Rectal and colon cancer are among the most common types of cancer in the world. Despite its seriousness, it does not receive the necessary attention like other types of cancer. The symptoms of rectal cancer are similar to some medical conditions, so in this article we will shed light on rectal cancer, treatment methods, and how to prevent it.

What is rectal cancer

Colorectal cancer is a type of Cancer Which affects the large intestine (colon) or rectum, and represents about 10 percent of all cancer cases.

The term rectal cancer refers to all types of cancer and malignant tumors that infect, begin and affect the rectum area, which is the tube that connects the colon to the anus.

In general, cancer occurs when some cells begin to divide abnormally and out of control. Colorectal cancer usually develops from non-cancerous growths called polyps that form in the inner lining of the colon or rectum.

It takes years for benign polyps to turn into cancer.

Early symptoms of rectal cancer 

In the early stages, no clear symptoms may appear, or the symptoms may be mild and many people misinterpret them as normal digestive problems or irritable bowel syndrome. The most prominent of these symptoms are:

1- Mild anal bleeding or blood in the stool

It is one of the most common symptoms, and is often caused by erosion of the rectal wall due to the presence of a tumor, and it usually appears in the form of:

• Bright red blood in the toilet, sometimes mixed with the stool. 
• It may appear in a dark color, in some cases, and is only noticed in a stool analysis.
• Some may think that the blood is caused by hemorrhoids or anal fissures, but continued bleeding must be examined carefully, especially with age.

2- Persistent changes in bowel movement

Due to the effect of the tumor in the rectum on the passage of waste, including:

• Chronic constipation that does not respond to treatment.
• Frequent diarrhea, or intermittent bouts of diarrhea and constipation.

3- Change in the consistency and color of stool

The stool becomes very thin, like a ribbon, or flattened due to the narrowing of the anal canal. A change in the pattern of defecation that persists for a long time is a warning of an organic disorder in the rectum.

4- The presence of mucus in the stool

Mucus comes out as a result of inflammation of the lining of the rectum due to the tumor.

• A clear or whitish secretion surrounding the stool.
• It appears without the presence of worms or infectious disease.

5- Mild pain in the rectum or lower abdomen

It results from chronic irritation or changes in the rectal wall.

• Dull, intermittent pain, or a constant feeling of fullness.
• It increases during defecation.

6- A constant feeling of the need to defecate (Tenesmus)

It is the feeling of wanting to defecate even after you have actually finished.

7- Gradual weight loss

It occurs as a result of the tumor affecting appetite or food absorption.

• Loss of desire to eat.
• Feeling full quickly.
• Losing weight without diet or effort.

8- Fatigue or general weakness

It often results from chronic anemia due to persistent bleeding from the tumor.

• Fatigue quickly from the slightest effort.
• Dizziness or persistent headache.
• Pale skin or shortness of breath.

9- Itching or irritation in the anal area

In some cases, the tumor causes skin irritation or secretes mucous substances that irritate the skin.

• A burning sensation and constant itching.
• Discomfort when sitting or after defecation.

10- Feeling a lump or swelling in or around the rectum

Some patients may feel the presence of a foreign body or mass, which is discovered while cleaning the area or during a self-examination.

Learn about: What are the symptoms of colon cancer in its various stages and how to treat it

Symptoms of advanced rectal cancer 

Some of the symptoms that appear in the early stage of rectal cancer persist and increase in severity in the advanced stage, but they are accompanied by new symptoms as a result of the tumor spreading and growing in a way that affects neighboring organs and tissues.

1- Severe or persistent pain in the pelvis or lower back

Caused by tumor growth and pressure on surrounding nerves or tissues.

2- Partial or complete obstruction of the intestine

It may lead to severe constipation, pronounced abdominal distension, persistent nausea and vomiting, and occurs when the anal canal becomes significantly narrowed due to the tumor.

3- Fecal incontinence or loss of control over defecation

It occurs when the tumor affects the rectal sphincter or surrounding nerves.

4- Symptoms resulting from its spread to other organs

Due to the occurrence of metastases, where cancer cells move from the primary tumor to other organs or places in the body, and the formation of new tumors. The organs to which rectal cancer can spread are:

• Liver: Symptoms such as yellowing of the skin and eyes (jaundice), pain in the upper right side of the abdomen, and ascites (accumulation of fluid in the abdomen) appear.
• Lungs: Chronic unexplained cough, shortness of breath, and chest pain.
• Bones: The spread of cancer appears in symptoms such as severe and concentrated pain in the bones, especially the pelvis and spine.

5- Swelling in the legs or feet

In advanced stages, it may result in pressure on blood vessels or spread to the lymph nodes, causing swelling in the legs or feet.

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Causes of rectal cancer

Scientists have not identified the main causes of rectal cancer, but there are some factors that may increase the chances of the problem occurring, including:

• Genetic mutations: Some mutations and changes may occur in the DNA of rectal cells, which affects the growth of these cells more than usual, and the formation of cancerous cells and masses. 
• Genetic syndromes: Some mutations may occur for genetic reasons, the most famous of which is Lynch syndrome, also known as colorectal cancer (HNPCC).
• Age: The likelihood of developing rectal cancer increases with age, especially in people over 50 years of age.
• Genetic history: When a family member has this health problem,  it is more likely to occur.
• Some chronic diseases: Such as diabetes and chronic inflammatory bowel disease.
• Obesity and weight gain.
• Smoking.

You can also learn about: Learn how to prevent cancer

Complications and risk factors for rectal cancer

Although there is no clear cause for rectal cancer, there are some risk factors that increase the chances of developing it, as follows:

• Aging: Most cases occur in individuals over 50 years of age.
• Family history of the disease: Having a family history of rectal cancer or some genetic mutations increases the likelihood of developing the disease.
• Unhealthy lifestyles: Maintaining a diet rich in processed meat and containing a small amount of fruits and vegetables, in addition to neglecting exercise and movement, obesity, smoking and excessive alcohol consumption, increases the risk of contracting the disease.

Neglecting treatment leads to the emergence of some complications, including:

• Acute peripheral circulatory failure: the result of accompanying excessive bleeding, which appears in the form of symptoms, such as: fatigue, dizziness, nausea, cold sweats, severe blood loss, and weak pulse.
• Colon obstruction.
• Acute renal failure.
• The spread of cancer to other parts of the body.

Stages of rectal cancer 

Its stages are divided into several main stages, and each stage expresses the extent of the development and spread of the tumor within the rectum or to other organs.

Stage 0 (pre-cancer)

Also called the “in situ tumor stage,” this stage is characterized by:

• Abnormal growth in cells lining the rectum only.
• It did not penetrate the rectal wall.
• The chances of cure are very high upon resection.

First stage

The tumor penetrates the inner lining, and has reached the muscular layer of the rectal wall, but has not reached the lymph nodes or other organs.

The second stage

The tumor has penetrated the wall of the rectum, but has not reached the lymph nodes. The tumor extends to nearby tissues such as the peritoneum or nearby organs, without spreading to the lymph nodes. 

The third stage

The tumor has spread to one or more nearby lymph nodes, but has not spread to distant organs. 

Fourth stage

This stage is known as “metastatic cancer.” Cancer cells spread to distant organs such as the liver, lungs, bones, and rarely to the brain.

Preventing rectal cancer

Colorectal cancer is one of the types that can be easily prevented through regular screening and early detection.

In general, the surest way to reduce the risk of rectal cancer is to undergo a routine and regular rectal examination, especially from the age of 40.

 Rectal cancer prevention tips

It includes the following:

• Follow-up and periodic medical examinations.
• Follow a healthy, balanced diet rich in dietary fiber.
• Drink plenty of water.
• ممارسة التمارين الرياضية بانتظام.
• Make sure to reduce your intake of fatty foods and processed meats.
• Weight loss, especially in cases of overweight or obesity.
• Quit smoking.
• Reduce drinking alcohol.
• Reducing levels of psychological pressure, stress and tension

How is rectal cancer diagnosed?

Because the symptoms of rectal cancer are similar to many medical conditions, especially those affecting the digestive system, detection and diagnosis of rectal cancer depend on special examinations, which include the following:

1. Colonoscopy

The doctor can see the rectal area closely by using a colonoscope, which is a thin, flexible tube connected to a small camera that records live video of the area and displays it on an external screen.

The doctor gently and slowly inserts the colonoscope through the anus until it reaches the rectal area.

2. Sigmoidoscopy3.

It is similar to a colonoscopy, but it does not reach the upper parts and is limited to the lower part of the colon only.

3. Stool occult blood test

This test can detect the presence of blood in the stool, even if it is in small quantities that cannot be seen with the eye.

4. Blood test to detect indicators of cancerous tumor

Including the carcinoembryonic antigen analysis, known as the blood tumor markers test.

The test measures the amount of carcinoembryonic antigen in the body, and is particularly used in colon cancer and rectal cancer.

5. Imaging examinations of the abdominal area

These include ultrasound, positron emission tomography, or CT scan.

Methods of treating rectal cancer

Treatment of rectal cancers depends on determining the stage of the disease, the size of the tumor, and the extent of its spread, in addition to the patient’s general health condition.

First: surgical intervention

Surgery is the first option for treating rectal cancers, especially in its early stages. The most important types of surgery are:

1. Local lumpectomy: Used in very early stages (stage 0 or 1), only the tumor is removed without complete resection of the rectum.
2. Partial or total proctectomy: This procedure is used in the intermediate and advanced stages. The patient may need a temporary or permanent fecal diversion (colostomy).
3. Laparoscopic or robotic surgery: modern methods with higher accuracy and faster recovery.

Second: Radiotherapy

It is used to shrink the tumor before surgery or to reduce the chance of it coming back after surgery.

Third: Chemotherapy

Medicines that target and eliminate cancer cells or prevent their growth.

It is used in cases of:

• After surgery to eliminate remaining cancer cells (adjuvant therapy).
• Before surgery, to shrink the tumor.
• In advanced or metastatic stages, to control the spread.

Fourth: Immunotherapy and targeted therapy

It is only used in cases of metastatic cancer, especially if there are certain gene mutations.

Fifth: Symptomatic and supportive treatment

It is used to improve the quality of life and reduce side effects, especially in advanced stages.

• Pain control.
• Treating constipation, anemia, and nausea.
• Psychological and nutritional support.

Can rectal cancer be completely cured?

Yes;

But complete recovery from rectal and colon cancer depends on many factors, such as:

• The stage or grade of cancer;
• The age and health condition of the injured person.
• The nature and details of cancer.
• The type of treatment chosen.

The cure rate for rectal and colon cancer also varies depending on the factors we mentioned, for example:

• Colorectal cancer localized in a specific part;
• The second stage of rectal and colon cancer has a cure rate of 85%.
• The third stage, in which the cancer reaches the lymph nodes, has a cure rate of 65%.
• While the cure rate decreases if the cancer spreads to other organs, reaching 10-20%.

What is the difference between proctitis and rectal cancer?

In general, the symptoms of both hemorrhoids, proctitis, and rectal tumors are similar, but the symptoms of proctitis may be characterized by the release of mucous secretions from the rectum or pus, and hemorrhoids are characterized by the patient feeling itching or burning at the opening of the rectum.

Hemorrhoids are known as inflammation and swelling of the anal veins, and are likened to varicose veins. Hemorrhoids arise in two main forms, either inside the rectum or under the skin surrounding the anus.

As for proctitis, it is an inflammation of the mucous membrane of the rectum. The inflammation may be chronic and recurrent, and it may also accompany ulcerative inflammation of the large intestine, which is characterized by persistent inflammation of the mucous membrane starting from the anus.

Rectal tumors are tumors or cancers that appear in the internal tissues of the rectum in the last part of the colon.

With examination and diagnosis, the doctor can discover the cause of proctitis, while there is no specific cause of rectal cancer.

Does rectal cancer cause pain when sitting?

In some cases, the patient feels pain while sitting, but usually the patient does not feel pain from the cancer itself except in cases where the cancer has spread to the tissue outside the rectum.

How do I know that the rectum is healthy?

One of the common questions is for fear of contracting rectal cancer without realizing it. How do I know that the rectum is healthy?

If you feel any pain, the presence of secretions, or notice a change in defecation habits, you should visit a doctor to perform a rectal examination.

The examination is performed by the patient lying on his left side with his knees bent. The doctor performs a careful manual examination of the anal area.

There is also a test to measure the efficiency of the anal and rectal muscles, in which the doctor inserts a small catheter tube through the anus to pass through the sphincter muscles that surround the anus.

Then the balloon fixed at the tip of the catheter is gradually inflated, and the nerves and muscles of the rectum and anus begin to press and tighten the balloon.

The other end of the catheter is outside the anus and is connected to a device that records the contraction and relaxation of the rectum and anal sphincter muscles.

In conclusion, a patient can be cured Rectal cancerThe cure rate is high in the stages in which the patient notices the symptoms of rectal cancer early and is treated quickly and completely.

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The hospital also adheres to hygiene and sterilization standards, which provides a safe and healthy environment for patients and also ensures the quality of services provided. You can book a consultation immediately by calling the numbers listed on the website.

FAQs

Is rectal tumor removal surgery dangerous? 

The process of removing a tumor in the rectum is not dangerous in most cases, but it is considered a delicate and sensitive operation due to the proximity of the rectum to the nerves and vital organs in the pelvis. However, using modern techniques (such as laparoscopic or robotic surgery), and the presence of a prior treatment plan that includes preoperative preparation, the operation is safe and has a high success rate.

Does rectal cancer come back after its removal?

It is possible for tumor relapse or recurrence after tumor removal only in certain cases, such as if the tumor is at an advanced stage, if the tumor is not completely removed and there are tiny cancer cells remaining, if the patient does not undergo follow-up and periodic examinations after treatment, and if there are hereditary factors or genetic mutations that increase the risk of its recurrence.

Is rectal cancer painful?

Yes, it can be painful, but the level of pain varies depending on the stage of the disease and the location and size of the tumor.

Medical references 

Rectal cancer – mayoclinic

Rectal Cancer – clevelandclinic