Have you ever noticed a little blood in your stool when you go to the toilet? Or do you often experience sudden changes in your bowel movements, abdominal pain, or constipation? Don't dismiss these as normal. Because these can be early signs of a serious condition like rectal cancer. It may seem a little awkward to talk about, but it's important to be aware of your health. So, let's talk about this in detail, in a very simple way.
Simply put, what is rectal cancer?
Colon cancer is the uncontrolled growth of abnormal cells in the wall of the colon, including the rectum. This is usually a very slow-growing type of cancer.
Most of the time, it starts as small growths (polyps) that form on the inside wall of the rectum. We call these growths adenomas . It can take 10 to 15 years for a small growth like this to become cancerous. Yes, that's true. That means it doesn't happen overnight.
The best part is that tests like colonoscopy can detect and remove these polyps before they become cancerous. Therefore, getting these tests done on time can greatly reduce the risk of developing colorectal cancer. Even if cancer has developed, if it is detected early, it can be completely cured with surgery to remove the polyp.
Among the cancers that develop in our digestive system, rectal cancer is the most common, after colon cancer and pancreatic cancer.
Be aware of these symptoms.
In most cases, this cancer can remain in the body for years without showing any symptoms in the early stages. However, some people may experience some warning signs. It is important for you to be aware of these.
Remember, not everyone with these symptoms has cancer. But if these symptoms persist, be sure to see your doctor for advice.
| Symptom | A simple explanation |
|---|---|
| Rectal bleeding | Bright red or dark blood in the stool. |
| Diarrhea | Persistent flatulence. |
| Constipation | Difficulty defecating, not having a bowel movement for days. |
| Change in bowel movement pattern | Sudden changes in things like frequency and time of going to the bathroom. |
| Change in the shape of stools | The stool is as thin as a pencil and comes out like a string. |
| Sudden fatigue and weakness | Extreme fatigue for no reason. |
| Stomach pain | Stomach aches and discomforts such as bloating. |
| Weight loss for no reason | Sudden weight loss without dieting or exercise. |
What are the risk factors for developing rectal cancer?
The exact cause of this cancer has not yet been discovered. However, doctors have identified some factors that increase the risk of developing this disease. Let's take a look at what they are.
| Risk factor | Description |
|---|---|
| Age | As with other cancers, the risk increases with age. On average, most patients are diagnosed around the age of 63. |
| Some medical conditions | People with inflammatory bowel conditions, such as Crohn's disease and ulcerative colitis, are at higher risk. |
| Processed meat dishes | People who regularly eat red meat and processed meats such as sausages and bacon are at higher risk. |
| Family history | If someone in your immediate family (mother, father, siblings) has had this cancer, your risk of developing it is about twice as high. |
| Gender | Men are slightly more likely to develop this cancer than women. |
| Hereditary diseases | Some genetic conditions increase the risk of this cancer. Examples include Lynch syndrome and Familial adenomatous polyposis (FAP) . |
| Obesity | People who are obese are at higher risk than those who are of normal weight. |
| Smoking | Recent research has shown that smokers have a higher risk of dying from this cancer than non-smokers. |
How is this cancer diagnosed?
Diagnosis usually begins with a general examination by a doctor, and then various tests are ordered as needed.
Basic tests
First, your doctor will ask you about your symptoms and perform a physical exam, which may include a digital rectal examination (DRE) .
Then, the most important test to confirm the diagnosis is a colonoscopy . In this test, a thin tube with a camera is inserted through the anus and the inside of the rectum and colon is examined completely. If a suspicious lump (polyp) is seen at this time, a small piece of tissue is taken for examination. We call this a biopsy .
Tests to be performed if cancer is confirmed
If the biopsy confirms that there are cancer cells, the doctor will refer you to an oncologist, who will perform several more tests to determine the exact stage of the cancer.
Blood Tests
- Complete Blood Count (CBC): This helps to check for conditions such as anemia, which may be caused by blood loss due to cancer.
- Comprehensive Metabolic Panel (CMP): This can give you an idea of the functioning of organs like your kidneys and liver.
- Liver Enzyme Test: This is important to see if the cancer has spread to the liver.
- Tumor Marker Tests: These check the levels of certain substances (tumor markers) released into the blood by cancer cells. In rectal cancer, the marker CEA (Carcinoembryonic Antigens) is the main one checked.
Other tests
- Proctoscopy: An examination that looks only inside the rectum.
- CT scan (Computed Tomography scan): This helps to see if the cancer has spread to other organs in the abdomen.
- MRI scan (Magnetic Resonance Imaging): An MRI scan is very important to see very clearly how far the cancer has spread to the tissues around the anus.
- Pelvic Ultrasound: This is also used to see the spread of cancer in the pelvic cavity.
How are the stages of cancer determined?
Based on the information obtained from each of these tests, doctors determine the stage of the cancer. This is very important for planning treatment. There are mainly 5 stages.
- Stage 0: Cancer cells are only in the superficial layer of the inner wall of the rectum.
- Stage 1: The cancer has grown past the surface layer of the wall and has grown slightly into the wall.
- Stage 2: The tumor has grown through the rectal wall and may have spread to surrounding tissue.
- Stage 3: The cancer has spread to the lymph nodes near the rectum.
- Stage 4: The cancer has spread (metastasized) to distant organs such as the liver and lungs.
What are the treatment options?
There are several treatment options for rectal cancer. Your medical team will determine the best treatment for you based on many factors, including the stage and size of your cancer, and your overall health.
Surgery
The most common treatment is to remove the cancerous tumor. There are several types of surgery.
| Name of the surgery | What are you doing? |
|---|---|
| Transanal Endoscopic Microsurgery (TEMS) | In this, a special instrument inserted through the anus is used to remove very small, low-risk cancerous tumors. |
| Low Anterior Resection (LAR) | If the cancer is quite large, the part of the rectum where the cancer is located is removed, either completely or partially. |
| Abdominoperineal Resection (APR) | This surgery is done if the cancer is very close to the anus and the tumor cannot be removed without damaging the muscles that control bowel movements. In this surgery, the anus, rectum, and part of the colon are removed. An opening is made in the abdomen for stool to pass through. This is called a colostomy . |
Treatments in addition to surgery
Sometimes other treatments are used before surgery to shrink the tumor or to destroy any remaining cancer cells after surgery.
- Chemotherapy: A drug treatment that destroys cancer cells.
- Radiation Therapy: Destroying cancer cells using high-energy rays.
- Immunotherapy: Stimulating the body's own immune system to fight cancer cells.
- Targeted Therapy: Drugs that target specific molecules that affect the growth of cancer cells.
Palliative care may be available to help manage side effects and symptoms during treatment. Talk to your doctor about this.
What can we do to protect ourselves from this cancer?
Although there is no way to 100% prevent this cancer, there are many things we can do to reduce the risk.
- Maintain a healthy weight that suits you. If you are unsure, consult a doctor.
- Exercise regularly.
- Avoid processed meats. Instead, eat a balanced diet rich in lean meats, whole grains, and green vegetables and fruits.
- Avoid drinking alcohol.
- If you smoke, stop.
The most important thing is to get screened for cancer at the right time. Because through this, polyps can be identified and removed before they become cancerous. Also, even if cancer has developed, it can be detected at a very early stage. Then the chances of treatment and cure are much higher.
Colonoscopy is the main test. In addition, there are several other tests:
- Fecal Occult Blood Test (FOBT): A test that checks for blood in the stool that is not visible to the eye.
- Fecal DNA test: Checks for genetic changes and blood components in stool that are linked to cancer.
- Sigmoidoscopy: Examination of the lower part of the colon and rectum.
- Virtual Colonoscopy: A CT scan checks for tumors in the colon and rectum.
Generally, everyone over the age of 45 should have these tests. Talk to your doctor about the test that is right for you and when to have it, based on your family history and other risk factors.
When do you need to see a doctor urgently?
If you are being treated for this cancer, notify your doctor immediately or go to the hospital's Emergency Treatment Unit (ETU) if you experience the following symptoms:
- Fever of 38 degrees Celsius (100.4 Fahrenheit) or higher.
- Severe headache.
- Feeling cold and shivering.
- Blood in the urine.
- Chest pain.
- Difficulty breathing.
- Confusion.
Questions to ask your doctor
If you are diagnosed with this disease, it is normal for you to have many questions in your mind. So, without fear or hesitation, ask your doctor about these things and find out.
- What stage of cancer do I have?
- How far has the cancer spread?
- What treatment options do I have?
- If I have surgery, will I need a colostomy?
Rectal cancer can be a difficult topic to talk about. And the tests can be a little intimidating. But remember, your life is worth more than your embarrassment or discomfort. Don't ignore symptoms. The earlier you catch it, the better your chances of getting treated and cured. If you have any questions or concerns, talk to your doctor today.
Take-Home Message
- If you notice a change in your bowel habits (diarrhea, constipation) or blood in your stool, do not ignore it. Seek medical advice immediately.
- This cancer is almost completely curable if detected early, so talk to your doctor about screening tests like colonoscopy after age 45.
- A healthy lifestyle (balanced diet, exercise, avoiding smoking and alcohol) can reduce the risk.
- There are many successful treatments for this, such as surgery, chemotherapy, and radiation therapy.
- Don't be afraid to talk openly with your doctor about your health, especially things like this that you may find uncomfortable.
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