body.

The stage of colorectal cancer depends on how deeply the tumor has affected the organ and spread beyond it.

Familial cases

The risk of developing colorectal cancer is higher in people with a family history of the disease. Cancer in first-degree relatives such as parents and siblings is a big concern, but cancer in distant relatives is also important. The presence of two or more relatives with colorectal cancer in the family is more significant than the presence of only one relative. The age at which the cancer was diagnosed must also be taken into account: if the cancer was discovered at a younger age, for example, before 60 years of age, then screening activities should begin 10–15 years before this age.

Individuals with a family history of the disease are advised to undergo genetic counseling. A geneticist, based on a family history, can calculate individual risks of developing the disease and recommend, if necessary, genetic testing. Based on genetic testing, preventive measures can be suggested to help reduce the risk of colorectal cancer. For example, participating in screening more than once a year, changing diet, etc.

Clinical manifestations and symptoms of the disease

The most common symptoms are pain, impaired motor-evacuation function (discomfort, feeling of heaviness, vomiting, loss of appetite), the presence of pathological discharge with feces. In most cases, the tumor remains unrecognized for a long time, and only if it goes beyond the organ or reaches a large size, a person can complain and consult a doctor.

When the colon is affected, it matters which section is affected. There is a difference in the cancer clinics of the right and left colon.

With right-sided localization of the tumor, the pain syndrome is observed 2-3 times more often than with the left-sided one. Tumor growth is accompanied by paroxysmal pain, predominantly on the right, intestinal disorders, fever, fatigue and weakness. Quite often, patients note gastrointestinal discomfort, indicating functional disorders of neighboring sections of the gastrointestinal tract.

Left-sided lesion of the colon is more often associated with the clinic of intestinal obstruction, therefore, the presence of the disease may indicate the alternation of constipation and liquid fetid stools, bloating. The pain is colicky in nature.

Colon cancer is accompanied by bleeding during bowel movements. A frequent symptom is “intestinal discomfort” – a feeling of incomplete emptying and the presence of a foreign body in the rectum, as well as constipation, which occurs in 40% of cases.

In the presence of metastases, ascites, an increase in the size of the liver and lymph nodes are observed.

Colorectal cancer diagnostics

Diagnosis of colorectal cancer is complex and includes examination, endoscopic, morphological, and ultrasound methods.

The first diagnostic method is an external examination, which is carried out using digital rectal examination (DRE) of the anus and rectum. Up to 70% of tumors can be diagnosed using PRI. If there are indications, examination and palpation of the inguinal lymph nodes, palpation of the abdomen and liver are performed.

Sigmoidoscopy – allows you to examine the rectum and distal sigmoid colon (over 30 cm). During the procedure, it is possible to take a piece of material for a biopsy.

Irrigoscopy — X-ray examination of the colon. With the help of barium enema with double contrasting, the doctor determines the extent of the tumor, determines the form of growth, the presence of fistulas and ulcerations. It is carried out in various projections, reveals formations up to 0.5 cm in diameter.

Colonoscopy – endoscopic examination of the rectum, colon, part of the small intestine (over 2 m). The colonoscopy method is convenient in that it allows you to examine the entire mucosa and take a tissue biopsy for histological examination in suspicious cases.

Ultrasound method – allows you to assess the prevalence of the tumor process.

After the diagnosis of cancer and its confirmation by the histological method, the patient is assigned a computed tomography.

Tumor markers CEA and CA 19-9 are not pathognomonic and are used to monitor recurrence after tumor resection.

Treatment

The main method of treatment is surgical, taking into account the modern principle of oncological radicalism. Depending on the severity of intestinal obstruction, various types of resections are used – from one-stage to palliative.

Radiation therapy is also prescribed as one of the means that increase the effectiveness of surgical intervention.

Colorectal cancer: symptoms, signs, treatment, prognosis

Colorectal cancer is a life-threatening tumor of various parts of the colon or rectum.
Such neoplasms are called malignant, since their cells are able to grow into the surrounding tissues, spread throughout the body and create metastases in its various parts – additional foci of the disease.

How does cancer start?

The disease occurs after the appearance in the body of only one mutated, or altered cell. It is formed due to various health problems, bad habits, lifestyle or random failures, and it multiplies rapidly. Most of them detect and destroy our immunity, but some still manage to survive, create many copies of themselves and form a tumor.
Some properties make them especially dangerous:

• apoptosis does not work for them – the most important natural mechanism of “programmed” death, due to which tissues are constantly renewed. Disabling it leads to serious consequences – such cells do not die at the end of the normal life cycle and exist for a very long time.
• Unlike normal cells, which are born, work and die in a strictly defined place, cancer cells are able to move through the body. They enter the vessels of the circulatory and lymphatic systems. The lymphatic system complements the cardiovascular system. Lymph circulates in it – a liquid that washes all the cells of the body, delivers the necessary substances to them and takes away waste. In the lymph nodes, which act as “filters”, dangerous substances are neutralized and removed from the body. systems, with their help spread to various structures and create metastases in them – additional oncological neoplasms.

Over time, the disease affects an increasing number of tissues, destroys vital organs and disrupts the functioning of all systems.

What is colorectal cancer?

Colorectal tumors are called tumors that develop in the following parts of the digestive system:

• The first section of the large intestine – ascending colon . It starts with caecum , which receives undigested food from the small intestine.
• The second section – transverse colon passing through the body from right to left.
• Third – descending colon descending down the left side.
• The fourth – sigmoid colon , so named because of its S-shaped shape.
• It passes into rectum ending with anus .

How do they work?
Partially digested food in the stomach enters the small intestine, where most of the nutrients are absorbed. It then passes into the large intestine, which absorbs water and salts. The remaining mass enters the rectum – the last 15 cm of the digestive tract, accumulates and is stored there, after which it exits through the anus.

How does colorectal cancer start?

Most cases of the disease begin with polyps – proliferation of tissues of the inner lining of the colon or rectum. Some of their types can eventually degenerate into neoplasms:

• Adenomatous , or adenomas: able to turn into dangerous tumors.
• Hyperplastic
  and inflammatory : quite common, but observation usually requires only those of them whose size exceeds 1 cm.
• Toothed
  and polyps sessile : often require the same treatment approach as adenomas, as they increase the risk of developing cancer.

Such growths are formed on the mucous membrane – the inner layer of the intestine. The cancer cells that appear in them gradually grow into the intestinal wall, go beyond it, enter the blood or lymphatic vessels and spread throughout the body.

Types of colorectal oncology

Most of the diagnoses are adenocarcinomas that start in the cells that produce the mucus needed to lubricate the inner surface of the colon and rectum.
The following types of neoplasms are much less common:

• Carcinoid tumors : arise in cells that produce hormones – substances that are created by our glands, enter the bloodstream, travel with it to organs and tissues and tell them how to act – work or rest, excrete something or absorb.
• Gastrointestinal or gastrointestinal stromal tumors : arise in the interstitial cells of Cajal, which set the rhythm of intestinal contractions. Not all of them are malignant, that is, capable of growing into surrounding tissues and creating metastases – additional cancerous foci in other areas of the body.
• Lymphomas – cancer of the immune system. They mainly begin in the lymph nodes, which trap and neutralize dangerous substances, but can also form in other organs – the spleen, bone marrow. Bone marrow is a soft tissue located in some parts of the skeleton. New blood cells and part of lymphocytes are formed in it – proteins that protect the body from bacteria and viruses. Thymus The thymus, or thymus, is a small organ located in front of the heart. Some types of lymphocytes, proteins that protect the body from bacteria and viruses, mature and develop in it. Tonsils Tonsils, or tonsils, are organs located in the back of the throat in which antibodies are produced – proteins that stop the reproduction of inhaled and swallowed microorganisms. and digestive tract.
• Sarcomas : may develop in blood vessels, muscle layers, and other areas of the wall of the colon and rectum.

Why does colorectal cancer occur?

The disease develops when abnormalities appear in DNA – a repository of hereditary information that contains genes that control the functioning of cells:

• Oncogenes
  help them grow, survive and make copies of themselves.
• Tumor suppressors control their division and trigger apoptosis, a mechanism by which cells that have completed their tasks die after a certain time.

If a change occurs in DNA that “turns on” oncogenes or “turns off” tumor suppressors, cancer can occur in the human body – uncontrolled growth and division of cells.
Their exact causes are still not always clear, but scientists know factors that can increase the likelihood of developing dangerous tumors. These include:

• Type 2 diabetes – the inability of the body to transfer glucose from the blood to tissue cells to obtain the energy they need.
• Being overweight : increases the risk not only of oncology, but also of death from it.
• Lack of physical activity disrupts the functioning of the body and all its systems.
• Diet low in fiber and high in saturated fat, calories and red meat – beef, pork, mutton or liver, as well as preparations thereof. Cooking it at very high temperatures, such as frying, leads to the formation of carcinogens, chemicals that increase the likelihood of dangerous tumors.
• Smoking . Compounds in tobacco smoke affect the cells of the whole body, change them and increase the chance of developing cancer of the stomach, esophagus, kidney, cervix, liver, bladder, pancreas, intestines and other organs.
• Age : this type of cancer also affects young people, but most often occurs after 50 years.
• Alcohol consumption even in moderate amounts is also considered a risk factor.
• Adenomatous polyps , or adenomas, especially if there are many of them or if any of them has dysplasia, a change that causes cells to differ from normal and can eventually become cancerous.
• Inflammatory bowel disease, including ulcerative colitis or Crohn’s disease, causing inflammation of the intestinal mucosa.

Approximately 5% of diagnoses are made in people who have inherited gene mutations:

• Lynch syndrome – increases the risk of colorectal and other forms of cancer before age 50.
• Familial adenomatous polyposis , leading to the formation of many polyps on the intestinal mucosa.
• Peutz-Jeghers syndrome , causing the appearance of hamartomas – tumors of the digestive tract.
• MutYH-associated polyposis , whose owners develop a large number of polyps in the colon.

Some scientific papers have shown that previously unknown factors also influence the likelihood of colorectal cancer:

• Regular night shift . Perhaps this relationship is caused by changes in the level of melatonin, a hormone whose production depends on the level of illumination.
• Presence of other types of cancer and previous treatment , including radiation therapy of the abdominal cavity, testicles or prostate.

Symptoms and signs of colorectal cancer

In the early stages, the disease often does not cause any health problems – as a rule, they appear later, after the growth of the tumor to a large size or damage to other tissues. Symptoms of colorectal cancer may include:

• Change in stool: diarrhea, constipation, or thin stools lasting more than a few days.
• Sensation of incomplete emptying of the bowels even after going to the toilet.
• Cramping or pain in the abdomen.
• Noticeable weight loss without any effort.
• This type of tumor often bleeds, causing dark brown or black stools and bright red blood from the anus. In addition, over time, this leads to anemia – a decrease in the number of oxygen-carrying red blood cells.
• Weakness and fatigue.
• Bloating.
• Feeling of satiety even when eating small amounts of food or on an empty stomach.
• When cancer spreads to the liver, the outflow of the fluid necessary for digestion – bile, is disrupted, which leads to yellowing of the skin and whites of the eyes.
• The appearance of metastases – additional oncological neoplasms in the lungs leads to breathing problems.

Many of these symptoms can be caused by other disorders, such as an infection or hemorrhoids, which are dilated veins in the lower rectum. If any of them appear, it is necessary to seek medical help as soon as possible, since the earlier the disease is detected, the easier it is to treat.

Colorectal cancer diagnostics

The examination includes many procedures:

• Poll – about the state of health, health problems, symptoms, the date of their onset and risk factors that can provoke the development of the disease.
• Examination , including palpation – probing the abdomen to detect neoplasms and enlarged organs, as well as digital rectal examination.
• Stool tests to detect blood in it.
• Blood tests : needed to evaluate the number of oxygen-carrying red blood cells and the quality of the liver and kidneys. In addition, with their help, doctors detect proteins secreted by a colorectal tumor – tumor markers, the most common of which is CEA.
• Colonoscopy : examination of the colon and rectum with a colonoscope, a thin, flexible tube with a video camera and a light source. During the procedure, you can not only study the state of the digestive system, but also remove polyps and perform a biopsy – take a small amount of tissue for further research.
• Rectoscopy : insertion through the anus of a rectoscope, a thin, rigid tube used to measure and pinpoint rectal growths.
• Biopsy – taking tissues from a suspicious area and sending them to a laboratory for a thorough study of cell properties. To date, this method is the only way to accurately and accurately make an oncological diagnosis.
• Lab Specimen Tests: Ordered to detect changes in cancer cells, look for hereditary diseases, and select appropriate targeted therapies.
  Imaging tests: used to look at suspicious areas that may be tumors, assess the spread of altered cells, determine the effectiveness of treatment and look for signs of a return of the disease:
• Computed tomography, CT . The tomograph takes a lot of x-rays, combined by a computer into one, very detailed picture. The method allows you to detect damage to the lymph nodes, liver, lungs and other organs.
• Ultrasound – imaging of internal tissues using sound waves. It is carried out to search for neoplasms in the rectum, liver, gallbladder, pancreas and other areas of the abdominal cavity. Endorectal ultrasound is performed using a special probe inserted into the anus. During this procedure, doctors evaluate the spread of the tumor to nearby structures, as well as plan surgeries and other treatments.
• Magnetic Resonance Imaging, MRI Uses radio waves and powerful magnets to create extremely clear images of soft tissue. MRI can be used to study the condition of the liver, brain, and spinal cord.
• Positron emission tomography, PET
  – a scan that allows you to detect even the smallest clusters of altered cells in any area of ​​the body.

Specialists of the Lapino-2 Cancer Center conduct a complete diagnosis of colorectal cancer.
We perform all the necessary research, take tests, get their results from our own laboratory and quickly identify any diseases.
Our clinic has the most modern equipment and highly qualified specialists – candidates and doctors of medical sciences with extensive experience in the detection and fight against dangerous tumors.

Colorectal cancer stages

Immediately after the disease is detected, doctors determine its stage – they find out whether the cancer has spread throughout the body and what tissues have been damaged. This information is necessary for specialists to assess the patient’s prognosis and choose the most optimal treatment regimen for him.

Staging is carried out according to the international TNM system, based on 3 key elements:

• T , tumor size – damage to various layers of the intestinal wall and other tissues.
• N – damage by altered cells of the lymph nodes.
• M – the presence of metastases, or additional oncological tumors in various parts of the body.

Stages:
0 , Tis, or precancer – carcinoma in situ. At this stage, there are altered cells only in the inner layer – the mucous membrane of the colon or rectum.
I: Abnormal cells have grown through the inner layer but have not spread beyond the intestinal wall.
II : Cancer affects the entire intestinal wall, but other tissues are healthy.
III : Cancer found in nearby lymph nodes.
IV : There are metastases in the body – new tumors in other parts of the body, such as the liver or lungs.

Liver metastases: diagnosis and treatment.

Treatment of colorectal cancer

The fight against cancer involves many different approaches.
Surgery is often the main method of treatment in the first stages. . In such cases, the doctor removes the tumor, a small amount of tissue surrounding it, and nearby lymph nodes to prevent recurrence of the tumor. Then the specialist stitches the healthy edges of the intestine, and if necessary, creates a colostomy – an opening in the abdominal wall through which feces, gases and mucus are excreted from the body.
In the early stages during the operation, all cancerous foci can be completely removed from the body. In the later stages, such an intervention is no longer able to stop the spread of the disease, but it can be used to deal with complications such as intestinal blockage.

Chemotherapy – the destruction of altered cells with special drugs that enter the bloodstream and affect all tissues of the body. They are used, among other things, to shrink tumors before surgery and relieve symptoms in the last stages.

Targeted therapy – drugs that affect only certain proteins found in certain tumor cells. Such treatment slows or prevents their growth, and does little to no damage to healthy tissue.

Immunotherapy are drugs that help a person’s own immune system recognize and destroy cancer cells.

Radiation therapy – the destruction of altered cells and the prevention of their reproduction by exposure to radiation. It is prescribed both independently and in combination with chemotherapy, including to reduce the size of the neoplasm before or after surgery, to affect the remaining foci of the disease in the body.

Ablation
– destruction of small metastases in the liver or lungs with microwaves, ethanol or low temperatures without removing them.

If oncology has spread to important organs outside the colon and rectum, doctors offer palliative treatment , the task of which is not to completely get rid of the changed cells, but to improve the quality of life. In such cases, they perform surgery to remove the blockage of the intestine, radiation or chemotherapy to shrink the tumor, relieve pain and fight the side effects of drugs.

Lapino-2 Cancer Center provides any treatment for colorectal cancer at all stages.
Our doctors are world-class specialists with vast experience in federal medical institutions. We use only the most modern equipment and original preparations that give a predictable result.
Our patients do not have to waste time – we do not have queues, and a full examination and therapy can be completed without leaving the territory of the Center.

“Oncological hospital Lapino-2.”

Colorectal cancer prognosis and survival

The prospects for each person are individual and depend on a large number of factors – the prevalence of altered cells in the body, age, the presence of other health problems and the response of the tumor to treatment.
Oncologists present approximate forecasts based on the data of a special indicator – “five-year survival rate”, which says nothing about the chances of each individual patient. It is a statistical sample compiled according to previous years – the number of patients with a certain stage who are still alive after 5 or more years from the moment of diagnosis.