In the world of health and wellness, knowledge is power. When it comes to a complex and potentially life-altering condition like rectal cancer, understanding the ins and outs is crucial. This blog aims to empower you with a comprehensive grasp of rectal cancer, breaking down its symptoms, treatment options, causes, and stages in a unique and easily digestible manner.

Rectal cancer can often hide in plain sight, with its early symptoms being subtle and easily mistaken for other less concerning issues. Common signs to be aware of include changes in bowel habits, like diarrhea, constipation, or narrower stools. Blood in the stool or rectal bleeding, consistent abdominal discomfort, unexplained weight loss, and fatigue are other red flags. Recognizing these symptoms early can be a game-changer in the battle against rectal cancer.

Understanding the causes of rectal cancer is an essential piece of the puzzle. While no single cause can be pinpointed, certain risk factors increase your likelihood of developing this condition. Age plays a role, as rectal cancer is more common in older individuals. Lifestyle factors like smoking, a diet high in processed foods, and sedentary habits can contribute to the risk. Additionally, a family history of colorectal cancer or inherited genetic mutations can increase your susceptibility.

Rectal cancer, like many cancers, progresses through stages that describe its extent and severity. These stages range from 0 to IV, with 0 being the earliest and IV the most advanced. Stage 0 signifies that cancer is limited to the inner lining of the rectum, while Stage IV indicates that it has spread to distant organs. The stage of rectal cancer plays a pivotal role in determining treatment options and prognosis.

Now, we will try to learn each of these aspects to equip you with the knowledge you need to make informed decisions about rectal cancer. 

Rectal Cancer Meaning

Rectal Cancer Symptoms

Rectal cancer is a type of cancer that originates in the rectum, which is the last part of the large intestine or colon. It is a malignant tumor that develops in the cells lining the inner wall of the rectum. Like other forms of colorectal cancer, rectal cancer usually starts as a small polyp that can eventually become cancerous if not detected and treated early.

Diagnosis tests typically involve a combination of medical history, physical examination, imaging tests (such as a colonoscopy or sigmoidoscopy), and biopsy to confirm the presence of cancer.

Treatment options often involve surgery to eliminate the cancerous tissue, radiation therapy, & chemotherapy. The specific treatment plan depends on the stage of the cancer, its location, and the patient’s overall health. Early detection & timely treatment can significantly improve the prognosis and outcomes for individuals with rectal cancer.

Rectal Cancer Symptoms

Rectal cancer is a kind of colorectal cancer that originates in the rectum, which is the last several inches of the large intestine. The symptoms of rectal cancer can differ from person to person, and some individuals may not experience any symptoms in the early stages of the disease. Common symptoms may include:

1. Changes in bowel habits: This can include constipation, diarrhea, or a feeling that the abdomen does not empty entirely.

2. Blood in the stool: Rectal bleeding, or the presence of blood in the stool, is a common and often alarming symptom of rectal cancer. It may appear as bright red blood in the toilet bowl or as dark, tarry stools.

3. Abdominal discomfort or pain: Pain or discomfort in the lower abdomen, particularly in the rectal area, may be a sign of rectal cancer.

4. Unexplained weight loss: Significant and unexplained weight loss, without changes in diet or exercise, can be a symptom of various kinds of cancer, including rectal cancer.

5. Fatigue: General fatigue or weakness can be a non-specific symptom of many conditions, including cancer. It may occur as a result of anemia, which can be caused by rectal bleeding.

6. Anemia: A low red blood cell count can result from chronic rectal bleeding and may lead to fatigue, weakness, and paleness.

7. Changes in stool consistency: Stools may become narrow or ribbon-like in appearance, which is sometimes referred to as pencil-thin stools.

8. Rectal pain or discomfort: This can include pain during bowel movements or a constant feeling of discomfort in the rectal area.

9. Bowel urgency: A persistent and urgent need to have a bowel movement can be a symptom.

It’s important to note that other, less severe conditions can also cause these symptoms, but they should not be ignored. If you experience any persistent or unexplained symptoms related to your bowel habits, you must contact a healthcare professional for a thorough evaluation & diagnosis. 

Rectal Cancer Treatment

The treatment depends on several factors, such as the stage of the cancer, the location & size of the tumor, the patient’s overall health and preferences, and the potential side effects of the treatment. The main types of rectal cancer treatment are surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. These medical treatments can be used alone or in combination, depending on the situation.

Surgery is the most standard treatment for rectal cancer. It involves removing the tumor and some surrounding healthy tissue, as well as nearby lymph nodes. The type of surgery depends on how far the cancer has grown into the wall of the rectum and how close it is to the anus. Some types of surgery are:

– Local excision: This is a procedure that removes small tumors that are only in the inner layer of the rectum. It can be done through the anus or a small cut in the abdomen.

– Transanal resection: This is a procedure that removes larger tumors that are in the inner or middle layer of the rectum. It is done through the anus using special instruments.

– Low anterior resection: This is a procedure that removes tumors that are in the upper part of the rectum. It is done through a cut in the abdomen. The surgeon reconnects the remaining portion of the rectum to the colon, creating a new pathway for stool.

– Abdominoperineal resection: This is a procedure that removes tumors that are in the lower part of the rectum or close to the anus. It is done through cuts in both the abdomen and the perineum (the area between the anus and genitals). The surgeon removes the entire rectum and anus and creates an opening in the abdomen (called a colostomy) for stool to come out into a bag.

Radiation therapy utilizes high-energy beams to kill or shrink cancer tumors. It can be given before surgery to make the tumor smaller and more accessible to remove or, after surgery, kill any remaining cancer cells and lower the risk of recurrence. Radiation therapy can also be given along with chemotherapy (called chemoradiation) to make it more effective. It can be given in two forms:

– External beam radiation therapy: This is a type of radiation therapy that comes from a machine outside the body. The device aims radiation at a specific body area where the cancer is located. The treatment is usually given five days a week for several weeks.

– Internal radiation therapy (brachytherapy): This is a type of radiation therapy that involves placing radioactive sources inside or near the tumor. The sources give off radiation for a short time and then are removed. This type of radiation therapy can deliver a higher level of radiation to a smaller area, reducing damage to nearby healthy tissues.

Chemotherapy is a treatment that utilizes drugs to kill or stop cancer cells from growing. It can be given before surgery to reduce tumors or after surgery to destroy any cancer tumors left & lower the risk of recurrence. Chemotherapy can also be given along with radiation therapy (called chemoradiation) to make it more effective. Chemotherapy can be given in different ways:

– Systemic chemotherapy: This is a type of chemotherapy that involves taking drugs by mouth or through a vein. The drugs travel through the bloodstream & reach all parts of the body.

– Regional chemotherapy: This is a type of chemotherapy that involves injecting drugs directly into an artery that leads to the tumor. This way, more drugs reach the tumor and less reach other parts of the body.

Targeted therapy uses drugs to attack specific molecules in cancer cells or their environment. These molecules are involved in the growth, spread, or survival of cancer cells. By blocking these molecules, targeted therapy can stop or slow down cancer growth or make it more sensitive to other treatments. Targeted therapy can be given by mouth or through a vein. Some examples of targeted drugs are:

– Bevacizumab (Avastin): This drug targets a protein known as vascular endothelial growth factor (VEGF), which helps tumors form new blood vessels & get oxygen and nutrients.

– Cetuximab (Erbitux) and panitumumab (Vectibix): These are drugs that target a protein referred to as epidermal growth factor receptor (EGFR), which helps tumors grow and spread.

– Regorafenib (Stivarga): This is a drug that targets several proteins that result in tumor growth, blood vessel formation, and inflammation.

Immunotherapy uses the body’s immune system to fight cancer. It can be given by mouth or through a vein. Some examples of immunotherapy drugs for rectal cancer are:

– Pembrolizumab (Keytruda) and nivolumab (Opdivo): These are drugs that target a protein called programmed death-1 (PD-1), which is found on some immune cells. PD-1 usually acts as a brake on the immune system, preventing it from attacking normal cells. Some cancer cells have a protein called programmed death-ligand 1 (PD-L1), which binds to PD-1 and turns off the immune response. By blocking PD-1, these drugs unleash the immune system to attack cancer cells.

– Atezolizumab (Tecentriq): This drug targets PD-L1, preventing it from binding to PD-1 and reducing the immune response.

The choice of rectal cancer treatment depends on many factors, like the stage of the cancer, the location & size of the tumor, the patient’s overall health and preferences, and the potential side effects of the treatment. The treatment plan may change over time based on the response to the treatment and the development of new symptoms or side effects. The patient should discuss with their doctor about the best treatment options for their situation.

Rectal Cancer Causes

Rectal cancer, like other forms of cancer, can develop due to a mixture of genetic, environmental, and lifestyle factors. While the real cause of rectal cancer is not always clear, there are several known risk factors and potential contributors to its development:

1. Age: The risk of developing rectal cancer increases with age, and it is more common in individuals over the age of 50.

2. Family history and genetics: A family history of colorectal cancer or certain genetic mutations, such as those associated with Lynch syndrome or familial adenomatous polyposis (FAP), can increase the chances of getting rectal cancer.

3. Personal history of colorectal polyps or cancer: If you’ve had colorectal polyps or cancer in the past, your risk of developing rectal cancer may be higher.

4. Inflammatory bowel disease (IBD): Chronic conditions such as ulcerative colitis and Crohn’s disease that cause inflammation in the colon and rectum can increase the risk of rectal cancer.

5. Diet: A diet high in red and processed meats, as well as low in fiber, fruits, & vegetables, may contribute to an increased risk of rectal cancer.

6. Physical inactivity: Lack of regular physical activity may be associated with a higher risk of colorectal cancer, including rectal cancer.

7. Obesity: Being overweight or obese is a risk factor for rectal cancer.

8. Smoking: Smoking tobacco is a known risk factor for colorectal cancer, including rectal cancer.

9. Alcohol consumption: Excessive alcohol consumption has been linked to a higher risk of getting rectal cancer.

10. Radiation therapy: Prior radiation therapy to the abdomen or pelvis for other medical conditions may increase the risk of developing rectal cancer.

11. Diabetes: Some studies suggest a link between type 2 diabetes & an increased risk of colorectal cancer, though the relationship is not fully understood.

12. Racial and ethnic factors: Rectal cancer rates vary among different racial and ethnic groups, with higher rates often seen in African Americans and individuals of Ashkenazi Jewish descent.

It’s vital to note that having one or more of these risk factors does not assure the development of rectal cancer, and many people with one or more risk factors never get the disease. If you have concerns about your risk for rectal cancer, it’s advisable to discuss them with a medical provider who can provide guidance & recommend appropriate screening and prevention strategies.

Rectal Cancer Staging

Staging is a process that determines how advanced the cancer is and how far it has spread. Staging helps doctors plan the best treatment options and estimate the prognosis (chance of recovery) for each patient. Staging also helps compare the results of different treatments and clinical trials.

There are different systems for staging rectal cancer, but the most commonly used is the TNM system. TNM stands for tumor, node, and metastasis. The TNM system assigns a number or letter to each of these factors based on how much they are affected by the cancer.

– Tumor (T): This describes the size and extent of the primary tumor in the rectum. The cancer is classified from T0 (no evidence of tumor) to T4 (tumor invades nearby organs or structures).

– Node (N): This describes whether the cancer has moved to nearby lymph nodes, which are small bean-shaped organs that help fight infections. The node status is classified from N0 (no tumor or cancer in lymph nodes) to N3 (cancer in many or large lymph nodes).

– Metastasis (M): This describes whether the cancer has advanced to distant organs or tissues, such as the liver, lungs, or bones. The metastasis status is classified as M0 (no distant spread) or M1 (distant spread).

The TNM categories are combined to determine the overall stage of the cancer, from stage 0 (in situ or non-invasive) to stage IV (metastatic). The stage also takes into account other factors, such as the location of the tumor in the rectum, the degree of differentiation (how much the cancer cells look similar to normal body cells), & the presence of certain biomarkers (substances that indicate how aggressive the cancer is).

The stage of rectal cancer affects the treatment options and outcomes for each patient. For example, early-stage rectal cancer may be treated with surgery alone or with radiation therapy and chemotherapy before or after surgery. Advanced-stage rectal cancer may require more intensive treatments, such as targeted therapy, immunotherapy, or palliative care, to relieve symptoms & enrich the quality of life.

It is vital for patients to discuss their staging results and treatment options with their doctors and get a second opinion if needed.

Is Rectal Cancer Curable?

Rectal cancer is curable, primarily when it is found and treated at an early stage. The treatment choice for rectal cancer depends on the stage of the disease, which is determined by how far the cancer has grown into the rectal wall and whether it has spread to nearby lymph nodes or other organs. The main treatments for rectal cancer are surgery, chemotherapy, and radiation therapy.

The prognosis for people with rectal cancer depends on many factors, such as the stage of the disease, the response to treatment, & the overall health of the patient. However, with advances in diagnosis and treatment, more people are surviving rectal cancer than ever before. According to the American Cancer Society (ACS), the 5-year relative survival rate for people with stage I rectal cancer is about 90%, for stage II is about 75%, for stage III is about 60%, and for stage IV is about 15%.

Some recent advances in rectal cancer treatment have shown promising results. For example, a new drug called dostarlimab, an immunotherapy drug that restricts a protein called PD-1 on immune cells, has been shown to cure rectal cancer in 100% of patients in a small clinical trial. These patients had stage 2 or 3 rectal cancer with a specific mutation that made them more sensitive to immunotherapy. They received dostarlimab every three weeks for six months, and their tumors disappeared completely.

Another example is a new technique called transanal total mesorectal excision (TaTME), which is a minimally invasive surgery that removes the entire rectum and surrounding tissue through the anus without making any incisions in the abdomen. This technique has been shown to reduce complications, improve recovery time, and preserve sexual and urinary function better than conventional surgery.

However, more medical studies are needed to confirm their safety & effectiveness in larger groups of patients and compare them with existing treatments.

Rectal Cancer Treatment Cost In India

The cost of rectal cancer treatment in India varies depending on the type and duration of treatment, the hospital and doctor’s fees, the patient’s insurance coverage, and other factors. The average cost of rectal cancer treatment in India ranges from INR 3 lakhs to INR 15 lakhs. However, this is only a rough estimate, and the actual price may differ from case to case.

Conclusion

Rectal cancer is a severe medical condition that affects the rectum, the last part of the colon. Its symptoms can vary but commonly include differences in bowel habits, blood in the stool, & abdominal discomfort. It’s crucial to be vigilant and consult a healthcare professional if you notice these signs.

Understanding the causes of rectal cancer is essential for prevention. While genetics can play a role, lifestyle factors like diet, smoking, and sedentary habits are significant contributors. Maintaining a healthy lifestyle can limit your risk.

The stages of rectal cancer help doctors determine the extent of the disease. Early stages offer a better prognosis, while advanced stages may require more aggressive treatment. Surgery, chemotherapy, & radiation therapy are common treatment choices, often used in combination to increase the chances of a successful outcome.

In conclusion, rectal cancer is a complex condition, but early detection, understanding its causes, and exploring treatment options can make a significant difference. Regular screenings, a healthy lifestyle, and proactive medical care are essential in the fight against rectal cancer.

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