Rectal cancer is cancer in the rectum, the last part of the large intestine. The rectum allows waste to pass out of the body.
Cancer occurs when cells in the body divide without control or order. These uncontrolled cells form a growth or tumor. These growths are malignant. This means they invade nearby tissue and can spread to other parts of the body. It is not clear what causes these problems in the cells. Both your genes and factors like smoking or diet may play a role.
Being over 50 years of age increases your chance of rectal cancer. Other factors that may increase your chance of rectal cancer include:
Rectal cancer may not cause symptoms in most people. Some may have:
You will be asked about your symptoms and medical history. A physical exam will be done. Your rectum will be checked for lumps or abnormal areas.
If the doctor finds a problem during the exam, further tests may be needed. These may include:
A sample of abnormal tissue may be removed for a biopsy. The tissue will be closely looked at in a lab. The doctor will decide if it is cancer after these tests are complete.
Further tests may be done to find the stage of the cancer. Staging is based on factors like how far the cancer has spread. It will help to determine the treatment plan. Testing may include:
Talk with your doctor about the best treatment plan for you. Treatment may include one or more of the following options:
Surgery is the main treatment for rectal cancer. There are several options for surgery depending on the location of the cancer and how much it has spread:
Some surgeries may require temporary or permanent colostomies. A colostomy is a surgical opening through the wall of the abdomen into the colon. This is used as a path for waste material to leave the body. After a colostomy, you will wear a special bag to collect body waste. If the bladder is removed, you will also need a urostomy. A urostomy is an opening in the abdominal wall that allows for the passage of urine.
Radiation is used to kill cancer cells and shrink tumors. It is directed at the site of the tumor from a source outside the body. This therapy is aimed at the immediate area of the cancer. It is used alone or with chemotherapy.
This therapy uses drugs to kill cancer cells. It may be given in many forms, including pill, injection, and via a catheter. Drugs enter the bloodstream and travel through the body killing cancer cells. They can also kill healthy cells. This therapy is systemic, meaning it affects your entire body.
Targeted therapy uses medications to target and kill cancer cells, while sparing healthy tissue. They are currently used to treat advanced cancers. Targeted therapy is less harmful to healthy tissue, which reduces side effects. It may be used alone or in combination with chemotherapy.
Some medications can be used as part of a treatment plan. Other medications may help to either prevent or reduce side effects of treatments, or to manage certain side effects if they occur. These include:
The causes of most cancers are not known. However, it is possible to prevent many colon and rectal cancers by finding and removing polyps that could become cancerous. Beginning at age 50, both men and women at average risk should follow one of the following screening options:
People with any of the following risk factors should begin colon and rectal cancer screening earlier and/or undergo screening more often:
Be sure to discuss colon cancer screening with your doctor to see how and when you should be screened.
Lifestyle changes that may reduce your risk of rectal cancer:
American Cancer Society
National Cancer Institute
Canadian Cancer Society
Colorectal Cancer Association of Canada
Colorectal cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Updated April 28, 2015. Accessed September 6, 2016.
Colorectal cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113642/Colorectal-cancer. Updated August 18, 2016. Accessed September 6, 2016.
Colorectal cancer screening tests. American Cancer Society website. Available at: http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-screening-tests-used. Updated June 24, 2016. Accessed September 6, 2016.
General information about rectal cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq. Updated June 30, 2016. Accessed September 6, 2016.
Rex DK, Johnson DA, Anderson JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2009. Am J Gastroenterol. 2009;104(3):739-750.
11/19/2010 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113642/Colorectal-cancer: Kirkegaard H, Johnsen NF, Christensen J, Frederiksen K, Overvad K, Tjønneland A. Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. BMJ. 2010;341:c5504.
4/8/2014 DynaMed's Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T113642/Colorectal-cancer: Yee J, Kim DH, Rosen MP, et al. Colorectal cancer screening. American College of Radiology (ACR) Appropriateness Criteria. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ColorectalCancerScreening.pdf. Updated 2013. Accessed September 6, 2016.
Last reviewed May 2016 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.