Rectum Cancer: What is it, Causes, Symptoms and Treatment
Rectal cancer is a type of cancer that arises from the cells in the last part of the colon (large intestine) called the rectum. Both the rectum and colon are important parts of the digestive system, and cancers occurring here are often referred to by the common name “colorectal cancer”. Worldwide, colorectal cancer is the second most common type of cancer in women and the third most common type of cancer in men.
Colorectal cancers, including rectal cancer, are diseases that usually occur after the age of 50. Familial transmission can be detected in approximately 10% of these cases. Care should be taken because rectal cancers, which are transmitted through various genetic syndromes, have a risk of occurring before the age of 50.
What is Rectum Cancer Disease?
Cancer in the rectal area is called rectal cancer. The rectum, which begins in the last part of the large intestine, continues for a short distance and ends at the beginning of the anus, which is the part where the digestive tract opens to the outside of the body.
Although colon and rectum cancer have many aspects in common, they have several differences in terms of their treatments. This occurs because the rectum is located in a very narrow space and is relatively isolated from other structures. The narrowness of this area may also cause surgical interventions to become more complex.
What are the symptoms of rectum cancer?
Some symptoms that a person may experience with rectal cancer may be similar to some other diseases:
- Fatigue and weakness
- decreased appetite
- unintentional weight loss
- Frequent occurrence of digestive system complaints such as gas, cramps or pain
It is recommended to be careful as some symptoms other than these complaints may indicate rectal cancer:
- Change in the frequency of going to the toilet
- Maroon or light red blood in the stool
- thinning of stool
- Feeling like you are not fully relieved after going to the toilet
- iron deficiency anemia
No matter where it is in the body, a cancer disease can progress to surrounding tissues or spread, called metastasis. For this purpose, it usually uses circulatory facilities such as the lymph system or blood vessels. These progression and spread situations are generally taken into consideration in the staging of cancers.
Stages of Rectum Cancer
The first stage of rectal cancer is called “Stage 0” (carcinoma in situ). At this stage, cancer cells are located only in the inner layer of the rectum wall.
Stage 1 rectal cancer is the stage of rectal cancer that indicates that these cancer cells have started to progress from the inner part of the rectum wall to the outside.
When rectal cancer reaches Stage 2, cancer cells that have advanced into the wall of this structure or into the outer muscle layer can be detected. In the initial stage, the progression has not yet reached the lymph system or is not in the intra-abdominal region and is defined as stage 2A. After it is determined that the intra-abdominal structures are also affected, the stage of the disease is called stage 2B.
In stage 3 rectal cancer, cancer cells have advanced to the outermost part of the wall of this structure and affected several surrounding lymph nodes. As in Stage 2, this stage is also divided into subgroups. These stages, defined as Stage 3A, 3B and 3C, are distinguished from each other according to how many different lymph tissues are affected by the disease.
Stage 4 rectal cancer is the last stage of this disease and indicates that the disease has now spread to various other distant organs such as the liver or lungs.
What Causes Rectum Cancer?
Rectal cancer may result from mutations (changes) in the DNA of healthy cells in this area. As a result of these changes, cell growth and division become out of control, and while cells normally give way to younger cells at some point in their lives, cancerous cells continue to replicate themselves. The tissue formed by cells reaching a certain number is referred to as a tumor. If, over time, this tumoral structure exhibits malignant behavior such as invading surrounding healthy tissues or spreading to other parts of the body, this is defined as cancer.
In most cases of rectal cancer, the cause of the underlying mutations cannot be determined. Genetically transmitted mutations in some families may lead to an increased risk of rectal cancer. Hereditary nonpolyposis colorectal cancer (Lynch syndrome) is one of the genetic disorders that may develop rectal cancer. In this disease, there is generally an increased risk for both colon and rectum cancer, especially in individuals before the age of 50.
Another syndrome, familial adenomatous polyposis, is a rare disorder characterized by the development of finger-like tissue called polyps on the inner wall of the colon and rectum. If appropriate treatment is not given to this disorder, there may be an increased risk of developing colorectal and other types of cancer, especially for individuals before the age of 40.
In addition to such genetic diseases, other risk factors that may play a role in the development of rectal cancer can be summarized as follows:
- advanced age
- Presence of other members of the family affected by this disease
- Having radiation therapy applied to the lower abdominal area for various reasons
- Ovarian cancer
- Detection of many polyps in the intestine
- Inflammatory bowel diseases
- Obesity
- Type 2 Diabetes
How is Rectum Cancer Diagnosed?
The first stage of the diagnostic approach for people who apply to health institutions with rectal cancer is a detailed medical history and physical examination. While taking a medical history provides a preliminary idea that a person may have familial rectal cancer, a digital rectal examination during the physical examination examines whether there is any structural abnormality in the rectal area of the person. Computed tomography and magnetic resonance imaging methods are very important in diagnosing the disease and detecting its spread.
Many other laboratory tests and radiological examinations can also be used in the diagnosis of rectal cancer:
- colonoscopy
A thin, long and flexible tube called a colonoscope is used during this examination, which allows physicians to monitor the internal structure of the colon and rectum through the camera and light source on it. During this imaging process, removal of structures such as polyps can also be performed. Tissue samples taken during colonoscopy can be sent to the laboratory for further examination.
- Biopsy
If physicians detect any suspicious area during imaging of the inside of the colon, the tissue sample removed from this area is evaluated by pathology physicians who are experts in tissue examination. The sample taken is examined under a microscope with various histological techniques and it is determined whether it is a cancer cell or not.
- Blood Tests
Tests such as complete blood count, iron parameters and liver function test are among the applications that may be useful for the diagnosis of rectal cancer. Although these tests are not specific to this disease, they are important because they can give an idea about the course of the disease.
It may be useful to examine some substances whose levels change in the bloodstream, as they may indicate tumor development. In rectal cancer, an increase in the blood level of a substance called carcinoembryogenic antigen (CEA) may occur. This parameter is not specific for rectal cancer and allows the course of the disease and the person’s response to treatment to be examined.
How is Rectum Cancer Treated?
Rectum cancer treatment is a form of treatment that uses different approaches together. In suitable patients, surgeons remove cancer tissue and aim to clear all remaining cancer cells through methods such as chemotherapy or radiation therapy. Which of the surgical approaches is preferred may vary depending on the person and the condition of the disease.
In some cases, cancer cells contain certain abnormalities, which allows targeted therapy applications to be used in this disease. These drugs are generally used together with chemotherapy drugs and are preferred in patients in advanced stages.
Another treatment approach called immunotherapy aims to support the person’s immune system in its fight against this disease. Some cancer cells can hide themselves from the cells of the defense system through the various proteins they synthesize. With immunotherapy, cells responsible for protecting immunity can detect cancer cells more easily and ensure their elimination.
Rectum cancer, for which early diagnosis and treatment is very important, is among the common types of cancer. If you detect symptoms of this disease in your body, it is recommended that you contact health institutions and get help from specialist physicians.
