Rectal Cancer is a malignancy that originates in the cells of the rectum, which is the final segment of the large intestine, connecting the colon to the anus. It typically develops slowly over time, starting as small growths called polyps on the inner lining of the rectum. While not all polyps become cancerous, some may progress into cancer if left untreated.

CAUSES AND RISK FACTORS:

Several factors may contribute to the development of Rectal Cancer. These include:

Age: The risk of Rectal Cancer increases with age, with the majority of cases diagnosed in individuals over 50 years old.

Family history: A family history of colorectal cancer or certain hereditary conditions, such as familial adenomatous polyposis (FAP) or Lynch syndrome, can elevate the risk.

Dietary Factors: Consuming a diet high in red and processed meats, and low in fiber, fruits, and vegetables may increase the risk of Rectal Cancer.

Lifestyle Choices: Factors like smoking, excessive alcohol consumption, and a sedentary lifestyle have been linked to an increased risk of Colorectal Cancer.

Inflammatory Bowel Disease (IBD): Chronic conditions like ulcerative colitis or Crohn’s disease affecting the colon and rectum may raise the risk of developing Rectal Cancer over time.

SYMPTOMS

The symptoms of Rectal Cancer can vary depending on the stage and location of the tumor. Common signs and symptoms include:

• Persistent changes in bowel habits, such as diarrhea or constipation
• Rectal bleeding / the presence of blood in the stool.
• Abdominal discomfort or pain, including cramps or bloating
• Unexplained weight loss
• Fatigue or weakness
• A feeling of incomplete bowel emptying
• Rectal pain or discomfort
• Iron Deficiency Anemia resulting from blood loss.

HOW TO TREAT IT?

SURGERY

Surgery is often the primary treatment for Rectal Cancer, particularly in early-stage disease. The goal of surgery is to remove the Tumour and any surrounding tissue affected by cancer while preserving bowel function and quality of life. Several surgical procedures may be employed, depending on the stage and location of the cancer:

1. Local Excision: This minimally invasive procedure is suitable for small, early-stage Tumours confined to the inner layers of the rectal wall. It involves the removal of the Tumour and a small margin of surrounding tissue through the rectum.
2. Low Anterior Resection (LAR): LAR is performed for Tumours located in the upper part of the rectum. It involves removing the affected portion of the rectum and reconnecting the remaining healthy bowel to the anus.
3. Abdominoperineal Resection (APR): APR is reserved for Tumours located in the lower part of the rectum or close to the anus. It involves the removal of the entire rectum, anus, and surrounding tissue, with the creation of a permanent colostomy.
4. Total Mesorectal Excision (TME): TME is a meticulous surgical technique used to remove the rectum and surrounding lymph nodes while preserving the integrity of the Mesorectal tissue. The goal is to lower the chances of cancer returning and enhance long-term results.

CHEMOTHERAPY:

Chemotherapy utilizes potent medications to eliminate or slow the growth of cancer cells. It may be recommended before or after surgery, depending on the stage and aggressiveness of the cancer. Neoadjuvant chemotherapy is administered before surgery to shrink the Tumour and make it more manageable for surgical removal. Adjuvant chemotherapy is given after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence.

RADIATION THERAPY:

Radiation therapy uses high-energy beams to target and destroy cancer cells. It may be used alone or in combination with chemotherapy (Chemo radiation) to shrink Tumours before surgery, reduce the risk of local recurrence, or treat metastatic disease. Radiation therapy can also be employed as palliative treatment to alleviate symptoms and improve quality of life in advanced cases.

TARGETED THERAPY:

Targeted therapy drugs are designed to interfere with specific molecules involved in cancer growth and progression. In Rectal Cancer treatment, targeted therapy may involve medications that target the vascular endothelial growth factor (VEGF) or epidermal growth factor receptor (EGFR), among others. These drugs can be used in combination with other treatments to improve outcomes, particularly in advanced or metastatic disease.

IMMUNOTHERAPY:

Immunotherapy utilizes the immune system’s capabilities to identify and eradicate cancer cells. While still relatively new in the realm of Rectal Cancer treatment, immunotherapy shows promise in certain cases, particularly for cancers that express specific biomarkers such as microsatellite instability-high (MSI-H) or deficient mismatch repair (DMMR). Immunotherapy drugs may be used alone or in combination with other treatments to enhance the body’s immune response against cancer cells.

CONCLUSION

Rectal Cancer is a significant health concern worldwide, but advancements in early detection and treatment have improved survival rates and quality of life for many patients. Awareness of risk factors, regular screening, and prompt medical evaluation of symptoms are essential for the timely diagnosis and management of Rectal Cancer. At our Oncology department, with a multidisciplinary approach involving surgery, chemotherapy, and radiation therapy, along with ongoing research into immunotherapies, there is hope for continued progress in the fight against Rectal Cancer.

To learn more about our services and treatments, Schedule an appointment today or call 0491 251 5717.