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Rectal cancer

Rectal cancer

Dr. Faozat Aragbaye
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Rectal cancer is the growth of abnormal cancerous cells in lower part of the colon , that connects the anus to the large bowel.

Causes

Rectal cancer usually develops over several years, first growing as a precancerous called polyp. Mistakes in DNA can cause cells to grow out of control.

 There are some inherited gene mutations that can increase risk. One of these is hereditary nonpolyposis colorectal cancer, known as Lynch syndrome. This disorder raises the risk of colon and other cancers, especially before age 50.

Another such syndrome is familial adenomatous polyposis. This rare disorder can cause polyps in the lining of the colon and rectum. Without treatment, it can raise the risk of colon or rectal cancer especially before age 40.

Risk factors

The following are the risk factors for developing rectal cancer:

  • Increasing age
  • Smoking
  • Family history of colon or rectal cancer
  • Personal or family history of polyps or colorectal cancer
  • Inflammatory bowel disease
  • Race: African-Americans are at higher risk than people of European descent.
  • Previous radiation treatment to the abdomen
  • Alcohol
  • Lack of exercise

Symptoms

Rectal cancer can cause many symptoms and signs and it may also be present without symptoms. Symptoms and signs include:

  • Bleeding. The most common symptom; present in about 80% of individuals with rectal cancer
  • Bloody stool or mucus stool
  • Weakness and fatigue
  • Diarrhea or constipation
  • Frequent abdominal discomfort, gas, cramps ,pain
  • Pencil-thin or narrow stool
  • Sensation of not completely evacuated the bowel after bowel movement
  • Weight loss
  • Appetite changes
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Diagnosis

Diagnosis includes:

  • Physical examination
  • Colonoscopy
  • Complete blood count
  • Carcinoembryonic antigen
  • Chemistry panel
  • CT scan
  • MRI

Treatment

Rectal cancer often requires more than one treatment modality. In general the treatment modalities used in rectal cancer are the same ones used to treat many other types of cancer. They are:

  • Surgery. Removing the tumour
  • Chemotherapy
  • Radiation therapy

Prevention

Appropriate colorectal screening lading to detection and removal of precancerous growths is the only way to prevent the disease. Screening tests for rectal cancer include faecal occult blood and endoscopy.

If a family history of colorectal cancer is present in a first degree relative ( a parent or a sibling)then endoscopy of the colon and rectum should begin 10years before the age of the relative’s diagnosis or at age 50years whichever comes first.

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